Diversity In Research Study Group Inspires Student Research Collaborations

“Through this study group we are creating a supportive framework not just for diversity-related research but for all student research,” said Mill Etienne, M.D. '02, M.P.H., vice chancellor for diversity and inclusion at NYMC and associate dean of student affairs and associate professor of neurology and of medicine in the School of Medicine (SOM). “A major reason we want to see this move forward is because students who engage in research are more likely to go into academic medicine in the future, and we want to create that pipeline. It’s also an excellent way to increase the numbers of Black and Hispanic men in medicine and the numbers of women in medicine—groups that are underrepresented. By creating these opportunities, we are further engaging these students and patching the holes in the pipeline.”

The resulting collaborations have been well received with research projects focused on a wide variety of topics across multiple specialties already accepted and published in academic and scientific journals and presentations at regional, national and international conferences.

“Recently, students presenting their research at the New York State Neurological Society Annual Meeting were approached by an editor from a major journal who was interested in publishing their research and invited them to write manuscripts to submit,” said Dr. Etienne.

While the group itself is interdisciplinary in nature and students can choose any research topic, research related to health care disparities and lack of diversity in clinical trials is a particular focus of the students in the group because it’s often not as well documented yet represents a critical need for clinicians to properly treat a diverse population.

“As medical students, we think about what impact this research has on clinical management. As future clinicians, we need to be able to explain to patients of increasingly diverse populations how medications may work for them but how can we do that if we don’t have that information because of a lack of diversity in clinical trials. Though there have been improvements, certain demographics continue to be underrepresented. The research projects being conducted work to highlight that,” said Maya Pandit, SOM Class of 2023, one of the student leaders of the study group, who along with Ebtisam Zeynu, SOM Class of 2023, has been working on a research project focused on racial disparities among migraine clinical trials. A variety of results from their ongoing analyses have been presented at  several conferences, including the American Neurological Association and American Public Health Association annual meetings.

“In clinical trials for stroke for example, there is a drastic under recruitment of Black participants, when we know this disease disproportionately impacts African Americans. We see trials being conducted on diseases that mostly affect women where the plurality of participants are men, said Dr. Etienne. “So basically, treatments are being developed that aren't necessarily being tested on those most impacted by a disease, so we don't even know if that treatment works for that population or adequately accounts for social factors that may interact with the disease and treatment. This disparity needs to be revealed if change is to occur. Race, gender and ethnicity must be factored into these trials if we are to develop effective treatments.”

Currently, the research study group boasts students from a wide range of demographics. The group takes advantage of the various students’ skill sets to form research teams. Students more interested in data gathering or writing focus on those areas of the research project, while students with a stronger biostatistics background focus on the data analysis, for example. This has inspired a strong collaborative aspect to the research projects. Fourth year students run small group workshops to train students on how to generate a hypothesis, study design and methods, PRISMA guidelines, data analysis and abstract preparation. Students also receive training and mentorship on the IRB submission process.

“As the number of students has grown, and the spectrum of their interest has spread, specialty leads now manage all projects within a specialty, with each project spearheaded by one student lead who then recruits fellow students to be involved. Having peer mentors and having other students teach you is a particularly good aspect to the study group,” said Schan Lartigue, SOM Class of 2024, who presented on the study group at the national AAMC Learn, Serve, Lead Conference in mid-November.

“We are not only learning so much about diversity in medicine but also about working together, taking each other's ideas into account and considering how we can support each other,” said Pandit. “It's a very collaborative and supportive group where there’s a comfort level that goes beyond the research and extends to open and honest communication about diversity and inclusion.”

“Often students’ discomfort with discussing these topics is a major barrier to them engaging in discussions, but we've been able to bring together a diverse group of students who are not only comfortable interpreting our results with each other but also during question-and-answer sessions with large audiences at conferences, and that's a really special skill that we're developing from this work,” said Pandit.

The study group has also attracted interest from students at other medical schools, including Columbia University, Yale University, the City University of New York (CUNY) and Albert Einstein College of Medicine. Jason Morency, a rising third-year medical school at the CUNY School of Medicine, serves as research coordinator of the study group and leads several research teams. He recently completed his own research project with a student from the Idaho College of Osteopathic Medicine on race and sex disparities in stroke clinical trials, which was presented at the American Medical Association Research Challenge, Medscapes LIVE: Neurology Exchange and the World Stroke Congress.

“It is exciting to see the direction this research group is going. Recently, while presenting at my school’s research day, people approached me to tell me that they thought this work could impact clinical trials and journal requirements moving forward. The first step is exposing these disparities and now we are in control of how far this could go,” said Morency.

As more of these studies focusing on disparities in clinical trials are published, drug companies are taking notice and working to recruit more diverse participants for clinical trials.

“This type of research opens the way for more advocacy in this area as well,” said Dr. Etienne. “For example, by pushing journals to make it more of a requirement that to be published there be a diverse group of participants in the study. This is why it is important to have a diversity of students involved in research because when someone does the analysis and interpretation, they need to understand the nuances of that community so when they write the paper, it makes sense.”

Ultimately, the goal of the study group is to support all medical students to become better researchers.

“It’s important for everybody to be involved in diversity-related research, because no matter the institutions that these students go to next, and especially when they become attendings, we want them to be comfortable navigating diversity and inclusion and mentoring and leading discussions on these topics,” said Dr. Etienne. “In the end, the goal is to actually improve patient care by demystifying people from different races, genders, ethnicities, abilities, so as clinicians the students feel more comfortable working with those patients and so that their patients are  humanized for them, and they don’t just see them as an ‘other.’”