(A151) The Need for Otolaryngology Medical Pathway Programs in Rural Areas: Demonstrating Existing National Disparities

Introduction: High School Pathway Programs (HMPP) are developed by academic medical institutions (AMA) to decrease disparities and increase exposure to opportunities and careers in healthcare. The aim of this study is to compare the national presence of HMPP in rural counties (RC) and urban counties (UC) with emphasis on the need for the development of rural pipeline programs focused on improving the disproportionality in healthcare - ultimately enhancing representation of individuals from diverse background in otolaryngology programs.

Methods: Demographic data for (sex, race, and ethnicity) for individuals ages 15 to 19 years was collected from the 2023 American Community Survey. Counties were categorized as rural or urban based on their Rural-Urban Continuum Codes (RUCC): RUCC values 1 – 3 were classified as urban/metropolitan and RUCC values 4-9 were defined as rural/non-metropolitan. 347 HMPP established by AMA were found in both RC and UC. A descriptive analysis was performed for demographics characteristics and HMPP availability.

Results: Of a total of 3,144 counties across 50 states, 150 counties were identified. These counties included 194 AMA (Allopathic and Osteopathic) with an established HMPP. No HMPP was identified in RC within the Western/Pacific regions. Higher percentages of access to HMPP related to AMA presence were found in UC compared to RC in all regions. The regions with the lowest access were Northeast (NE) and South (S) RC (0% and 67%, respectively), and the highest access were NE and MW UC (93% and 90%, respectively). Race percentage composition in RC with AMA for White (MW: 87.0 ± 2.3; S:75.8 ± 21.1) and Native American (MW: 2.9 ± 3.5; S: 7.9 ± 16.2) populations were the highest in the S and MW. There were similar percentages of 15–19-year-old in RC and UC across regions.

Conclusions: The disproportion of HMMP amongst RC across the country especially in historically disadvantaged groups such as Native Americans is evident by the diminished access to AMA, and lack of availability of programs. Establishing virtual HMMPs or partnerships between local medical practices and high schools would address these disparities.