Presented By: Priyadarshini Dattathreya, Hackensack Meridian School of Medicine

Purpose
This narrative literature review describes the scope of pre-matriculation courses in medical schools and their ability to facilitate transition of diverse groups of students into medical schools. With a focus on objectives, structure, and outcomes, the review aims to develop a conceptual framework that provides a comprehensive understanding of the pre-matriculation initiatives in medical education.

Methods
Employing a critical narrative approach, this review explores pre-matriculation initiatives through a systematic search targeting peer-reviewed publication from 1985 to 2023. Databases such as MEDLINE, ProQuest, Google Scholar, and EBSCO were utilized, covering articles reporting on goals, structures, outcomes, and evaluations of pre-matriculation initiatives. Articles were categorized based on the scope of the initiatives including their objectives and the activities/experiences offered to students.

Results
The review uncovers a spectrum of pre-matriculation initiatives designed to support transition of students into medical schools. Significant variation exists in program length, mode of delivery, objectives and reported outcomes. When compared across the spectrum, the scope of the initiatives can be described as multi-layered that spans from broader community immersion.  Nested within this overarching framework are targeted focuses, including integration into the learning environment, introduction to the curriculum, and development of skills essential for success in medical school. However, reported outcomes exhibit notable variance, emphasizing the complexity of creating equitable courses that address diverse student needs. The review also reveals a need for an overarching level that promotes equity, inclusivity, and individualization in pre-matriculation courses.

Conclusion
The conceptual framework derived from this narrative review offers valuable insights into pre-matriculation initiatives in medical education. This framework serves as a guide for medical schools in tailoring initiatives that effectively facilitate a smoother transition of students into the unique contexts of their respective institutions. Further research could explore innovative initiatives that enhance the effectiveness of pre-matriculation initiatives while supporting equity, inclusivity, and individualized support.

Presented By: Katie Hartnett, Geisel School of Medicine
Co-Authors: Khaqan Ahmad, Geisel School of Medicine
Daniella Azulai, Geisel School of Medicine
A. Konopasky, Geisel School of Medicine
L.C. Meyers, Geisel School of Medicine
Rajiv Potluri, Geisel School of Medicine

Purpose 
Alongside building complete knowledge bases, medical education should maintain student's mental health.  Academic origins of stress/anxiety in early medical school include new learning modalities and seeking 'work-life' balance. Exam scores bring immediacy to these concerns.  To promote a sustainable culture of learning in our school's first course, Foundations, we implemented an exam 'safety net' program (SNP) to allow students to improve a low score (<77.5%) through a minimal-stress open-book learning exercise.  Prior studies of remediation focused on low-scoring students; however, our study focused on the SNP's broader impact on the learning environment through class-wide exam performance, the student's perception of exams, and student wellness.   

Methods 
Foundations had two summative 'mid-term' exams, for which the SNP was offered, and a comprehensive final (no SNP).  To evaluate impact on exam scores we compared class-wide aggregated data from no intervention (2021) and intervention (2022 & 2023) classes.  Mixed-methods content analysis of narrative feedback from anonymous surveys and focus groups with students was used to determine impact on student perception of the learning environment.  

Results 
Non-adjusted scores on Foundations exams with the SNP as well as the final (no SNP) increased for classes with the SNP versus 'no intervention.'  Students who utilized the program increased their scores on subsequent exams more than the class as a whole.  Major SNP-associated themes in the narrative data included: mastery learning; study strategy experimentation; a low-anxiety introduction to the testing process; and collaborative learning.  

Conclusions  
The SNP led to favorable student perceptions of the learning environment without any negative impact on exam performance.  While faculty time for the program is challenging, with institutional buy-in and suitable exam structures, an SNP could be implemented elsewhere. 

