In the spring of 2013, Jemima Akinsanya, DO, then a first-year medical student at TouroCOM—NY, was tutoring a local high school sophomore through MedAchieve, a medical science enrichment program at TouroCOM for local high school students. She saw that this student was bright and ambitious but lacked a clear road map to achieve her goals. Around the same time, Dr. Akinsanya had also spoken with classmates about their paths to medical school. These conversations illuminated some of the difficulties URM students experience in obtaining useful guidance on the college and medical school path. Dr. Akinsanya thought that starting a program to help future minority students might also help those already enrolled at TouroCOM—NY by providing a stronger support system. With this in mind, the seeds of COMPASS were planted. 

The need for recruitment work was critical. During academic year 2013, the nationwide percentage of URM student matriculants at osteopathic medical schools was only 6%; ¹² this was among the reasons that TouroCOM—NY made an institutional commitment to recruit URM and promote cultural competency for all students. After a few recruitment initiatives, such as emails and phone calls to minority candidates, Dr. Akinsanya received positive feedback from the prospective student participants. The feedback from the prospects included informal email and verbal responses that her communications made them feel welcomed at and positive about TouroCOM—NY. Motivated by the positive response, Dr. Akinsanya and her peers set out to make COMPASS a part of the college’s admission process. 

In 2015, COMPASS student interest group leaders searched for creative ways to engage in the admissions process while enhancing their efforts toward recruitment of minority students. COMPASS leaders looked for a path that would ensure continued support while also providing a specific role in the college’s admission recruitment cycle. In 2016, COMPASS began an energetic peer-to-peer program with specific goals and strategies. Working collaboratively with the Dean of Student Affairs office, the COMPASS welcoming program brought minority student prospect candidates from the application cycle together with current TouroCOM—NY URM medical students. 

Utilizing the American Association of Colleges of Osteopathic Medicine’s Application Service (AACOMAS), an invitation was sent to students who self-identified as URM applicants to the COM on behalf of the COMPASS program. COMPASS student leaders organized an agenda for a single in-person welcoming program specifically for invited applicants. The Office of Student Affairs provided funding for refreshments through a specific budgeted allocation for student activities. The program was student-led and did not include administration or admissions officers. Student leaders were instructed to refer specific questions related to a candidate’s academic/admissions standing to admissions officers, which kept the focus of events on providing a social, supportive, and welcoming atmosphere. TouroCOM admissions materials were also distributed; these included information about admissions requirements, processes and procedures, and the principles of osteopathic manipulative medicine (OMM), as well as Touro-branded promotional materials (e.g., t-shirts, pens, bags) typically distributed during recruitment. COMPASS leaders also invited other TouroCOM student leaders representing the Student National Medical Association, Latino Student Medical Association, and the Student Diversity Committee to participate in the welcoming event on campus. Again, the event focused primarily on answering questions about student life and providing applicants with direct exposure to URM students currently attending TouroCOM—NY. The rationale for this approach was that by fostering a positive social atmosphere with current minority medical students with whom they could relate, prospective minority students could envision themselves as potential members of TouroCOM—NY. From an admissions perspective, this was an important strategy in reassuring URM students that they could “accept” us. 

From 2015 to 2018, approximately 700 invitations were sent each year through the AACOMAS system. A mean of 33.4 candidates accepted the invitation each year (range, 24–42 candidates), typically students already living in the New York, New Jersey, and Connecticut tristate area. A total of 124 (74.3%) respondents attended COMPASS events from 2015 to 2018 (Table 1). Beginning with the graduating class of 2020 (enrollment year 2016), our URM student enrollment has steadily increased at TouroCOM (Table 2). The Mann-Kendal test of trend for URM matriculation over time was tau=0.5 with p=0.022, indicating a significant upward trend regarding the matriculation of URM students to TouroCOM—NY. Statistical comparisons were made with R version 3.4.4 (2018-03-15) (Microsoft, Mountain View, CA). 

The issue of matriculation in medical school is a complex, multifactorial process. The addition of the COMPASS program helped to change the atmosphere on campus, adding a sense of belonging that was difficult to promote prior to this type of activity. As the COMPASS program began with the class matriculating in the fall of 2016, only one cohort of students who participated in the COMPASS program has graduated. Of the 25 students who attended the inaugural COMPASS event, two students matriculated into TouroCOM—NY; one graduated with the Class of 2020 and one is expected to graduate with the class of 2021. As more cohorts complete their education, we will be able to provide comprehensive data on student performance. 

