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Med Teach. 2018 Aug;40(8):762-780. doi: 10.1080/0142159X.2018.1473562. Epub 2018 Jul 22.

What are the features of targeted or system-wide initiatives that affect diversity in health professions trainees? A BEME systematic review: BEME Guide No. 50.

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a Department of Medicine, Faculty of Medicine and Dentistry , University of Alberta , Edmonton , Canada.
b Division of Infectious Diseases , University of Alberta , Edmonton , Canada.
c Department of Family Medicine, Division of Community Engagement , University of Alberta , Edmonton , Canada.
d John W. Scott Health Sciences Library, University of Alberta , Edmonton , Canada.
e Department of Pediatrics , University of Alberta , Edmonton , Canada.
f Department of Medicine, Division of Rheumatology , University of Alberta , Edmonton , Canada.



There is interest to increase diversity among health professions trainees. This study aims to determine the features/effects of interventions to promote recruitment/admission of under-represented minority (URM) students to health professions programs.


This registered BEME review applied systematic methods to: title/full-text inclusion review, data extraction, and quality assessment (QA). Included studies reported outcomes for interventions designed to increase diversity of health professions education (HPE) programs' recruitment and admissions.


Of 7225 studies identified 86 met inclusion criteria. Interventions addressed: admissions (34%), enrichment (19%), outreach (15%), curriculum (3%), and mixed (29%). They were mostly single center (76%), from the United States (81%), in medicine (45%) or dentistry (22%). URM definition was stated in only 24%. The dimension most commonly considered was ethnicity/race (88%). The majority of studies (81%) found positive effects. Heterogeneity precluded meta-analysis. Qualitative analysis identified key features: admissions studies points systems and altered weightings; enrichment studies highlighted academic, application and exam preparation, and workplace exposure.


Several intervention types may increase diversity. Limited applicant pools were a rate-limiting feature, suggesting efforts earlier in the continuum are needed to broaden applicant pools. There is a need to examine underlying cultural and external pressures that limit programs' acceptance of initiatives to increase diversity.

[Indexed for MEDLINE]

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