An Evaluation of a Pipeline Program to Support Diversity in the Public Health Workforce: CDC Undergraduate Public Health Scholars (CUPS) Program

Established by the Centers for Disease Control and Prevention (CDC), the goal of the CDC Undergraduate Public Health Scholars (CUPS) program is to expose students underrepresented in public health and medicine to careers in public health; ultimately, increasing the membership of these groups in these fields including biomedical sciences. CDC implemented a retrospective outcome evaluation of 1,047 students who participated in the program from 2012 to 2017. Seventy-four percent (775) of students responded to the survey that captures their academic attainment and employment status, as well as their perception of the program’s and mentors’ influence on their career path. As of 2020, 639 (83.4%) of 775 participants have enrolled in an advanced degree program, with over 80% of 639 participants pursuing degrees in biomedical sciences, public health, or health care (BSPHHC)–related fields. Two thirds (374/566) of participants who reported they had ever been employed in a career position are working/have worked in BSPHHC-related fields. Overall, 77.4% (600) of 775 participants reported either the program or the mentors, or both were extremely or very influential to their career path. Students claimed the CUPS program had “opened their eyes,” inspired their interest, cultivated their passion for the field of public health, and fueled their drive to find solutions to and in social determinants of health and contribute to health equity. The opportunity to gain work and research experience through internship placements in CUPS has “opened doors” to first jobs and advanced education and training opportunities for many students.

An analysis of the selection criteria for postgraduate physician assistant residency and fellowship programs in the United States

Background This study aims to investigate the admission criteria used by physician assistant postgraduate education programs in selecting licensed PA applicants for postgraduate training in the United States. To our knowledge, there have been no previously published reports on selection criteria and/or other factors influencing postgraduate PA admission decisions. Method A non-experimental, descriptive research study was designed to obtain information from members of the Association of Postgraduate Physician Assistant Programs (APPAP). Results Twenty-three out of 73 postgraduate programs (35%) responded to the survey. The study reported that applicant PAs and NPs are largely selected on the basis of several factors. The most heavily weighted factor is the interview itself; other selection criteria perceived to be extremely/very important included board certification/eligibility, letters of recommendation, advanced degree, and personal essay. Survey data suggest that publications, undergraduate transcripts, and class rankings are not considered to be of high importance in applicant selection. The number of PA applicants applying to each postgraduate training program averages around 26 and total number of enrollees is about 3.6 per program. Additionally, some programs reported furloughing of trainees (temporary suspension of didactic and clinical training) during the pandemic, whereas the vast majority of postgraduate PA programs remained operational and some even experienced an increase in application volume. The total cost of training a PA resident or fellow in postgraduate programs is currently $93,000 whereas the average cost of training a categorical physician resident is estimated at $150,000 per year when considering both salary and benefits. Conclusions This novel study examined criteria and other factors used by postgraduate PA programs in selecting candidates for admission. Results can be used by postgraduate programs to improve or modify current selection criteria to enhance the quality of trainee selection. Further research is needed to examine correlations between applicant attributes, selection criteria, and trainee success in completing postgraduate training.

P.212 Demographic Trends in Canadian Neurosurgery Training & Academic Neurosurgery

Background: Exploring current trends in career outcomes can guide further expansion and diversity in neurosurgery demographics, as well as inform medical trainees of qualifications required for a career in neurosurgery. This study therefore aims to explore temporal trends and gender distribution in training, teaching, and leadership positions among currently practicing neurosurgeons. Methods: A list of practicing Canadian neurosurgeons and their certification year, degrees, fellowships, and teaching positions was created using publicly available information and phone/email confirmation by surgeons. Results: We identified 297 neurosurgeons currently practicing in Canada (F=32, M=265). There was a significant trend towards a greater number of neurosurgical staff having at least one advanced degree or fellowship over time (p=0.0012, p=0.0048 respectively), with no significant difference between proportions of males and females. Within academia, women represent 33% of adjunct professors, 8% of associate professors, and 15.2% of full professors. Two neurosurgical departments in Canada are led by women. Conclusions: Literature shows there is an underrepresentation of women in neurosurgery, particularly in higher-ranking teaching and leadership positions, yet our results suggest there is no significant differences in qualifications between males and females. Further exploration is needed to identify reasons underlying these trends and propose solutions to promote growth in the field.

