A Conceptual Framework for Exploring the Experiences of Underrepresented Racial Minorities in Pharmacy School

Working environment for historically marginalized faculty, administrators, and librarians in pharmacy education

INTRODUCTION

Promoting diversity among faculty, administrators, and librarians in schools and colleges of pharmacy (SCOP) would be beneficial for the recruitment and retention of students from diverse backgrounds. Graduating such diverse pharmacists could assist in reducing healthcare disparities. Promoting diversity requires a climate that is inclusive of people from all backgrounds. The goal of this study was to examine the working environment of historically marginalized faculty, administrators, and librarians within pharmacy education.

METHODS

An electronic survey was administered to all faculty, administrators, and librarians listed in the American Association of Colleges of Pharmacy roster.

RESULTS

Responses from 339 participants were analyzed. Twenty-seven percent of these participants either observed or personally experienced misconduct during the previous five years. When action was taken, it resulted in the cessation of the misconduct only 38% of the time. Respondents most frequently identified the following as ways to make it easier to address misconduct: support from supervisors, support from peers, and education on how to address misconduct.

CONCLUSIONS

Exclusionary, intimidating, offensive, and/or hostile communication/behaviors towards historically marginalized faculty, administrators, and librarians do exist in SCOP. The academy should work towards promoting diversity, equity, and inclusion in SCOP through education and provide administrative and peer support for reporting and managing professional misconduct.

Minority Student Perceptions of the Impact of Financial Cost of Pharmacy School and Career Choice at a Historically Black College and University (HBCU)

OBJECTIVE

One of the barriers that might prevent an underrepresented minority (URM) individual from pursuing a professional career in the United States is finances. The high disproportionate burden of student debt among URM students further perpetuates the racial wealth gap. Therefore, this study sought to evaluate the extent to which URM students' personal finance perceptions, and current and projected student loan indebtedness affect postgraduation career intentions.

METHODS

A cross-sectional analysis was conducted using data from four cohorts of pharmacy students using a survey from November 2, 2022, to February 1, 2023. The financial perception survey included subscales namely personal finance self-efficacy, debt influence and pressure, and risk mitigation and retirement. Descriptive statistics, simple logistic regression, and multivariate logistic regression analyses were conducted.

RESULTS

In total, 93 students completed the survey and had a mean age of 28.1 ± 5.3 years. Seventy-one percent of the respondents were female, and 67.7 % had completed a 4-year bachelor's degree. There was a significant association between age and the intention to pursue postgraduate training as well as a significant association between risk mitigation and retirement perceptions and intention to pursue postgraduate training after adjusting for other factors.

CONCLUSION

Among students from largely minority backgrounds, age, and confidence in their ability to make wise investment decisions for retirement are associated with a greater likelihood of pursuing postgraduate training opportunities.

From Desegregation and Integration to Diversity and Inclusion: The Environment Was Just Ice

The process of desegregation at Southern schools of pharmacy was long and arduous. Despite persistent protests, struggles, and lawsuits, many schools of pharmacy did not graduate their first Black students until the 1970s. The School of Pharmacy at the University of North Carolina at Chapel Hill unintentionally desegregated in 1962 when its first Black student, William Wicker, was inadvertently admitted. His personal story and those of his fellow pioneers in desegregation, Mona (Boston) Reddick and James Barnes, provide valuable context to Diversity, Equity, and Inclusion efforts. The historical proximity of desegregation affords the pharmacy profession only one or two generations of Black pharmacists trained during an era when Southern pharmacy education was broadly available. These stories personify the legacy of segregation, confront the ongoing impact of structural racism, and meaningfully inform conversations about Diversity, Equity, and Inclusion in pharmacy education.

Understanding faculty perceptions and experiences related to climate, diversity, equity, and inclusion at a college of pharmacy: A pilot study

INTRODUCTION

A climate survey was piloted to obtain an understanding of the perceptions and personal experiences of faculty for intentional planning of future meaningful, effective, and sustainable diversity, equity, and inclusion (DEI) efforts at a college of pharmacy.

METHODS

A 48-item, four section, online survey was developed and administered to 69 faculty between October and November 2021. Likert-like five-point scales and free-text items were included to determine an overall assessment of climate, as well as perceptions and/or personal experiences for each domain of DEI, and demographics.

