Black Students’ Perception of Belonging: A Focus Group Approach with Black Students at the Uniformed Services University of the Health Sciences
Keywords:Medical students, Qualitative Research, Minority Groups, Social Perception, Undergraduate medical education, Medical education
Background: Finding that enrollment of Underrepresented in Medicine students at the Uniformed Services University of the Health Sciences was considerably below the national average, researchers sought to understand the experiences of minority students. The goal is to develop an academic and social support structure that sustains and attracts students of diverse backgrounds and races.
Methods: Individual interviews of eight matriculated Black medical students and a focus group were conducted, with Institutional Review Board approval, to obtain feasible methodologies and implement change. Student's perspectives and experiences regarding their institution were investigated using qualitative thematic analysis.
Results: The analysis revealed six themes from the individual interviews: Experience as a minority; Admission process; Difference in backgrounds; Curriculum culture; Diversity at the school; Military medicine. The overarching message from the students was “If you don’t see yourself represented somewhere, it’s hard to believe that you belong.” The focus group made four recommendations: Add a minority viewpoint to curriculum; Add textbooks that portray black skin; Collaborate with Historically Black Colleges and Universities; Increase recruitment of Black students and faculty.
Conclusion: It is hard for minority students to believe they belong in environments without the representation and infrastructure needed to support their unique needs. Implementing ideas, such as those described in this report, is an important step towards creating inclusion and equity.
Association of American Medical Colleges. Underrepresented in medicine definition. Available from: https://www.aamc.org/what-we-do/diversity-inclusion/underrepresented-in-medicine. Last updated March 19, 2004; cited Nov 3, 2020.
Association of American Medical Colleges. Total U.S. Medical School Enrollment. https://www.aamc.org/system/files/2020-11/2020_FACTS_Table_B-3.pdf. Last updated November 3, 2020; cited Nov 3, 2020.
Orom H, Semalulu T, Underwood III W. The social and learning environments experienced by underrepresented minority medical students: a narrative review. Acad Med. 2013 Nov;88(11):1765-77.
Strayhorn G, Frierson H. Assessing correlations between black and white students' perceptions of the medical school learning environment, their academic performances, and their well-being. Acad Med. 1989 Aug;64(8):468-73.
Frierson Jr HT. Black medical students' perceptions of the academic environment and of faculty and peer interactions. J Natl Med Assoc. 1987 Jul;79(7):737.
Calkins E, Arnold L, Willoughby TL. Medical students' perceptions of stress: gender and ethnic considerations. Acad Med. 1994 Oct;69(10);Suppl 22-4.
Tatum BD. "Why Are All the Black Kids Still Sitting Together in the Cafeteria?" and Other Conversations about Race in the Twenty-First Century." Liberal Education. 2017;103:n3-4.
Hadinger MA. Underrepresented minorities in medical school admissions: a qualitative study. Teach Learn Med. 2017 Jan-Mar;29(1):31-41.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101.
Cleland JA. The qualitative orientation in medical education research. Korean J Med Educ. 2017 Jun;29(2):61.
Parkman A. The imposter phenomenon in higher education: Incidence and impact. J Higher Educ. 2016;16(1):51.
Osseo-Asare A, Balasuriya L, Huot SJ, Keene D, Berg D, Nunez-Smith M et al. Minority resident physicians’ views on the role of race/ethnicity in their training experiences in the workplace. JAMA Netw. 2018 Sep 7;1(5):e182723-e182723.
Roberts LW. Belonging, respectful inclusion, and diversity in medical education. Acad Med. 2020 May;95(5):661-4.
Thomas B, Booth-McCoy AN. Blackface, implicit bias, and the informal curriculum: shaping the healthcare workforce, and improving health. J Natl Med Assoc. 2020 Oct;112(5):533-40.
Acosta D, Ackerman-Barger K. Breaking the silence: time to talk about race and racism. Acad Med. 2017 Mar;92(3):285-8.
Walters FP, Anyane-Yeboa A, Landry AM. The not-so-silent killer missing in medical-training curricula: racism. Nat Med. 2020 Aug;26(8):1160-1.
Vick AD, Baugh A, Lambert J, Vanderbilt AA, Ingram E, Garcia R, et al. Levers of change: a review of contemporary interventions to enhance diversity in medical schools in the USA. Adv Med Educ Pract.2018 Jan;9:53.
Garces LM, Jayakumar UM. Dynamic diversity: Toward a contextual understanding of critical mass. Educ Res. 2014;43(3):115-24.
Smitherman HC, Aranha AN, Dignan A, Morrison M, Ayers E, Robinson L. Impact of a 50-Year Premedical Postbaccalaureate Program in Graduating Physicians for Practice in Primary Care and Underserved Areas. Acad Med. 2021 Mar 1;96(3): 416-24.
Metz AM. Medical school outcomes, primary care specialty choice, and practice in medically underserved areas by physician alumni of MEDPREP, a postbaccalaureate premedical program for underrepresented and disadvantaged students. Teach Learn Med. 2017 Jul-Sep;29(3):351-9.
Haggins A, Sandhu G, Ross PT. Value of near-peer mentorship from protégé and mentor perspectives: a strategy to increase physician workforce diversity. J Natl Medl Assoc. 2018 Aug;110(4):399-406.
Afghani B, Santos R, Angulo M, Muratori W. A novel enrichment program using cascading mentorship to increase diversity in the health care professions. Acad Med. 2013 Sep;88(9):1232-8.
Quaye SJ, Shaw MD, Hill DC. Blending scholar and activist identities: Establishing the need for scholar activism. J Divers High Educ. 2017;10(4):381.
Rodríguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: what of the minority tax? BMC Med Educ. 2015 Feb 1;15(1):1-5.
How to Cite
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to firstname.lastname@example.org
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to email@example.com