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Shifting the Curve: Fostering Academic Success in a Diverse Student Body

Elks, Martha L. MD, PhD; Herbert-Carter, Janice MD, MGA; Smith, Marjorie MD; Klement, Brenda PhD; Knight, Brandi Brandon PhD; Anachebe, Ngozi F. MD, PharmD
doi: 10.1097/ACM.0000000000001783
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Diversity in the health care workforce is key to achieving health equity. Although U.S. medical schools have worked to increase the matriculation and academic success of underrepresented minority (URM) students (African Americans, Latinos, others), they have had only limited success. Lower standardized test scores, including on the Medical College Admission Test (MCAT), have been a barrier to matriculation for many URM applicants. Lower subsequent standardized exam scores, including on the United States Medical Licensing Exam Step 1, also have been an impediment to students’ progress, with mean scores for URM students lagging behind those for others.


Faculty at the Morehouse School of Medicine developed and implemented interventions to enhance the academic success of their URM students (about 75% are African American, and 5% are from other URM groups). To assess the outcomes of this work, the authors analyzed the MCAT scores and subsequent Step 1 scores of students in the graduating classes of 2009–2014. They also reviewed course evaluations, Graduation Questionnaires, and student and faculty interviews and focus groups.


Students’ Step 1 scores exceeded those expected based on their MCAT scores. This success was due to three key elements: (1) milieu and mentoring, (2) structure and content of the curriculum, and (3) monitoring.

Next Steps

A series of mixed-method studies are planned to better discern the core elements of faculty–student relationships that are key to students’ success. Lower test scores are not a fixed attribute; with the elements described, success is attainable for all students.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Funding/Support: Funding for this work was provided in part by a Health Resources and Services Administration grant (D3EHP16487).

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Martha L. Elks, Morehouse School of Medicine, 720 Westview Dr., SW, Atlanta, GA 30310-1495; telephone: (404) 752-1881; e-mail:

© 2017 by the Association of American Medical Colleges