Presented By: Dolly Anadkat, Tulane University School of Medicine
Co-Authors: Samir Anadkat, Tulane University School of Medicine
Paula Majeau, Tulane University School of Medicine
Guenevere Rae, Tulane University School of Medicine

Purpose 
Anxiety and burnout experienced by medical students is at an all-time high, and the importance of wellness is increasingly recognized by both students and medical schools. Students often lack the tools, skills, and motivation to practice resilience building activities. We have introduced multiple strategies and entry points to guided mindfulness meditation for our students. 

Method 
Mindfulness was introduced as a tool for resilience building during first-year student orientation. An introduction to mindfulness session including a10 minutes of guided meditation practice was incorporated into Foundations in medicine (FIM) session as part of the formal curriculum for M1 & M2 students. A curated outside resource list on mindfulness practice was made available. In addition, invitation to both in-person and virtual weekly group sessions on mindfulness meditation was extended. During individual meetings with the Learning Specialist (LS), guided mindfulness meditation was offered to students in addition to other interventions. Recordings of these sessions were provided for individual self-practice. 

Results 
Approximately 380 medical students attended the FIM mindfulness sessions in years 1 and 2 at TUSOM. Students (n=245) responded to a short post session survey. Prior to the session, 53% of the students reported their stress level at a 6 or higher on a 10-point scale and 14% of students reported stress levels below 3. After the session, only 17% of students reported being at a 6 or higher, while more than 52% reported stress levels below 3. Positive feedback from more than 70 students who benefited from individualized session with LS included: immediate reduction of stress, reduced test anxiety, increased focus, and effectiveness in studying. 

Conclusion 
It was concluded that exposure to mindfulness in the curriculum and combining it with individual advisement is highly effective and well received by students.

Presented By: Amy Baldwin, Augusta University/University of Georgia Medical Partnership
Co-Authors: Casey Bassett, Augusta University/University of Georgia Medical Partnership
Tucker Hickox, Augusta University/University of Georgia Medical Partnership
Janette Hill, University of Georgia
Delaney Metcalf, Augusta University/University of Georgia Medical Partnership
Cathy Snapp, Augusta University/University of Georgia Medical Partnership

Purpose
Peer-assisted learning (PAL) is a well-accepted, learner-led model that encourages collaborative experiences in medical training. PAL initiatives are powerful tools in co-creating a culture of well-being and connection throughout medical education. PAL can instill health promotion tools for individual and community resilience and promote strong camaraderie between students. 

Methods
Medical students and faculty at the AU/UGA Medical Partnership (MP) collaborated to design a PAL well-being program for 60 first-year medical learners. Teams of first-year students (M1s) met twice with peer coaches (second-year students) and supporting faculty members during orientation. Students engaged in a facilitated improvisation session and two Skull Sessions which involved discussions of meaning, purpose, and connection. After each session, students participated in a post-survey focused on perceptions of connection and support and well-being as a priority at the school. A subgroup of students and faculty also participated in a focus group regarding the effectiveness of the sessions. 

Results
Results indicated that the M1s perceived a connection with their peers after both well-being sessions (98%, 100%; CI95%). Students reported that peer support is important (98%, 100%; CI95%), and they perceive having support from peer coaches, classmates, and faculty (100%, 100%; CI95%). Further, the M1s perceived well-being is a priority at the MP (98%, 100%; CI95%). One student's open-ended comment illustrates the perceptions of connection, support, and well-being: "This feels like an intentional and close-knit community."

Conclusions 
This interclass program centers on personal well-being and supportive relationships that are key for resilience. The collaboration between faculty, students, and their peers has created a palpable sense of companionship on our campus. Next steps include planned group and peer-peer PAL sessions throughout the year to encourage further community and well-being. 

Presented By: Lucia Pérez Gomez, International Federation of Medical Students Associations (IFMSA)
Co-Authors: Ahmed Rjoub, International Federation of Medical Students Associations (IFMSA)

Purpose 
The International Federation of Medical Students' Associations (IFMSA) perceives research as one of the cornerstones of society, science, and health evolution. The IFMSA advocates for access to research and research education for medical students worldwide through educational activities that are closely formulated and monitored to ensure the quality and relevance of the information and to increase the reach of research knowledge among medical students worldwide. 