RESULTS

Thirty-nine (57%) faculty completed the survey. For climate, every attribute had at least one respondent that observed someone make an insensitive or disparaging remark "rarely," "occasionally," and "frequently." The response pattern was similar for personal experience with insensitive remarks. For participation in diversity activities, "awareness without participation" was selected by 56% of respondents. For perceptions of diversity, "fairly" or "very" was selected by 38% to 54% of respondents. For equity, "attainable for some" to "not attainable" was identified for 15% to 26% of respondents.

CONCLUSIONS

These pilot climate survey results inform climate improvement as it relates to DEI and informs survey instrument refinement.

Analysis of Gender and Race in Pharmacy Faculty and Administrators

OBJECTIVE

The objective of this report is to identify and characterize the relative likelihood of women and racially minoritized pharmacy faculty being promoted, advancing within leadership roles, and earning comparable salaries.

METHODS

Data from the 2010-2021 American Association of Colleges of Pharmacy Profile of Pharmacy Faculty surveys were analyzed to compare odds ratios for promotion, leadership roles, and salary gaps of pharmacy faculty according to race and gender. Changes in the odds ratios over time were characterized by linear regression and predictions about when and if equality would be achieved according to current trends were calculated.

RESULTS

Compared to White male counterparts, faculty identifying as women, Black, Hispanic, or Asian had a significantly lower odds ratio of promotion to associate or full professor. Women and Asian faculty also had a lower likelihood of promotion from assistant to associate or Chief Executive Officer (CEO) dean. No demographics studied were more likely than White men to advance in rank or attain associate or CEO dean leadership positions. Furthermore, negative salary gaps for women emerge after promotion from assistant professor, becoming significant and continuing to widen at the associate (-$20,419) and CEO dean (-$37,495) level.

CONCLUSION

Despite attention to matters of diversity, equity, and inclusion, female and racially minoritized faculty continue to experience lower rates of promotion, leadership advancement, and wages compared to White male colleagues. These results have negative consequences for recruiting and retaining talented faculty and students, and compromise the benefits that a diverse faculty is known to provide on student learning outcomes.

The Influence of Intersectionality on Professional Identity Formation among Underrepresented Pharmacy Students

OBJECTIVE

The objective of this study is to explore professional identity formation (PIF) among student pharmacists from underrepresented groups (URGs).

METHODS

In this qualitative study, 15 student pharmacists from the University of Georgia and Midwestern University Colleges of Pharmacy were recruited for interviews to explore the influence of intersectionality of race, ethnicity, and gender on PIF. Interview data were analyzed using constructivist grounded theory to identify themes and then further analyzed using Crenshaw's theory of intersectionality, namely structural, political, and representational intersectionality.

RESULTS

Intersectionality of identities created situations where participants expressed advantages belonging to certain social categories, while simultaneously being disadvantaged belonging to other social categories. This awareness led to strategies to overcome these collective obstacles for themselves and their communities. Participants then described ways to shift perceptions of how society depicts pharmacists and the pharmacy profession. The results depict these processes and how intersectionality influences PIF for URG student pharmacists.

CONCLUSION

The sociocultural aspects of race, ethnicity, and gender influence the PIF of student pharmacists who belong to URGs. Intersectionality helps us better understand the ways in which inequality compounds itself, and this results in URG student pharmacists creating opportunities for belongingness and representation. Resultantly, URGs create opportunities for inclusivity and representation. To continue to facilitate this it is essential for educators and university systems to promote ways to foster and incorporate PIF in student pharmacists.

Envisioning the Future of Student Success: Report of the 2022-2023 AACP Student Affairs Standing Committee

Over the past several years, traditional metrics have indicated declining student success within colleges and schools of pharmacy. Though students may be less well-prepared for professional school than in years past, once candidates are admitted to our institutions, we have a responsibility to effectively support their progression through the program. The 2022-2023 Student Affairs Committee was convened to evaluate and advance the construct of student success within Doctor of Pharmacy programs. The Student Affairs Committee was charged with identifying environmental factors affecting the ability of pharmacy students to be successful; determining how colleges and schools of pharmacy are currently meeting needs related to student progress; conducting a literature review to determine what academic support measures minimize attrition; and developing innovative suggestions and recommendations that better support student success. To accomplish this work, we conducted an extensive literature review and synthesis of evidence, engaged in professional networking across the Academy, and administered a wide-ranging student success survey to all colleges and schools of pharmacy. In this report, we explore the complex and interacting systems that affect learning behavior and academic success and offer a novel, comprehensive description of how the Academy is currently responding to challenges of academic and student success. Additionally, we envision the future of student success, offering 7 recommendations to the American Association of Colleges of Pharmacy and 5 suggestions to members of the Academy to advance this vision.