24. An analysis of the National Institutes of Health All of Us Research Database: Sociodemographic Disparities Among Patients Who Received Vaccinations

Background The National Institutes of Health All of Us (AoU) research program is building a diversified database of 1 million+ adult subjects. With this database, we seek to describe the sociodemographic characteristics of those with documented vaccinations. Methods The AoU recruited subjects ≥ 18 years beginning in 2018. Eligible subjects were subsequently divided into five vaccine cohorts based on their vaccine history [influenza, hepatitis B (HepB), pneumococcal (Pneu) < 65, Pneu ≥ 65, human papillomavirus (HPV)]. The vaccine cohorts were compared to the general AoU cohort. Subjects in the influenza cohort had documented influenza vaccinations from 09/2017-05/2018. Other vaccine cohorts comprised subjects with ≥ 1 lifetime record(s) of vaccination by 12/2018. The Pneu < 65 and ≥ 65 cohorts comprised those who received pneumococcal vaccination before or after (inclusive) 65 years old, respectively. Descriptive statistics for all cohorts were generated using survey and electronic health record (EHR) data. Results We analyzed 315297 subjects in the AoU dataset R2020Q4R2. The cohort sizes were: influenza (n=15346), HepB (n=6323), HPV (n=2125), and Pneu (< 65 n=15217; ≥65 n=15100). For all vaccine cohorts, comparing the 95% confidence intervals (CIs), the proportions of whites and non-Hispanics/Latinos were statistically higher than the general AoU cohort, the largest being from the Pneu ≥ 65 cohort (Table 1). For educational attainment, the Pneu < 65 (36.5%) had the smallest proportion of college or advanced degree graduates while the largest was observed in the Pneu ≥ 65 cohort (59.0%). The proportions of subjects with < &10k in annual household income (AHI) were largest among Pneu < 65 (17.1%) and smallest among Pneu ≥ 65 (3.8%). In contrast, the largest proportion of subjects with ≥ &100k AHI was among Pneu ≥ 65 (25.3%) and the smallest among Pneu < 65 (15.8%). Table 1. Sociodemographic characteristics of subjects in the All of Us research program based on vaccine receipt Conclusion Racial and ethnic disparities in vaccinations were apparent. Pneumococcal vaccination at age 65 years and above was more prevalent among white, non-Hispanic/Latino subjects who were also more educated and affluent. Conversely, those receiving pneumococcal vaccination before age 65 years were less educated and had lower AHI. Disclosures All Authors: No reported disclosures

Working More, Less or the Same During COVID-19? A Mixed Method, Intersectional Analysis of Remote Workers

The COVID-19 pandemic has transformed where paid work is done. Workers able to do so have been required to work remotely. We draw on survey data collected in October 2020 from a nationally representative sample of 3,017 remote workers, as well as qualitative survey data collected from 231 remote workers, to examine perceived changes in work hours from before to during the pandemic. Results indicate women are at greater risk of change (either a major decrease or a major increase)—rather than stability—in work hours. Gender also intersects with caregiving, race/ethnicity, prior remote work experiences, and socioeconomic status to shape changes in hours. Women and men in the sandwich generation, as well as women (but not men) with pre-school children, are the most likely to report a decrease in work hours, whereas women with older children at home or caring for adults (but not both) are the most likely to have an increase in hours. Remote working Black women and women moving into remote work are more likely to experience a major increase in hours worked, even as Hispanic women and Black men are the most likely to report somewhat of a reduction in work hours. Gender also intersects with SES, such that women without a college degree are more likely to have a decrease in work hours, while women with an advanced degree and women managers report a considerable increase in work hours. Qualitative data further illuminate why work hours change or remain stable for remote workers during COVID-19.

