Attracting a Diversity of Students to Dentistry through the Dental Pipeline Program

A profile of Ernestine S. Lacy, DDS

    • November 19, 2012

As a Round 2 participant in RWJF's Dental Pipeline Program, Texas A&M Health Science Center Baylor College of Dentistry expanded its Bridge to Dentistry program for underrepresented minority and low-income students.

The challenge. Baylor College of Dentistry at Texas A&M Health Science Center had a strong track record of recruiting and enrolling a diverse student body, aided by pipeline programs along the academic continuum from elementary school through post-baccalaureate. The dental school wanted to expand its reach to attract more underrepresented minority and low-income students to dentistry.

The path to dentistry. Baylor has long been committed to the recruitment of underrepresented minority and low-income students to its dental school and had a summer enrichment program in place in the early 1990s.

In 1996 Baylor changed focus. "We felt that the program needed to come from a different angle," remembers Ernestine (Ernie) S. Lacy, DDS, executive director of Student Development and Multicultural Affairs. "Instead of just career awareness the summer program needed to help students be more competitive for dental school and be more successful once they were there. We changed the direction so it was more academic, with Dental Admission Test [DAT] preparation and biomedical science courses."

Lacy had joined the Baylor dental faculty upon her graduation from the school in 1994, melding her dental education with her earlier 17-year career as a high school math and science teacher. As the director of Student Development she oversees Baylor's myriad of programs that funnel young people—from elementary school children to college graduates—to dentistry.

Bridge to Dentistry started in 1997 with a program for college students and added post-baccalaureate, elementary school, and high school components over time. "It took a while to get to the point where we could call it a comprehensive program," says Lacy.

Connecting with RWJF's Dental Pipeline Program. By 2007 Lacy and her staff wanted to expand Bridge to Dentistry and applied for Round 2 of the Robert Wood Johnson Foundation (RWJF) national program Pipeline, Profession and Practice: Community-Based Dental Education, known as the Dental Pipeline Program. As a program participant, Baylor was able "to offer its programs to more participants than we would have if we had not received the funding, and to add programs to expand the pipeline," says Lacy.

With the RWJF Dental Pipeline funding, Baylor added a Future Dentists Club at several elementary schools and a junior high school along with a citywide club for high school students. Previously, Lacy made annual presentations to the schools but "we wanted the students to have the opportunity for continued engagement," she says. "The Future Dentist Club provides continuity and nurtures students' interest."

The other missing link in Bridge to Dentistry was a summer enrichment program for recent high school graduates. "We already had summer programs for 9th, 10th, and 11th graders. The RWJF funding allowed us to build that link into the chain," says Lacy. "Adding the Summer Pre-Dental Enrichment Program for High School Graduates gave us a more complete pipeline."

Through the Dental Pipeline Program Baylor has been able to meet its goal for Bridge to Dentistry: for all students to have the opportunity at all levels to participate in pre-dental activities. "Children start forming their career goals early in life," notes Lacy. "Hopefully we can influence some to try dentistry."

All of this effort has paid off. During the 2009–2010 academic year Baylor had an underrepresented minority first-year student enrollment of 41.2 percent compared with just 12.7 percent among all U.S. dental schools.

A role model for other schools. Baylor's many years of successful pipeline experience have given it a prominent place as a role model for other dental schools seeking to increase their own enrollment of underrepresented minority and low-income students, says Lacy. She and her staff share their experiences with other schools at admissions workshops offered through the American Dental Education Association and at other meetings and seminars.

Most schools cannot offer programs at all levels. If a school can offer just one program, Lacy strongly recommends developing a post-baccalaureate program to help college graduates prepare for dental school application and for dental school itself. A post-baccalaureate year can strengthen students' academic foundation. "That has been our most productive program for getting students into dental school at Baylor," says Lacy. "You don't have to worry about your spot in dental school if you satisfy the program requirements."

As for other pipeline levels, Lacy advises going back "down the academic line" when adding programs. Her recommended second program choice is a summer enrichment program for college students.

At the same time, says Lacy, pipeline programs alone are not enough. "Students can participate in pipeline programs but dental schools have to be willing to accept them. Admissions committees must have a philosophy of accepting students who don't always fit the 'qualified student' picture in terms of DAT scores and GPAs—looking at the entire student, using whole file review." (Whole file review considers both quantitative measures, such as DAT scores and grade point averages, and qualitative factors such as motivation, life experiences, etc.)

"The pipeline programs are rigorous and are intense," continued Lacy. "My advice to dental schools is to look closely at students who have successfully completed one of these programs—that is an indication that they can be competitive dental school applicants."

For Baylor, funding continues to be a challenge and may affect the comprehensiveness of and the number of students accommodated through Bridge to Dentistry. But faculty and staff believe in the program and school leadership is committed to continuing it. "We will make it work," Lacy affirms.

RWJF perspective. The Dental Pipeline Program helped improve access to dental care for underserved populations from 2001 to 2010. The program funded dental schools to increase the diversity of dentists trained to deliver this care and enhance student exposure to community-based practices treating medically disadvantaged patients.

Round 1 funded 15 funded dental schools, which all developed community-based clinical education programs to provide care to those in need. Most schools also increased recruitment and retention of underrepresented minority and low-income students. Round 2 funded eight additional dental schools: four focused on community-based education and four focused on increasing minority and low-income student recruitment. The California Endowment funded dental schools in California (four in Round 1 and five in Round 2).

"The hard work and collective commitment of all the program directors and deans within the Dental Pipeline Program substantially contributed to the program's success," says Program Officer Denise Davis, DrPH, MPA. "Through collaborative learning about best practices, all dental schools were able to highlight their unique strengths and share their extensive expertise.

"An example is the amazing Bridge to Dentistry program at Baylor College of Dentistry. Through this program, Dr. Lacy innovatively recruits [applicants], creates a pipeline of diverse dental students, and ensures their professional success as evidenced by the consistently high minority enrollment at Baylor. The school exemplifies the kind of solutions to dental access that the Dental Pipeline Program was created to advance."