"Following your dreams, and not killing yourself to do so": Black PharmDstudent perceptions of pharmacy residency

OBJECTIVE

Residency training is a key element of advancing the roles of pharmacists in patient care. Diversifying the healthcare workforce is also crucial in reducing health disparities and improving health equity.¹ The objective of this study was to investigate Black Doctor of Pharmacy students' perceptions of pursuing pharmacy residency training to aid pharmacy educators in creating and improving structures to support the professional advancement of Black student pharmacists.

METHODS

A qualitative study employing focus groups was conducted at one of the top 20 colleges of pharmacy. Four focus groups consisting of Black students in years 2 through 4 of the Doctor of Pharmacy program were organized. A constructivist grounded theory approach2 was utilized to collect and analyze the data, which was organized into a conceptual framework.

RESULTS

The elements of the framework developed showcase Black students' consistent negotiation between personal well-being and pursuit of professional advancement. This framework also highlights how the experience of navigating personal wellness is unique for Black students, rather than simply a work/life balance concern.

CONCLUSION

The concepts in this framework may be valuable for colleges of pharmacy seeking to increase diversity in their residency pipeline. Targeted interventions to ensure adequate mentorship, mental health resources, diversity and inclusion efforts, and financial support will be necessary if the profession truly desires to expand increased diversity in clinical pharmacy.

Considering the Intercultural Development Inventory (IDI) to Assess Intercultural Competence at U.S. Pharmacy Schools

BACKGROUND

U.S. pharmacy schools need to engage in improving intercultural competence among administrators, faculty, staff, and students. The Intercultural Development Inventory (IDI) can be a possible tool to determine the level of intercultural competence. U.S. pharmacy schools need to examine the validity of the IDI within the context of health professional education prior to using this tool.

OBJECTIVES

To describe the relationship between the IDI and its underlying theory, identify whether the validity of the IDI has been established within two specific contexts, and discuss the practical issues and implications of using the IDI.

METHODS

Medline, Embase, and selected health professional education journal websites were searched to identify fully published studies utilizing the IDI within health professional education. Eligibility of articles was determined with a standardized approach.

RESULTS

Ten studies were identified by full-text reviews, but none investigated the validity of the IDI.

CONCLUSIONS

The IDI has been shown to be valid in certain contexts, but its validity has yet to be confirmed within health professional education. U.S. pharmacy schools need to examine practical issues and implications when deciding if the resources required to administer, analyze, and report IDI results are reasonable.

Identifying predictors of generalized anxiety among student pharmacists in response to the COVID-19 pandemic

INTRODUCTION

To explore the prevalence of generalized anxiety (GA) among doctor of pharmacy (PharmD) students at an academic institution during the COVID-19 pandemic and use Alderfer's existence, relatedness, and growth (ERG) theory to elucidate which unsatisfied needs are predictive of higher levels of GA symptoms.

METHODS

This was a cross-sectional, single-site survey administered to first- through fourth-year PharmD students from October 2020 to January 2021. The survey tool included demographic information, the validated Counseling Center Assessment of Psychological Symptoms-62 tool, and nine additional questions developed to assess Alderfer's ERG theory of needs. Predictors of GA symptoms were evaluated using descriptive statistics, multiple linear regression, correlation analysis, and multivariable analysis.

RESULTS

A total of 214 of 513 students completed the survey (42%) . Among students, 49.01% had no-clinical, 31.31% had low-clinical, and 19.63% had high-clinical GA symptoms. The relatedness needs, which included feeling disliked, socially disconnected, and misunderstood had the strongest correlation (65%) to GA symptoms and was most associated with GA symptoms (β = 0.56, P < .001). Students who did not exercise experienced more symptoms of GA (P = .008).

CONCLUSIONS

Over 50% of PharmD students met clinical cut-offs for GA symptoms and the relatedness need was most predictive of GA symptoms among students. Future student-centered interventions should aim to create opportunities that increase social connections, build resilience, and provide psychosocial support.

Five Essential Steps for Faculty to Mitigate Racial Bias and Microaggressions in the Classroom

Educators must recognize the pharmacy curriculum itself is an instrument that can propagate or discourage systemic racism. The role of pharmacy education in disseminating racial bias through didactics deserves further consideration. While microaggressions have begun to be acknowledged in the pharmacy learning environment, specific guidance on mitigating racial microaggressions in the classroom has not been provided. This paper aims to suggest actionable strategies pharmacy educators may use to mitigate or prevent these negative classroom experiences. As such, it combines five experiences of racial biases and microaggressions in the classroom with suggested action items in a practical guide for pharmacy faculty members. It is our hope that this commentary will challenge faculty to self-assess their teaching, with the aim of preventing racial biases from propagating and creating better learning environments for future pharmacists.