The most valuable lesson we have learned is that it is not enough to simply recruit diverse candidates—the environment on campus must also mirror that diversity and provide opportunities to connect with faculty who can provide necessary mentorship. A candidate’s decision to attend medical school, and subsequently selecting an appropriate school, are among the most life-changing decisions an applicant can make. The COMPASS program has helped revitalize the energy at TouroCOM—NY for URM applicants and help them assess its appropriateness for them. 

The process of applying to medical school can be daunting, particularly for first-generation and economically-disadvantaged students. ¹³ A lack of access or exposure to mentors in the healthcare professions heightens the sense of uncertainty about successfully applying to medical school. ¹⁴ Often, students have questions that are difficult to address during the traditional interview day. Therefore, creating a welcoming environment during the COMPASS event, void of the pressure to perform in front of an interviewer, was a well-received effort for applicants and enabled them to ask questions and interact with current URM medical students. 

Research about URM students who attend predominantly White institutions (PWI) indicates that these students feel a sense of loss after matriculating to a campus that is less diverse than they expected. ¹³ In such instances, the belonging uncertainty theory provides needed context through heightened levels of the imposter syndrome when a student subconsciously forms the impression that they are not meant to be there. ¹⁵ This feeling further affects their ability to form the necessary relationships with other students, faculty, and administration—the very relationships that are critical to success. ¹⁶ As it pertains to mentorship and within the context of academic achievement, at-risk students who participate in co-curricular activities and feel socially integrated dropout of school less. ¹⁵ Students who have trusting relationships with mentors are better able to take advantage of critical feedback and other opportunities to learn. ^{17, 18} At TouroCOM—NY all matriculated students are assigned a faculty mentor at the time of enrollment. This early introduction to a faculty mentor provides a foundation for a relationship that is used for guidance on academic progress, clinical advancement, and long-term career trajectory. Faculty mentors also play a significant role in advising medical student organizations that are structured around particular specialty interest. 

People of color, ¹⁹ first-generation college students, ²⁰ and women ²¹ may experience difficulties academically because they feel anxious about confirming negative social beliefs or stereotypes about their groups. These stereotypes are more powerful when students feel that they are not welcome in a community. Yet reassuring students that they indeed belong in a group protects them against negative stereotypes, allowing them to learn more, earn better grades, and even avoid illness. ¹⁶ Understanding the larger effect of the belonging uncertainty theory on an applicant’s perception of the school environment, additional keys to success in the recruitment of URM applicant were added to the TouroCOM interview day. These strategies were implemented outside of the COMPASS welcoming event and are specific to the admissions interview day. First, during admissions interview day, steps are taken to ensure that the student ambassadors who greet the students on interview day are as diverse as our student body. Second, additional effort is placed on ensuring that applicants interface with faculty and executive administration who further reinforce our campus diversity. In combination, these collective efforts create a comfortable, diverse environment that eases the stress of interviewing for medical school. 

While the COMPASS peer welcoming program is an attractive draw for candidates in the application cycle, it is not the only method by which minority students matriculate into TouroCOM—NY. The school’s Master’s program in Biomedical Sciences is a pathway program into our medical school and contributes approximately 20% of our incoming class each year (Table 2). The program is designed to offer students the opportunity to demonstrate that they can succeed with advanced-level science work. Students who are successful, earning a 3.50 GPA or better, are offered guaranteed admission into TouroCOM. 

COMPASS is a volunteer student initiative that assists solely with student recruitment. To address the ongoing needs of URM students after they matriculate, the TouroCOM—NY director of diversity, the Student Government Association’s Diversity Task Force, and other student organizations (including the aforementioned Student National Medical Association, Latino Medical Student Association, and Muslim Medical Student Organization) lead student efforts around diversity and inclusion on campus. 

Successful recruitment of URM applicants requires a variety of approaches, such as ensuring that prospective medical school students have opportunities to interact with current URM students, faculty, and administration who reflect diversity. Pathway programs also serve as a way to enhance the opportunities for prospective medical students. These programs help students recognize their academic capacity and provide the college with an assessment their potential for success. A student-led program like COMPASS that helps welcome and support applicants, allowing them to socialize with URM students, can also provide a greater understanding of the medical school’s culture. We recommend that all colleges of osteopathic medicine explore their current efforts to recruit prospective URM students and consider additional efforts that would be effective in their local community.