The underrepresented minority STEMM pipeline is a pipe dream: The pipes rarely connect

Building and sustaining a diverse health care workforce including members of underrepresented groups (URG) requires overcoming an intricate web of structural barriers and their downstream sequelae that conspire to perpetuate underrepresentation of many groups of Americans in science, technology, engineering, math, and medicine (STEMM). These include students from low income, marginalized racial and ethnic minority, gender minority, disabled, female, rural and other groups. Several recent efforts to better recognize and work through these barriers and capture talented URG youth in STEMM have targeted investments mainly at the undergraduate and graduate level, but some even earlier at the K-12 levels. A major strategy of increasing STEMM educational opportunities are short-term URG training programs designed to fill gaps in traditional education systems, that collectively have been termed the biomedical pipeline. Unfortunately, putting more trainees into a series of disconnected and leaky pipes have had only a limited impact and led to funders questioning investment in URG student/trainee pipelines. This is primarily predicated on a belief that the issue is with the ability of the students, when it is the fallacy of the pipeline as presently constructed. While our existing efforts to capture untapped URG talent and develop them into outstanding biomedical scientists and health professionals is crucial to advance the health of our nation, until we embrace and address the root cause of the existing inequities, our ability to improve representation for all groups in the biomedical and health professionals workforce will remain a pipe dream.