Methods 
A group of medical students affiliated with the IFMSA developed three Research Educational Activities. These are 90 to 120-minute ready-made training sessions that can be delivered by anyone with relevant research and training experience to exchange students before or during their Exchange. The topics tackled are "Basic Principles of Medical Research," "Research Methodology and Study Designs", and "Critical Appraisal." Through a global survey, we assessed the usage and satisfaction of the provided activities' toolkits among IFMSA Members. 

Results 
The national member organizations of IFMSA were further surveyed. Of the 85 participating, 48.8% confirmed they had used at least one Research Educational Activity for their students. On a ten-point scale (10 meaning very satisfied and 0 not satisfied), 49 (57%) National Member Organizations gave a satisfaction score of 7 or more, with a mean of answers of 9.45. 

Conclusion 
The educational activities developed have proven to help students ease and increase the spread of research-relevant skills in their community by providing a guided step-by-step approach. The ready-made training sessions have helped the IFMSA deliver specific information to medical students residing in over 130 countries, with the national member organizations involved in the study expressing their satisfaction with this approach to Information delivery, and a strategy has been settled to increase the number and the promotion of the IFMSA resources.

Presented By: Minnatallah Eltinay, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign
Co-Authors: Zakiya Leggett, North Carolina State University
Porché Spence, North Carolina State University

Purpose 
This study investigates the impact of gender on STEM confidence and support in undergraduate students, crucial for informing strategies in medical education. We explore potential barriers in transitioning through STEM pathways.

Methods 
Utilizing a quantitative questionnaire, we surveyed undergraduates in STEM disciplines at a four-year land-grant university, focusing on an introductory environmental sciences course. Questions covered gender identity, race, academic major, career interests, and support levels from various sources. Participants aged 18 to 34 provided valuable insights.

Results 
While females, particularly those of color, remain underrepresented in STEM, our study revealed comparable confidence levels between genders. Notably, both male and female students exhibited no significant difference in their ability to convey scientific concepts or in the influence of personal identities on confidence. Support levels from family, friends, peers, and professors showed no significant gender disparity. However, this paves the way for future studies to explore how additional factors, such as race and the intersection of various identities, may influence STEM confidence, and ultimately confidence within the medical student population. 

Conclusion 
This research suggests that gender-related confidence gaps in STEM may be narrower than perceived, emphasizing the need for inclusive educational strategies. In the context of medical education, we recommend adopting learner-centered approaches, integrating diverse role models, and implementing mentorship programs. By promoting excellence and innovation in teaching, student assessment, and instructional technology, medical educators can cultivate a supportive environment for students of all genders, backgrounds, and identities. This approach aims to advance teaching methodologies and foster inclusivity in health professions education. This informs future research that explores the intersectionality of individual identities in STEM confidence. Additionally, ongoing exploration of effective educational interventions, such as mentorship programs and diverse role model initiatives, is crucial for enhancing inclusivity in medical education.

Presented By: Grace Huertas, The International Federation of Medical Students' Associations (IFMSA)
Co-Authors: Abdelrahman Elgendy, The International Federation of Medical Students' Associations (IFMSA)
Michelle Lam, The International Federation of Medical Students' Associations (IFMSA)

Purpose 
The integration of Equity, Diversity, and Inclusion (EDI) principles in medical education is essential for addressing health disparities. Inclusive medical education, particularly after the COVID-19 pandemic, is crucial for recognizing global health inequities. Actively incorporating student perspectives refines curricula and ensures socially accountable medical education, serving diverse communities effectively. 