Addressing racism in respiratory therapy educational programs: An integrative literature review

INTRODUCTION/BACKGROUND

The impacts of racism on the experiences of under-represented minorities in health education programs such as respiratory therapy can impede the ability of these students to succeed in these programs and in the healthcare workplace. This can exacerbate the discrepancy between the racial diversity of the healthcare workforce and that of the population that they intend to serve.

METHODS

An integrative literature review was conducted to examine and integrate the published literature that describes how racism is expressed and addressed in health education programs and in healthcare workplaces.

RESULTS

Thirty-one studies were reviewed that included a variety of allied health professions. Racial discrimination in these programs is characterized as racial stereotyping, micro-aggressions, significant cognitive and emotional burdens, socio-economic challenges, and organizational impediments. Individual coping strategies such as confronting racism directly or minimizing its existence and seeking and offering social and cultural supports are reported. At an institutional level, policies to address racism, foster an inclusive culture, and develop programs that enable and support diversity and career progression have been described.

DISCUSSION

A conceptual model that frames the factors that enable racism (both extrinsic/societal and intrinsic/individual) against strategies that mitigate the effects of racism (both institutional and individual) is proposed and applied to respiratory therapy programming.

CONCLUSION

Respiratory therapy programs must acknowledge, prioritize, and address racism consistently and systemically. Targeted research is required to explore the specific experiences of this profession, and to validate the effectiveness of the strategies described to redress the inequities unmasked by racism.

A discussion of White fragility to facilitate cultural competence development in a foundations of pharmaceutical care class

INTRODUCTION

The objective of this study was to explore pharmacy students' emotional reaction to the concept of White fragility and garner ideas about improving pharmacy curriculum to initiate constructive patient engagement across racial divides.

METHODS

An online questionnaire was distributed to 160 first-year pharmacy students after reading the article "White Fragility" for a Foundations of Pharmaceutical Care Course. Class prep questions included (1) How can the college and you improve the capacity and stamina of Whites, so they are prepared to teach and initiate constructive patient engagement across racial divides? and (2) Recognizing that emotions play a critical role in learning, how does the information in the "White Fragility" article make you feel? Responses were analyzed using a constant comparative method by all three authors; discrepancies were resolved by consensus.

RESULTS

Of the 160 students across two campuses, 157 submitted responses. Four major categories of college culture, curriculum, educational topics, and educational suggestions or enhancements emerged "to improve the capacity and stamina of Whites." With regard to the observed feelings after reading "White Fragility," seven categories of feelings (frequency) emerged, including awareness (49%), discomfort (38.2%), empathy (19.7%), defensiveness (16.6%), frustration (15.9%), empowerment (11.5%), and curiosity (8.3%).

CONCLUSIONS

This student cohort is at the beginning of their intercultural journey in pharmacy. Many indicated that more emphasis on and discussion about issues like White fragility and racism would benefit their ability to care for people from a wide variety of cultures to optimize patient outcomes.

Transformative Learning in Graduate Medical Education: A Scoping Review

BACKGROUND

Transformative learning (TL) is an educational theory focused on deep fundamental shifts in an individual's worldview. Such shifts are well known to occur within graduate medical education (GME). However, TL in GME has yet to be formally explored.

OBJECTIVE

We performed a scoping review of the literature on TL within GME to identify areas where trainees currently experience or have potential to experience TL, and to explore areas where fostering TL has been used as a pedagogical tool.

METHODS

In January 2020, we searched 7 databases to identify literature on TL in GME. Additional articles were identified by hand-searching the Journal of Graduate Medical Education.

RESULTS

A total of 956 articles were identified through database search with 3 unique articles found via hand-searching. Abstracts and manuscripts were screened by 2 authors and disagreements arbitrated by a third, yielding 28 articles for our analysis. The main components of TL (disorienting dilemma, reflection, discourse, action) took various forms. TL was closely linked with professionalism training and professional identity formation. Training programs in primary care fields were most frequently referenced. Often, trainees were experiencing TL without recognition of the theory by their educators. Gaps in the graduate medical education literature exist pertaining to TL in venues such as diversity, equity, and inclusion.

