Are We Supporting Equity?: Education and Employment Outcomes of an Undergraduate Training Program to Enhance Entry of Historically Excluded Students into Biomedical Careers

Background: Diversity in the biomedical workforce contributes to greater innovation in research and improves health care for marginalized populations. However, significant disparities persist in the biomedical research workforce due to historic exclusion and underrepresentation based on socioeconomic status, disability, and racial/ethnic identity. Numerous interventions to promote racial equity and support students in overcoming systemic barriers have shown promise on indicators suggesting a biomedical research trajectory, but few provide evidence regarding actual post-graduate education and employment. Furthermore, such programs should demonstrate that disparities are not perpetuated among their participants from different backgrounds. The current study focuses on the NIH-funded BUILD EXITO program, a collaborative, cross-institutional initiative offering intensive, multidimensional training to support the entry of historically marginalized undergraduates into biomedical research careers. Education and employment outcomes are disaggregated by race and other factors to examine whether differences exist following program completion and to address the question: Are there differential outcomes among students participating in a program to promote equity?

Methods: The sample (n=233) draws from the first five cohorts in the comprehensive 3-year training model, allowing for analysis of outcomes after program completion. Student characteristics assessed included cohort, race/ethnicity, gender, need-based financial aid, first-generation college student, and transfer student from community college. Annual surveys of program alumni regarding employment and entry into advanced degree programs were supplemented with data received by direct communication to program staff and internet searches of publicly-available information. Three dichotomous outcome variables reflect employment in biomedical research or healthcare, acceptance into a graduate program, and a composite indicating employment and/or graduate education. After descriptive and univariate analyses, multivariable logistic regressions were conducted for each outcome.

Results: In years immediately following graduation, over half (54%) of BUILD EXITO alumni were employed in biomedical research or healthcare, and many (40%) were accepted into advanced degree programs. Three quarters (75%) had attained at least one of these specific program outcomes (with others employed in non-biomedical fields). Only a few statistical differences in outcomes were observed across demographic groups. Asian American graduates were more likely to be employed in biomedical positions than white or underrepresented minority graduates. Female alumni were more likely to enter graduate school (OR=3.24) and to achieve either outcome (OR=3.22). Transfer students were less likely to enter a graduate program (OR=0.52). Finally, first-generation students more often reported both working and pursuing further education.

Conclusions: Given all BUILD EXITO participants represent at least one NIH-defined underrepresented identity facing systemic and structural barriers, the high proportion of alumni pursuing an advanced degree or securing employment in the biomedical workforce shortly after program completion is encouraging. Furthermore, as hoped, differential outcomes across racial groups were not common, although effects associated with intersectional identities were not investigated. Asian American alumni reported higher levels of employment but not education compared to others. Men and transfer students were less likely to enter graduate programs, reflecting trends in educational attainment and calling greater attention to the needs of these populations. This study highlights that programs should disaggregate outcome data to ensure equity goals are achieved.