Methods
The International Federation of Medical Students' Associations (IFMSA) initiated a Working Group to advance the Equity, Diversity, and Inclusion (EDI) Global Assessment. The survey was shared with medical students from more than 130 countries and explored aspects such as institutional environment, resources, educator training, and students' perceptions of inclusion. A comprehensive analysis relevant to the Americas region will be presented at the conference. Additionally a toolkit was developed to support students in implementing EDI-related activities in their medical schools. 

Results 
The 2021 global assessment reached 110 medical students from 37 countries. Key findings include a 32.3% lack of an inclusive admission process, 56.1% absence of educators trained in EDI, and up to 50.4% unavailability of resources. The 2023 edition of the assessment will undergo analysis and comparative examination, shedding light on post-pandemic EDI evolution. The toolkit, emphasizing key EDI principles, provides case studies and guides medical students in advocating for EDI, addressing bias, and promoting inclusion. 

Conclusions
Active student involvement is crucial in designing and assessing medical education programs to promote EDI principles. IFMSA recognizes that basic parts of medical school, like the admission process, EDI trained educators or available resources are essential to create an inclusive environment for all stakeholders. Survey reports and the toolkit contribute to students' advocacy efforts in promoting inclusive medical education globally.

Presented By: Chelsea Price, University of Tennessee College of Education, Health, and Human Sciences
Co-Authors: Carrie Bailey, University of Tennessee School of Nursing
Lynn Beeler, University of Tennessee School of Nursing
Kaylan Gee, University of Tennessee Graduate School of Medicine
Lauren Grimsley, University of Tennessee Graduate School of Medicine
Robert Heidel, University of Tennessee Graduate School of Medicine
James Lewis, University of Tennessee Graduate School of Medicine
Steve McCallum, University of Tennessee College of Education, Health, and Human Sciences
Louis Rocconi, University of Tennessee College of Education, Health, and Human Sciences
Andrew Russ, University of Tennessee Graduate School of Medicine

Purpose 
Emotional Intelligence (EI) and burnout impact patient outcomes and healthcare-professional wellbeing. Pandemic impact on these wellness factors is unknown. We hypothesized the pandemic would negatively increase burnout while EI would be protective against increased burnout. 

Methods 
Demographics, EI, and burnout were assessed for incoming resident years 2018 to 2023. Cohorts were created; 2018-2019, 2020-2021 (pandemic), and 2022-2023. EI and burnout were assessed using the SEF:MED instrument and the Maslach Burnout Inventory (MBI), respectively. MBI is assessed using three subscales: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Achievement (PA). The effect of the pandemic on EI and burnout was assessed using One-Way ANOVAs. 

Results 
Incoming residents (n=330) participated over the six years; M=56.0 (±4.7) per year. Overall mean EI was M=3.92(± 0.34), scale 1-5. MBI overall mean EE,DP, and PA were M=18.07(±9.93), M=7.60( ±5.31), M=37.92(±6.49), respectively. Resident pre, intra, and post-pandemic sample sizes were n=108, 101, 121, respectively. EI was not significantly different across cohorts, F(2,320)=0.53, p=0.587. MBI-EE was significantly different across groups, F(2,327)=3.28, p=0.04. EE was significantly lower during intra-pandemic years (M=16.05[± 9.65]) compared to pre-pandemic years (M=19.43[±S9.75]). DP was also significantly different across groups, F(2,328)=5.29, p=0.006. DP was significantly lower in the intra-pandemic years (M=6.30[±4.85]) compared to pre-pandemic (M=8.63[±5.37]) and post-pandemic (M=7.79[±5.43]) years. PA was not significantly different across groups, F(2,328)=0.752, p=0.472. EI was moderately negatively correlated with EE [r(321)=-0.51, p < 0.001] and DP [r(322)=-0.53, p < 0.001]. EI was moderately positively correlated with PA [r(322)=0.53, p<0.001]. Higher EI was associated with lower EE and DP, and higher PA, regardless of cohort. 