CONCLUSIONS

Our scoping review uncovered the following themes: TL and professionalism, TL and primary care, and TL by other names. TL is likely occurring but going unrecognized in some settings.

Development of a Cultural Intelligence Framework in Pharmacy Education

Objective. Pharmacists must be equipped with the knowledge, skills, and attitudes necessary to provide culturally intelligent and patient-centered care; however, most are not trained to do so. In order to prepare culturally intelligent pharmacists, standards and curricula for cultural intelligence must be defined and implemented within pharmacy education. The objective of this study was to create a cultural intelligence framework (CIF) for pharmacy education and determine its alignment with Doctor of Pharmacy (PharmD) training.Methods. An extensive literature analysis on current methods of cultural intelligence education was used to construct a CIF, which integrates leading models of cultural intelligence in health care education with Bloom's Taxonomy. Five student focus groups were conducted to explore and map their cultural experiences to the CIF. All focus groups were recorded, transcribed, deidentified and deductively coded using the CIF.Results. The four CIF domains (awareness, knowledge, practice, desire) were observed in all five focus groups; however, not every participant expressed each domain when sharing their experiences. Most students expressed cultural awareness, knowledge, and desire, however, only a few students discussed cultural practice. Participant comments regarding their experiences differed by race and year in the curriculum.Conclusion. This study was a first step toward understanding cultural intelligence education and experiences in pharmacy. The CIF represents an evidence-based approach to cultural intelligence training that can help prepare pharmacy learners to be socially responsible health care practitioners.

The Evolving Role of Historically Black Pharmacy Schools in a Changing Environment

Objective. To provide a comprehensive review of the contributions of historically Black colleges and universities (HBCUs) to creating a diverse pharmacist workforce and identify opportunities for future contributions. This was accomplished by comparing enrollment at HBCUs to overall US enrollment of African American pharmacy students and then comparing those numbers to national enrollment of pharmacy students, analyzing contributions of HBCUs to underrepresented pharmacy student enrollment, evaluating overall changes to pharmacy school enrollment and impact on enrollment at HBCUs, and identifying areas of opportunity to enhance the future contributions of HBCUs.Findings. There are six HBCU pharmacy schools in the United States. Although HBCU pharmacy schools made up only 4% of the total number of US pharmacy schools, they accounted for an average of 22.8% of the total African American student enrollment in pharmacy schools over a five-year period (2015-2019). An average of 13.8% of the total population of underrepresented people of color (UPOC) enrolled in US pharmacy schools from 2015-2019 attended an HBCU pharmacy school.Summary. Historically Black colleges and universities have consistently made significant contributions to the total pharmacy school population of African Americans, as well as that of Native Hawaiian and other Pacific Islanders and American Indian and Alaska Natives. These institutions have an opportunity to enhance their impact and serve in graduating the diverse pharmacy workforce needed in the future. Historically Black colleges and universities can achieve this goal by making significant efforts to recruit LatinX pharmacy students and by increasing their recruitment of African Americans, Native Hawaiian and other Pacific Islanders, and American Indian and Alaska Natives.

Effects of Racial Trauma on Black Doctor of Pharmacy Students

Objective. In the wake of several high-profile police killings, in 2020 the United States began another reckoning with structural racism, injustice, and violence against Black Americans. The objectives of this study were to explore the impact of racialized sociopolitical events on Black Doctor of Pharmacy (PharmD) students.Methods. Focus groups were conducted with second- to fourth-year Black PharmD students enrolled at the University of Tennessee Health Science Center College of Pharmacy. The focus groups were conducted in summer 2020, beginning two months after the murder of George Floyd and concluding before the start of the fall semester. Data analysis was conducted using a phenomenological approach, and themes were identified using inductive coding.Results. Twenty-four participants were recruited into five focus group sessions. Thematic analysis of the transcripts resulted in three distinct themes related to the study objectives: Vicarious Trauma, Hypervigilance, and Fight or Flight Responses. Black students reported that they experienced significant psychological distress as a result of prominent racially traumatic events. Some Black students reported withdrawing from non-Black persons due to hypersensitivity and anxiety while others were willing to engage in candid conversations.Conclusion. Racial trauma has implications for student wellness and academic success. As racism and police brutality have proven to be an ever-present problem, this study offers key information for consideration as institutions recruit, support, and retain diverse learners. The data may also inform educators and pharmacy students regarding interactions with Black patients, coworkers, and health professionals during times of sociopolitical unrest.