187 Forage Agronomists Are Needed in Animal Science Departments

Ruminants serve a valuable role in sustainable agricultural systems, specifically in the conversion of renewable resources from grasslands, pasture, and other by-products into edible human food. Recognizing forage and grasses are grown on 25% of arable land, suitable agronomic practices for grazing livestock are necessary to minimize water and soil erosion. Demographics of Animal Science students have changed over the last several years with more students from urban backgrounds and with interests other than traditional animal agriculture. This makes continued emphasis on education programs supporting the grazing livestock industry that much more important. However, for many reasons, universities place less emphasis on training Ph.D. students in forage agronomy. Based on an email survey of 10 land grant institutions, typically one M.S. student/yr and one Ph.D. student/3–4 yr graduates with an advanced degree in forage agronomy. Most departments have experienced dramatic budget reductions. Challenges with funding faculty positions outside of a department’s emphasis area typically results in the question “Should forage agronomy students be trained in Departments of Animal Science or Crop/Soils Science?” It could be argued that either department is the best fit. Forage agronomy requires training in the basics of plant and soil science, but the application of those sciences relate more to animal science and animal production than to traditional crop production such as cereal grains. Departments of Animal Science must communicate the meaningful context of forage agronomy in an active learning environment developing students’ ability to critically think and solve problems. Those providing technical expertise to livestock producers can no longer make recommendations based solely on production efficiency and profitability. Instead, best management practices must include the impact of grazing livestock on the environment. Cooperative agreements between departments should be discussed to adequately support student development in this critical subject matter.

An Analysis of the Selection Criteria for Postgraduate Physician Assistant Residency and Fellowship Programs in the United States

BackgroundThis study aims to investigate the admission criteria used by PA postgraduate education programs in selecting licensed PA applicants for postgraduate training in the United States. To our knowledge, there have been no previously published reports on selection criteria and/or other factors influencing postgraduate PA admission decisions. This study both draws on and builds upon previous research conducted by Vasco Deon Kidd et. al in exploring the characteristics of PA postgraduate education programs in the United States.Method A non-experimental, descriptive research study was designed to obtain information from members of the Association of Postgraduate Physician Assistant Programs (APPAP). ResultsTwenty-three out of 73 postgraduate programs (35.1%) responded to the survey; the low response rate in our survey may have been attributed to the resurgence of COVID-19 fueled by the delta variant. Nevertheless, the study reported that applicant PAs and NPs are largely selected on the basis of several factors. The most heavily weighted factor is the interview itself; other selection criteria perceived to be extremely/very important included board certification/eligibility, letters of recommendation, advanced degree, and personal essay. Survey data suggest that publications, undergraduate transcripts, and class rankings are not considered to be of high importance in applicant selection. The total cost of training a PA resident or fellow in postgraduate programs is currently $93,000 whereas the average cost of training a categorical physician resident is estimated at $150,000 per year when considering both salary and benefits. The number of PA applicants applying to each postgraduate training program averages around 26 and total number of enrollees is 3.6 per program.ConclusionsThis is the first study to examine criteria and others factors used by postgraduate PA programs in selecting candidates for admission. Results can be used by postgraduate programs for quality improvement initiatives related to including additional or modifying current selection criteria to improve the quality of trainee selection. Further research is needed to examine correlations between applicant attributes, selection criteria, and trainee success in completing postgraduate training.

