title: Understanding the Leaky Pipeline: Perceived Barriers to Pursuing a Career in Medicine or Dentistry Among Underrepresented-in-Medicine Undergraduate Students.
abstract: Representation of persons from diverse backgrounds remains a persistent challenge for medicine and dentistry workforces. Past research has focused on quantifying factors such as markers of educational achievement to explain the difficulty of increasing diversity within the professions. There has been less effort toward understanding the perspectives of undergraduate students on the threshold of applying to medical/dental school about distinct barriers to pursuing a medical or dental career and continuing through the training pipeline.
  
  
  
  In 2012 and 2013, the authors conducted a qualitative study of undergraduate students participating in the Tour for Diversity in Medicine, a program where minority physicians and dentists visit colleges with large fractions of minority students to encourage careers in the health professions. Focus groups were convened during the visits to examine perceived barriers to pursuing careers in medicine and dentistry and challenges identified through thematic content analysis.
  
  
  
  Eighty-two students participated in discussions at 11 colleges visited between September 2012 and February 2013. Students described challenges including inadequate institutional resources (e.g., sparse clinical opportunities), strained personal resources (e.g., conflict arising from familial pressure), inadequate guidance and mentoring to assist with key career decisions, and societal barriers. For participants, these challenges caused them to question the viability of persisting in the pipeline to a medical or dental career.
  
  
  
  Solving the issue of diversity in medicine and dentistry is multifaceted, but elucidated challenges from the undergraduate student perspective offer targeted areas where intervention may help remedy barriers and decrease pipeline leakiness.
authors.affiliation: B.K. Freeman is assistant professor, Department of Pediatrics, University of Colorado Anschutz School of Medicine, Aurora, Colorado. She was in the Robert Wood Johnson Clinical Scholars Program at the University of Pennsylvania when this work was completed. A. Landry is codirector, Tour for Diversity in Medicine, Chicago, Illinois, and faculty assistant director, Office of Diversity Inclusion and Community Partnership, Harvard Medical School, Boston, Massachusetts. R. Trevino is a mentor for the Tour for Diversity in Medicine, Chicago, Illinois, and a medical student, Rush Medical College, Chicago, Illinois. D. Grande is assistant professor, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. J.A. Shea is professor of medicine and associate dean for medical education research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Brandi Kaye
authors.initials: BK
authors.lastname: Freeman
authors.forename: Alden
authors.initials: A
authors.lastname: Landry
authors.forename: Robert
authors.initials: R
authors.lastname: Trevino
authors.forename: David
authors.initials: D
authors.lastname: Grande
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
mesh_terms: D002321:Career Choice; D018864:Cultural Diversity; D004497:Education, Dental; D004501:Education, Medical; D005006:Ethnicity / Q000193:education; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000193:education*; D010465:Perception; D036301:Qualitative Research; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000193:education; D055815:Young Adult