Organizational commitment to diversity, equity, and inclusion: A strategic path forward

DISCLAIMER

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

PURPOSE

To describe an approach to diversity, equity, and inclusion (DEI) strategy development at a school of pharmacy aimed at stakeholder investment and infrastructure that can address systemic challenges in various healthcare settings.

SUMMARY

The UNC Eshelman School of Pharmacy utilized an organizational approach focused on infrastructure to produce a diverse and inclusive school community. The Office of Organizational Diversity and Inclusion (ODI) established vision and mission statements to represent the school's commitment and conducted a comprehensive environmental scan to compose a shared vision. Students, faculty, staff, and alumni participated in a series of retreats, symposiums, and focus groups to identify opportunities to cultivate a diverse and inclusive school community. A working group comprised of key leaders in the school developed and launched a 3-year DEI Strategic Plan along with initiatives and metrics for year 1. The plan's 3 priorities were (1) to recruit and retain diverse talent, (2) to prepare culturally intelligent professionals, and (3) to build an inclusive community. The ODI collaborated with internal and external stakeholders, which included students, faculty, staff, postdocs, alumni, and partners from health systems, industry, and other institutions and organizations, to initiate, implement, and monitor progress through an organizational approach to establish accountability and greater commitment.

CONCLUSION

An organizational approach to DEI strategy through stakeholder engagement and infrastructure increased commitment and shared ownership among members of the school community. Applications in an organizational approach can be adapted to multiple healthcare settings to contribute to the cultural transformation necessary to develop a diverse and inclusive healthcare workforce.

A Canadian perspective of pharmacy education for students belonging to diverse groups

BACKGROUND

Attention to equity, diversity, and inclusion (EDI) is on the rise in Canada, the United States, and the world. While there are evolving efforts across various sectors, post-secondary institutions, in particular, are growing in EDI efforts. For health professional programs, including pharmacy, health disparities are addressed and improvements in health care are realized when faculty are committed to EDI in hiring, admissions, and teaching and learning. To inform the direction and highlight the importance of further EDI research, programming, and evaluation, this paper analyzes the existing literature in pharmacy education and the education of diverse groups.

METHODS

Several databases were searched, resulting in 17 articles of varying scopes (e.g., reviews, commentaries, reports) that capture principles of pharmacy education for diverse or marginalized students. While other articles were screened for inclusion, the concepts of culture, equity, diversity, and inclusion were presented as part of classroom and curricular topics (e.g., learning about the topics) and did not contain mention or evaluation of the education of diverse or marginalized students in pharmacy.

RESULTS

Pharmacy education literature for diverse and/or marginalized student groups is limited. While significant publications exist regarding pharmacy education about EDI, little attention has been given to how pharmacy programs and educators may adapt their teaching and learning practices, policies, procedures, and admission processes to move beyond the status quo.

IMPLICATIONS

Findings from this review will better inform pharmacy education programs to engage in the research and practice of conscious continuous improvement of safe spaces for diverse pharmacy students.

Exploring the Career Engagement, Interests, and Goals of Pharmacy Students Identifying as Underrepresented Racial Minorities

Objective. To examine pharmacy career engagement, interest, and confidence in Doctor of Pharmacy (PharmD) students identifying as underrepresented racial minorities (URMs).Methods. A 15-item survey about career engagement, confidence, and goals was administered at a business session of a national conference. The survey included demographic items and items about career exposure prior to and during school, career aspirations after graduation, frequency of engagement in various settings, career factors, and career confidence. Cronbach alpha was used to examine survey reliability. Descriptive statistics and nonparametric statistical tests were used to analyze survey responses.Results. Sixty-nine URM students completed the survey. Most indicated frequent engagement with community pharmacy prior to and during school; no engagement with hospital pharmacy prior to school, yet occasional or frequent engagement during school; and no engagement with the pharmaceutical industry prior to and during school. Most selected hospital pharmacy as their career aspiration, followed by community pharmacy and industry. Approximately half indicated an interest in completing a postgraduate fellowship. Items selected as important to career choice included patient care, job security, and level of stress. Group differences were found by gender and year in school.Conclusion. Despite calls for diversity in pharmacy, there is a paucity of research in this area. This study provides a first glimpse into the career engagement, confidence, and goals of students identifying as URMs, raising a number of critical issues for pharmacy education. Moving forward, schools, employers, and researchers must work to better understand the career development of URM students, including barriers and facilitators to access and success.