Successfully Training and Educating Pre-medical Students (STEPS)
- Need: To increase the number of primary care providers in northeast Kentucky.
- Intervention: STEPS provides support such as physician shadowing, mock interviews, and MCAT practice exams for regional students applying to medical school.
- Results: Approximately 70% of participants have been accepted into medical school. The program has been replicated among all of Kentucky's regional AHECs.
Evidence-levelPromising (About evidence-level criteria)
In northeast Kentucky, almost half of the counties are considered Health Professional Shortage Areas (HPSAs) for primary medical care. In addition to low numbers of its students applying to medical school, the region has seen less than 30% of its applicants accepted into an in-state medical program.
In order to encourage local students to pursue medicine at Kentucky's three medical schools, the Northeast Kentucky Area Health Education Center (NE KY AHEC) created the Successfully Training and Educating Pre-medical Students (STEPS) program in 2013. STEPS supports pre-medical students in the Appalachian region as they apply for medical school.
Through STEPS, the NE KY AHEC partners with the three medical schools in Kentucky, which provide annual county-level data on applicants and matriculants. From 2013 to 2017, STEPS was almost entirely self-funded by the NE KY AHEC.
Pre-medical students attending college in northeast Kentucky or with a permanent address in the region are encouraged to apply for the STEPS program. Interested students must complete the following:
- Be enrolled in certain math and science courses
- Complete an online application
- Write a personal essay no longer than 500 words
- Submit a letter of recommendation from a professor
From 2013 to 2017, an average of 10 applicants were selected each year. After the NE KY AHEC received a state contract to expand and replicate STEPS, the number of participants per year was increased to 15 beginning in 2018 and the number of applicants was 21 and 20 for the 2019-20 and 2020-21 cohorts, respectively. Once accepted into the STEPS program, participants attend about 6 meetings, take an online Medical College Admission Test (MCAT) preparatory course, and receive:
- Medical school application process tutorials
- Weekly MCAT reviews
- MCAT practice exam(s)
- Mock interviews
- Personal statement writing workshops
- Physician shadowing in multiple specialties
- Other activities that will help pre-medical students prepare for medical school
From 2013 to 2015, a total of 28 students participated in STEPS, 25 of whom met all program requirements. Of these 25 participants, 22 were accepted by a medical school (21 to schools in Kentucky and one to West Virginia); this success rate of 88% exceeded the program's original goal of 70%.
On average, students' MCAT scores were 4.6 points higher than their practice scores in 2014. In 2015 and subsequent years, average MCAT scores have been approximately 7.6 points higher than practice scores.
There were 12 participants in STEPS' 2017-18 cohort. Of this group, 11 students matriculated to a Kentucky medical school in fall 2019. There were 15 participants in STEPS' 2018-19 cohort. Of this group, 10 students matriculated to medical school in fall 2020, with only one of these students going out of state.
As further evidence of STEPS' success, the NE KY AHEC has received a second two-year contract (July 2020-June 2022) from the Kentucky Primary Care Office to replicate various aspects of the program among the state's seven other regional AHECs, most of which had no prior pre-medicine preparation programming. After participating in 2018-19, the NE KY AHEC started its own pre-medicine prep program for the 2019-20 academic year.
Continuation of the statewide MCAT Project allows Kentucky's regional AHECs to track the results of previous years' pre-medicine prep participants. Most students participate as college juniors, so obtaining 2020 in-state medical school matriculation data allowed the AHECs to assess the results of 2018-19 pre-medicine prep participants:
- 36 of 59 pre-medicine prep participants (61%) supported by the Kentucky Primary Care Office during 2018-19 matriculated to medical school in fall 2020.
- 31 of these 36 matriculants (86.1%) are attending a medical school in Kentucky.
Program coordinators presented STEPS and their county-level medical school data tracking initiative at the 2015 and 2017 National Rural Health Association annual conferences, the 2016 National AHEC Organization biennial conference, and a 2018 HRSA Region IV Workforce Forum.
Due to the success of STEPS, the NE KY AHEC also was presented with the Center of Excellence for Distribution Award at the National AHEC Organization's 2018 conference. The award recognizes an AHEC program that is improving healthcare workforce distribution throughout the nation, particularly among rural and underserved areas and populations.
For more information:
Gross, D.A., Mattox, L.C., & Winkleman, N. (2016). Priming the Physician Pipeline: A Regional AHEC's Use of In-State Medical School Data to Guide Its Health Careers Programming. Journal of Health Care for the Poor and Underserved, 27(4A), 8-18. Article Abstract
STEPS coordinators initially had difficulty filling the slots each year with students only from northeast Kentucky, so they have accepted some students from the regional university who live in other areas. This was not the case in 2017, however, so program coordinators are hopeful that word of mouth about the program's successes has begun to spread to all pre-medicine students, including a higher proportion of those who are originally from northeast Kentucky.
The online MCAT preparatory course costs $2,300 per student. While the NE KY AHEC receives a discount that reduces this figure to $1,300 per student, the remaining cost is still a significant barrier for many. To overcome this barrier, the NE KY AHEC pays $1,000 per student, and each student pays the remaining $300.
In addition to rolling out the program content, the NE KY AHEC is assisting the other Kentucky AHECs with tracking applicant and matriculant data by county or medical school. This type of data collection can help AHECs determine which counties have the fewest applicants and, in response, target their efforts to encourage more students from underrepresented counties to pursue medical careers.
The NE KY AHEC also offers the Summer Health Internship Program (SHIP), which places students in six-week paid internships in local health organizations. This program helps students gain experience in the healthcare field and encourages them to work in the region after graduation. To date, all students (approximately 15) who have completed both STEPS and SHIP have matriculated to a Kentucky medical school.
Contact InformationDavid A. Gross, Director
Northeast Kentucky Area Health Education Center
Health workforce pipeline
November 29, 2016
Date updated or reviewed
November 4, 2020
Suggested citation: Rural Health Information Hub, 2020. Successfully Training and Educating Pre-medical Students (STEPS) [online]. Rural Health Information Hub. Available at: https://www.ruralhealthinfo.org/project-examples/938 [Accessed 12 May 2021]
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