Copyright © by the Association of American Medical Colleges. Unauthorized reproduction of this article is prohibited. Academic Medicine, Vol. XX, No. X / XX XXXX 1 Article The lack of diversity in the physician– scientist workforce in the United States remains a serious concern. 1–3 This pertains to both gender and ethnicity, and, despite a 30-year effort by the NIH, 4–6 only about 5.3% of the U.S. medical school faculty with an MD–PhD or MD plus another higher degree are members of underrepresented minority (URM) groups. 1 To increase the number of URM physician–scientists, the number of URM MD–PhD trainees needs to increase. This continues to be a challenge because the applicant pool is small (between 2007 and 2013, the percentage of URMs in the national applicant pool averaged 15%), 7 and many applicants lack the qualifications and research preparation to complete the training (between 2009 and 2015, the percentage of URM among MD–PhD matriculants averaged 10%) 8 ; the total enrollment of URM students in MD–PhD programs (2002–2013) averaged 12%. 9 Moreover, once matriculated, URM students seem to graduate at lower rates than majority students. 10 (The Association of American Medical Colleges has changed how it classifies individuals who are members of different ethnic groups, which complicates comparisons; the above numbers do not include students who declare “multiple race/ethnicity.”) In 1993, the Weill Cornell/Rockefeller/ Sloan Kettering Tri-Institutional MD–PhD Program became the first MD–PhD program to embrace the task of increasing the URM MD–PhD applicant and student pipeline. We developed a summer research training program for undergraduate students, Gateways to the Laboratory (Gateways), to provide everything we expected to see in a competitive MD–PhD applicant—strong academic performance and substantial research experience. To accomplish this, Gateways focuses on four elements: research experience that empowers the students; effective mentoring, focusing on the needs of the individual student; career development, where the students learn basic skills; and funding, so that students do not need to decide between supporting themselves and furthering their careers. These elements seem to be characteristic of summer programs that enhance students’ interest in pursuing a STEM (science, technology, engineering, and math) career. 11 Gateways is a 10-week summer program for URM, disadvantaged college students as well as those with disabilities who wish to become physician–scientists. Gateways incorporates a structure that mirrors the multiple responsibilities of a physician– scientist. It emphasizes hypothesis-driven research, clinical work, journal club, and multitiered mentoring. We describe the structure of Gateways, report on the educational paths of students who participated in the program during its first 20 years, and summarize what we believe to be the most successful interventions we have made. Program Organization and Culture There are two distinct, valid approaches to foster the development of research trainees: to grow talent—that is, to support trainees who, without their participation in a mentoring and training program, may not have entered a STEM field; and to harvest talent—that is, to support trainees who for a variety of reasons were likely to have “made it” whether or not they participated in such a program. 11 Gateways both grows and harvests talent, as we aim to both increase the diameter of the pipeline and seal the leaks. To accomplish these goals, we strive to instill into enrolled students a commitment to excellence. Abstract Traditional underrepresented minority (URM) groups (African Americans, Hispanic Americans, Native Americans) remain underrepresented among physician–scientists. To address the dearth of URM physician–scientists, in 1993 the Weill Cornell/Rockefeller/ Sloan Kettering Tri-Institutional MD–PhD Program developed a pipeline program, Gateways to the Laboratory (Gateways), which focuses on increasing the breadth and depth of the URM physician–scientist pipeline by offering an all-encompassing summer research training program which mirrors the life of a physician–scientist. This includes hypothesis-driven research and clinical shadowing opportunities, coupled with weekly career development workshops and extensive multitiered mentoring. Among the 245 alumni who had “graduated” from Gateways as of 2013, 88% have pursued or completed advanced degrees. Among these, 74% completed or are pursuing MD, PhD, or MD–PhD degrees; and 17% completed or are pursuing combined MD–PhD degrees, over one-third of whom are enrolled in the Tri-Institutional MD–PhD Program. Gateways outcomes are compared to other programs with similar missions, which shows that Gateways has been successful at preparing URMs for MD–PhD Programs. The program serves as a model for how to increase the national pool of competitive URM MD–PhD applicants. Gateways to the Laboratory: How an MD–PhD Program Increased the Number of Minority Physician–Scientists Ruth Gotian, MS, Jemella C. Raymore, MD, Shauna-Kay Rhooms, Laura Liberman, MD, and Olaf S. Andersen, MD Acad Med. XXXX;XX:00–00. First published online doi: 10.1097/ACM.0000000000001478 Please see the end of this article for information about the authors. Correspondence should be addressed to Ruth Gotian, Weill Cornell/Rockefeller/Sloan Kettering Tri- Institutional MD–PhD Program, 1300 York Ave., New York, NY 10065; telephone: (212) 746-6023; e-mail: rgotian@med.cornell.edu. Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A406.