Conclusions 
EI is protective against higher levels of Burnout depersonalization and emotional exhaustion, regardless of a global health threat. Surprisingly, EE and DP were significantly lower during intra-pandemic years, contrary to our hypothesis. We provide evidence that Burnout was healthcare-professional work-related during the pandemic.

Presented By: Lillian Sims, University of Kentucky College of Medicine
Co-Authors: Noor Ali, University of Kentucky College of Medicine
William Denton, University of Kentucky College of Medicine
Shelby McCubbin, University of Kentucky College of Medicine
Raven Piercey, University of Kentucky College of Medicine

Purpose
As USMLE Step 1 and many medical school curricula have transitioned to pass/fail systems, unintended consequences may include a need for innovative ways to recognize student strengths and accomplishments, which traditional assessments (e.g., grades; class rank) may be ill-suited to capture. Increasingly, we have seen students turn to their near-peers for mentorship - but with uneven results. Careful development and support are needed for expanded peer mentorship efforts.

Methods
In light of these challenges, we built the MedMentor program to provide 1-1 near-peer mentorship for our medical school's first year cohort. The program began as a pilot during the 2023-2024 academic year, with 22 second-year medical students each selected to mentor a small group of 6-8 first-year medical students (totaling 137 mentees). Goals of the program include building confidence and belonging among members of both cohorts and facilitating early interest in academic careers for underrepresented students in particular.

Results
While program leaders see the benefits of organic relationships with skilled peer mentors, facilitating a culture which enables those connections is complex, as incoming students are often accustomed to a competitive pre-medical environment. Our findings indicate that first-year students do take advantage of low-stakes peer mentor connections facilitated through a formal initiative. MedMentors collectively completed 22 small-group encounters per month during the academic year, and have also completed over 60 voluntary meetings with individual first-year mentees. Mentor students' interest in academic and teaching careers has also increased.

Conclusion
We anticipate that the MedMentors initiative could be adopted elsewhere to increase interest in mentoring careers as well as support for incoming students. Ultimately, well-evaluated peer mentorship programs have potential to diversify academic medicine by providing clear pathways through which preclinical students can begin to envision themselves as mentors and set themselves apart for the next stage of training.

Presented By: Chaveli Palau Morales, Nova Southeastern University
Co-Authors: Kyle Bauckman, Nova Southeastern University
Alyssa Haag, Nova Southeastern University
Beatrice Thomas, Nova Southeastern University

Purpose
The recent transition to Pass/Fail scoring on the USMLE Step1 augmented the perceived importance of research among medical students. We aimed to better understand the role of scholarly productivity for the selection of residency candidates now that applicants predominantly lack a STEP1 number. There is a growing emphasis on utilizing a more "holistic" approach but there is a lack of transparency in how these markers are quantified. There is a lack of information regarding what scholarly products program directors (PDs) value when considering a student's candidacy.  Our findings provide a guideline for medical school mentors and mentees a more granular approach toward scholarly productivity.

Methods
IRB approval was obtained through our institution. Emails were collected from the ACGME 2023 PD contact list. We employed Microsoft Forms Survey Tool for voluntary and anonymous survey distribution. The survey evaluated respondents' views regarding importance of types of scholarly endeavors, number of projects, and change in importance relative to STEP1. Utilizing Likert scale, results were aggregated based on program specialty, location, and institutional framework.

Results
336 individuals from a variety of specialties responded. Competitive programs including Ophthalmology deemed research "fairly important" to "very important". Primary care specialties rated research as "minimally important" to "neutral" when evaluating prospective students. Scholarly output importance varies by institution location; West Coast programs placed fair importance, while Central institutions are neutral. Interestingly, perceptions of research following changes with STEP1, was overwhelming "no change" regarding importance. This study was limited in scope as it reflects views of PDs prior to the 2024 match.