PRACTICING ANTHROPOLOGY IN THE POST-COVID WORLD: HOW TO GET HIRED AND WHERE TO LOOK

Whether teaching at the undergraduate or graduate level, we recognize anthropology is a discovery major. Students find their way into a class and something thrilling happens; they get hooked and claim anthropology as their major or advanced degree. What is it that lures students into anthropology? It is the process of understanding culture and power or being able to “make a difference” and contribute towards positive change in an organization or a community. This drive to make a difference for those we work with drew us in as academics and practitioners and kept us engaged in the discipline. It was this vocational motivation that inspired Susan to invite Victoria, Jennifer, and John to speak to her undergraduate Applied Anthropology class regarding our experiences as practitioners. She posed the questions: “What can you do with a degree in anthropology?” and “How do you go about getting those positions rather than becoming a professor?” There may be many jobs in one’s career journey as we see it; how do you get started, stay encouraged, “upgrade” your skills, and creatively adapt over time? This paper is a product of the discussion started in that class and hopefully adds to the larger conversation currently taking place in the field.

A snapshot of nurses’ understanding, perceptions and comfort level of genomics

Objective: The primary aim of this study explored holistic nurses’ self-perceived genomic knowledge, perceptions, attitude and comfort of genomics. A second aim compared results to previous findings of nurse educators and advanced degree practicing registered nurses’ genomic knowledge utilizing the same survey instruments.Methods: Design: Recruitment of participants, through the American Holistic Nurses Association (AHNA), was achieved via an anonymous Survey Monkey link of the Genetic and Genomic Literacy Assessment (GGLA) survey. The GGLA survey comprised three aspects: Self-Perceived Genomic Knowledge Survey; Perceptions and Attitudes about Genomics Integration into Nursing Practice Survey and the Comfort Level of Genomics Survey. Method: The GGLA survey link was made available via the AHNA newsletter.Results: Holistic nurses (n = 41) self-perceived genomic knowledge level demonstrated a knowledge base gap in their comprehension and ability to explain genomic concepts to their patients. Majority of holistic nurses were significantly not comfortable with their genomic knowledge (90% or greater). Comparison with nurse educators (n = 53) and advanced degree practicing registered nurses’ (n = 36) genomic knowledge provided additional insight.Conclusions: A significant majority of nurses are unprepared to adopt genomics into their practice whilst experiencing a lack comfort and confidence. The global success of nursing practice resides with its’ practitioners being fully informed and competent with all required competencies, especially if nursing is to remain prevalent within personalized healthcare.

Impact of Student-Run Clinics on Students’ Attitudes Toward People Experiencing Homelessness

Introduction: Student-run clinics can supplement medical education by exposing students to diverse clinical scenarios and collaborating with underresourced populations. We examined the impact of volunteering at THRIVE, a student-run bridge clinic located within sheltered housing for individuals with substance use disorder, on students’ attitudes toward people experiencing homelessness (PEH). Methods: This cohort study analyzed pre- and postsurvey matched responses from nonvolunteer and volunteer first-year medical students utilizing the Health Professional Attitudes Towards the Homeless (HPATHI) tool, totaled into three subcategories: Cynicism, Social Advocacy, and Personal Advocacy. We evaluated the association between change in scores and volunteering utilizing Student t tests and adjusting for participant characteristics using multivariable regression analysis. Results: We received 106 responses (53% response rate); 58 students (55%) volunteered at the clinic and were mostly female (62%), White (52%), and had previous experience working with PEH (71%). The mean change in Personal Advocacy scores was higher for volunteers compared to nonvolunteers, even when adjusting for respondent characteristics (P=.02). Additionally, students who held a prior advanced degree and/or current enrollment in the master of bioethics program (Higher Education Students) had a positive association with change in Personal Advocacy scores (P=.02). Conclusion: Volunteering at the THRIVE Clinic appears to impact the Personal Advocacy scores of medical students. This suggests that interacting with PEH early in students’ career may be associated with a commitment to working with this population. However, our study has multiple limitations, including self-selection bias, limited sample size, and unclear permanence of students’ attitudes over time. Further studies of this cohort could help clarify the significance and permanence of volunteering in student-run clinics.