| Summary: | The population of the United States is projected to become more racially and ethnically diverse, yet Black and Latinx physicians remain underrepresented in the medical professions. Pipeline programs are a long-standing strategy to increase the proportion of physicians from underrepresented minority (URM) backgrounds. Pipeline programs incorporate structured educational and experiential activities designed to prepare students for careers in medicine. However, little is known about the organizational sustainability of these programs over time, especially after they experience organizational disruptions such as changes in leadership or lapses in funding. This research explores how characteristics related to the sustainability of pipeline programs are reported in the literature, how organizational leaders responsible for implementing pipeline programs conceptualize and plan for sustainability, and how individual, organizational, and environmental factors contribute to the sustainability of pipeline programs.
The first study is a systematic scoping review that explores how the sustainability of pipeline programs is characterized in the literature on pipeline programs. Overall, none of the 24 articles identified in this study described sustainability as a programmatic outcome. However, a majority of studies reported on programmatic and organizational factors that facilitated program sustainability.
In the second study, qualitative interviews with 24 managers of pipeline programs were utilized to explore how they conceptualize and plan for sustainability as well as the barriers and facilitators to sustainability they encountered. Overall, there was significant heterogeneity in how respondents conceptualized sustainability. Furthermore, few program managers had created plans to ensure program sustainability.
Lastly, the third study is a case study of a single pipeline program located in a school of medicine that has been able to sustain its pipeline program over the last two decades despite multiple organizational threats. Findings of this study indicated that the program was able to maintain operation despite not having a plan for sustainability. This was due in part to committed program staff, supportive senior leaders, and adaptable policies and procedures.
Overall, these studies provide insight into the multitude of factors that influence pipeline program sustainability. This research also emphasizes the need to build the capacity of stakeholders responsible for pipeline program implementation to engage in long-term sustainability planning.
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