Conclusion
Pass/Fail STEP1 has fostered the perception that robust scholarly productivity is crucial for matching, but our findings indicate these concerns are overstated. We plan to use these insights to develop career development workshop for students. Future endeavors will explore the perceived value of the applicant's holistic profile including volunteering and work experience.

Presented By: Amber Fouts, Nova Southeastern University
Co-Authors: Kyle Bauckman, Nova Southeastern University

Purpose
Medical students applying for ophthalmology residency have high academic performance and invest significant time beyond their studies conducting research. Upon application, students discover there is a tacit understanding they must pass vision-based tests including: visual acuity (VA), stereopsis (SO), and colorblind (CB) examinations. Confirmation of these visual requirements is sparse or non-existent. We aim to clarify this requirement by asking program directors (PDs) if and how this information is collected so applicants may consider this early in their education.

Methods
IRB approval was obtained, and emails of ophthalmology PDs were acquired from the ACGME 2023 PD contact list. Voluntary anonymous surveys were distributed utilizing the Microsoft Forms Survey Tool. The survey utilized a Likert scale scoring system.

Results
Of the (n=12) respondents, 4 required submission of visual exams as part of the application or onboarding process. Of those, 2 reported a failed visual exam could negatively impact eligibility; 1 at the application stage and 1 at the onboarding stage. When asked if respondents (n=10) would discourage an applicant with visual deficits from pursuing ophthalmology results were mixed. For VA testing, 7 would discourage and 3 might discourage. For SO testing, 4 would discourage and 6 might discourage. For CB testing, 1 would discourage, 2 might discourage, and 7 would not discourage.

Conclusions: Ophthalmology residencies are divided on their visual requirements for applicants. The responses suggest, while not an official requirement, most PDs would discourage applicants who are unable to pass VA and SO exams, but not CB exams. The disconnect between actual requirements and PD recommendations, as well as the potential for disqualification, presents a late-stage challenge for applicants with visual impairments. This study emphasizes the need for clearer guidelines about visual requirements for prospective ophthalmologists.

Presented By: Kirsten Porter-Stransky, University of South Carolina School of Medicine Greenville
Co-Authors: Laura Bauler, Western Michigan University Homer Stryker M.D. School of Medicine
Kristine Gibson, Western Michigan University Homer Stryker M.D. School of Medicine
Christopher Haymaker, Western Michigan University Homer Stryker M.D. School of Medicine
Karen Horneffer-Ginter, Western Michigan University Homer Stryker M.D. School of Medicine
Maggie Rothney, Western Michigan University Homer Stryker M.D. School of Medicine

Purpose
Psychological safety refers to the ability to take interpersonal risks, such as speaking up, offering new ideas, or expressing concerns, without fear of punishment. Previous research shows that psychological safety predicts higher quality of healthcare, effective educational environments, and greater willingness to propose innovative ideas and admit mistakes. However, the hierarchical nature of academic medicine can hamper psychological safety, negatively impacting students, employees, and patients. There is a paucity of evidence-based ways to promote psychological safety. To fill this gap, the current project describes and evaluates a multi-year, medical school-wide psychological safety initiative. 

Methods 
An interdisciplinary team created and implemented educational training sessions, a psychological safety champions programs, and resources based on Tim Clark's stages of psychological safety. We purposefully focused on training leaders, faculty, and staff first, so that they could model psychological safety for learners. To assess the impact, employed faculty and staff were invited to complete annual surveys, which included the previously validated Psychological Safety Scale developed by Amy Edmondson. Data were analyzed with repeated measures ANOVA and descriptive statistics. This study was approved by the Institutional Review Board. 

Results 
The initiative is in its third year, with successful implementation of educational training sessions, departmental champions, and a variety of resources. Ninety-seven faculty and staff completed both annual surveys. Within 1 year after implementation of the initiative, psychological safety significantly improved at the departmental level (p < 0.05). Participants rated their psychological safety as higher at the departmental level than institutional level (p < 0.01). 

