The University of Missouri-Columbia post-baccalaureate research education program (MU PREP) is now in its 12^th year of operation.  With its strong emphasis on the development of students who would not otherwise be in the upper levels of the biomedical career track, successful applicants to the program are required to demonstrate high motivation to pursue doctoral study, but lacking in the requisite skill sets to be considered for admission into a competitive doctoral program in the biomedical sciences. Once admitted, MU PREP Scholars participate in a program regimen that addresses weaknesses in preparation, usually through enrollment in first year graduate course(s) and participation in a meaningful research experience.  MU PREP Scholars also participate in a weekly course designed to enhance professional communication skills as well as targeted preparation for the graduate school application process. While the program is designed to be successfully completed in one year, it is not uncommon for MU PREP Scholars to appeal for a second year of study.

In 2009, the MU PREP program leaders decided, as part of the application renewal process, to implement a more intense mentoring approach. The rationale for this shift was twofold: 1) while cultural sensitivity and solid support structures are critical components of the program, the leaders of the program were also sensitive to the unintended consequence of dependence on such supports by trainees; 2) professional success at the doctoral level is often predicted by “degree quality” as is often measured by levels of productivity, quality of networking circles, and training pedigree. As such, the program was modified to have an intense mentoring structure that prioritized rigor in training and an emphasis on developing cultural capital and identity as a successful scientist. During their first year, MU PREP Scholars receive very critical real-time feedback on their performance in venues such as journal clubs and snap research presentations within PREP group meetings. This critical feedback extends to regular individual meetings with a research mentoring committee and program leaders where all aspects of their performance in the program are discussed. Program expectations are mapped to Scholar performance with an emphasis on the development and performance consistent with maturity in scientific thought, behavior and performance. MU PREP Scholars expressed being overwhelmed in the first year, but scholars were in agreement with research mentors and program leaders that by the second year they had gained experience and confidence.

MU PREP Scholars reported in evaluation interviews and focus groups about being pushed almost to their limit in the journal club, and often being recipients of “tough love” in one-on-one and committee meetings. In hindsight (during the second year), they see how much those experiences challenged them and encouraged personal and professional growth. They came across as seasoned and much more senior when observed alongside second-year graduate students in joint focus group interviews. The shift in mentoring strategy was also evident in the program outcomes. Prior to the change in mentoring model, MU PREP Scholars were successful in making the transition to doctoral programs (93%), but were often placed in programs at mid-tier institutions.  After the shift in mentoring approach, MU PREP Scholars are more typically placed in higher-tier institutions (Hopkins, UPENN, UNC Chapel Hill, U, of Michigan etc.) to the extent that MU has considerable more difficulty retaining its own PREP Scholars in MU graduate programs. For MU PREP Scholars who completed the PhD, time to degree averaged 5.9 years with 3.4 average numbers of publications (median 2, high 11).

University of Texas Health Science Center at San Antonio (UTHSC-SA) is one of the country’s leading health sciences universities with its ranking in the top 3 % of all institutions worldwide receiving NIH funding. Located in the city with the largest Hispanic population (807,000) that comprises 60% of its residents, UTHSCSA faced significant challenges in the diversification of its student population in its Graduate School of Biomedical Sciences (GSBS) where six years ago, only 12% were from underrepresented (UR) groups in STEM.  Additionally, the program faced attrition of 40% of UR students who left the program in the first year, primarily for academic reasons. Of the remaining 60% that persisted, time to degree was delayed about a year compared with non- URM peers.

A series of interventions were employed to address these issues. Interventions included a strategic change in recruitment, the development of three pre-matriculation courses, individualized mentoring, tutoring and remediation programs (if needed), boot camp and community/cohort building interactions. Mentoring played a pivotal role in the development of these students.  Starting with peer mentors upon acceptance of the offer, 2 faculty mentors from the admission committee, the IMSD program director students are very carefully mentoring throughout their graduate careers.

In the first year of the new recruitment plan, 8 of the 42 matriculating students (19%) were URM, up from 12% in the previous year.  By 2011, the first year of the NIH funded IMSD program, the percentage of UR students applying to the integrated graduate program had increased with 42% of matriculated students coming from UR groups.  Undergraduate grade point average (GPA) of matriculating UR students has improved steadily over the duration of the grant registering 3.52 in 2014 (up from 3.05).  Of the 22 scholars who have been appointed to the IMSD grant, 50% completed the mandatory, 8 credit hour first year core course with a grade of “A”. None required remediation of the first year core course.  The first IMSD student defended his dissertation in April 2015 with a time to degree of under 4 years.

The interventions that guided the dramatic improvements in the recruitment, retention and persistence of IMSD scholars have now been adopted institutional wide by the graduate school at UTHSC-SA. The Boot Camp activity that was piloted in the IMSD program has been adopted as part of the IMGP program and is now slated to be incorporated as standard across the graduate school. The UTHSC-SA IMSD program continues to have a significant institutional impact with the recent reorganization of the graduate school curriculum that will incorporate many of the practices that first saw success in the UTHSC-SA IMSD program.