Conclusions 
The present study describes an effective school-wide program to improve psychological safety among faculty and staff at the departmental level. Training leaders and employees first is important to promote a psychologically safe learning environment for medical students and residents. This project serves as a template for other health professions schools seeking to improve psychological safety.

Presented By: Andrea Belovich, Idaho College of Osteopathic Medicine
Co-Authors: Mariluz Henshaw, Touro College of Osteopathic Medicine
Jennifer Hotzman, Idaho College of Osteopathic Medicine
Anne Weisman, Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas

Purpose 
The undergraduate medical education (UME) environment is critical to medical students' professional identity formation (PIF). PIF is influenced by both explicit and implicit factors, including socialization to the profession through interactions with peers and faculty. This abstract reports changes in the perceived quantity and quality of social interactions amongst undergraduate medical students during the SARS-CoV-2 pandemic.

Methods 
This cross-sectional, mixed-methods study was conducted following the return to in-person learning at Touro College of Osteopathic Medicine-NY, Idaho College of Osteopathic Medicine, and Kirk Kerkorian School of Medicine at UNLV. We administered a survey to assess the quantity and quality of social interactions of medical students throughout the pandemic-forced shutdowns. Demographic information was obtained. Frequency of meaningful social interactions between students and faculty/staff was assessed using a Likert scale for each semester. Using a phenomenological approach, qualitative descriptions were analyzed.

Results 
There were 122 participants. Self-reported meaningful social interactions decreased during the pandemic and, as of Spring 2022, did not recover to pre-pandemic frequencies except for intracohort interactions. Themes of loss due to being online, the importance of in person conversations, how meaningful it was to share meals together, and frequent text messaging helped foster connection emerged during analysis of qualitative data.

Conclusion 
Given that PIF does not occur in isolation and requires social interaction with other members of the medical professions, the reduction of medical students' self-reported meaningful social interactions during COVID-19 may have long-reaching implications. Specifically, the indolence of recovery of frequency of social interactions between medical students and faculty should receive attention and requires further study. Educators should consider mindful cultivation of professional relationships and opportunities for meaningful social interactions with students. Limitations of this study include sample size, and rate of completion of the survey.

Presented By: Mary Ruggeri, Independent Clinical Practice
Co-Authors: Derek Henderson, American Academy of PAs
Stephanie Neary, Yale University
Noel Smith, American Academy of PAs

Purpose
The average age of physician assistant students overlaps with the primary childbearing years of Americans. However, despite recent advancements in policies supporting parental leave for PA students, there remains a paucity of data on the perceptions of family planning or available resources during training. The purpose of this study is to explore the perceptions of support for, and impact on, family planning and parenting, including lactation, among PA students.

Methods
This cross-sectional study used data collected from the American Academy of PAs (AAPA) Student Survey between January and March 2023. Descriptive and inferential statistics were performed.

Results
A total of 557 students (557/1,353; 41.2%) completed the survey. Less than 15% of students (80/557; 14.4%) believed their program provides resources to support parental leave and many students (290/557; 52.1%) remained unsure whether resources exist. There was a significant difference for PA students (p=0.005) by gender in whether family planning impacted the decision to pursue PA training over another profession, with females proportionately affected more than males. Medical school was the most often profession considered aside from PA.  Most PA students (311/548; 56.8%) also felt pressure to wait until after training to have children, but there was no significant difference by gender (p>0.05).  Additionally, multiple students (26/554; 4.7%) admitted to being asked questions they believed were biased or inappropriate regarding pregnancy or parenting during the interview process for, or after beginning, PA school.

Conclusions
Family planning is a common consideration among PA students' when choosing to pursue the PA profession over other health professions. Programs should seek opportunities to support all students, not only pregnant women, through all stages of family planning. Support will require both cultural and structural shifts beginning with peer stigma and extending through admissions interview question audits, faculty training, university policies, and accreditation requirements.