Wonder Drake knows how being poor can hinder someone’s dream of becoming a biomedical researcher.

Raised in rural Alabama by a single mother who never graduated from high school, Drake overcame those obstacles by finding mentors willing to take her under their wing. Now a professor of medicine at Vanderbilt University in Nashville, Drake has repeatedly returned that favor by participating in a National Institutes of Health (NIH) program aimed at improving the diversity of the biomedical workforce.

Under the program, NIH grantees such as Drake can win additional funding, called diversity supplements, to aid students from one of several groups underrepresented in biomedical research. Some 90% of the awards made in 2018 serve students who are Hispanic or African American, whereas fewer than 1% of investigators cite the category of economically “disadvantaged” when applying for a diversity supplement.

NIH officials think that tiny slice should be bigger. So last month, the agency tweaked its definition of the word “disadvantaged” in hopes that the diversity supplements would serve a broader swath of that population.

Making it clear

Diversity supplements can be used to support students from high school through postdoctoral training. NIH’s previous definition of disadvantaged referred to students whose pursuit of a research career was hampered by living in “an educational environment such as those found in certain rural or inner-city environments.” But that language may have confused people, says Michael Lauer, who leads NIH’s office of extramural research. “What does [that] mean?” Lauer asked in a 26 November blog announcing the change, adding that the phrase “is nearly impossible to evaluate.”

NIH’s new definition of disadvantaged—which applies to all of the agency’s programs meant to foster diversity—has seven components. A person is eligible if they have been homeless, or qualified for a free or reduced-priced lunch in elementary or high school, or if they meet the income level requirements to receive a federal Pell grant to help finance their college education. NIH also invites in those who were in foster care, whose parents never graduated from college, or who grew up in a rural area or a region with a shortage of health professionals.

“We wanted to make it easy for students to self-identify while not being overly redundant,” says Jon Lorsch, director of the National Institute of General Medical Sciences in Bethesda, Maryland, the hub of NIH’s diversity activities. The goal of the supplements remains the same, he says: helping students overcome barriers caused by their low economic status.

Broadening the pool

Drake, for one, applauds NIH’s move. The new definition “may attract more students who are immigrants, or poor Caucasians,” she speculates. “Just think how useful their input would be in finding solutions to the opioid crisis, which is ravaging so many low-income communities.”

Drake notes that she would have met several of the new eligibility criteria when she was a student. “I certainly grew up disadvantaged,” she says. She is also African American, so she would have qualified in that category as well.

Drake, who has received many diversity supplements, typically chooses students from a racial or ethnic minority “because it’s obvious.” Students of color at Vanderbilt who want a research experience tend to seek her out, Drake adds.

But she also contacts nearby institutions that educate large numbers of students who fit NIH’s definition of diversity. “I call up the chair of the basic science department and I tell them, ‘I need your best student,’” she says. “Then I give them the chance to see what it’s like to be a scientist.” The goal is to have them complete a research project over the summer, she says, and then present a poster session at a scientific conference.

The new definition of disadvantaged could help more students tap into such experiences. And Drake says, “Based on my experience, the economically disadvantaged students are sometimes the most talented because they have had to overcome so much adversity.”

Adding another category?

Some diversity experts fear eligible students could shy away from identifying themselves as economically disadvantaged because of the stigma associated with the term. “I was a single mother on Medicaid and food stamps during part of my student years, and also the first in my family to go to college, but I never thought of it as being a disadvantage,” says a researcher who has led diversity efforts at her institution. “I am also averse to playing the hardship card.”

But others aren’t too worried. “I think that students with the potential to succeed in graduate school would not be dissuaded,” says Jacqueline Tanaka, a professor emeritus of biology at Temple University in Philadelphia, Pennsylvania, and former director of its Minority Access to Research Careers (MARC) program, one of NIH’s longest running diversity initiatives. “They are probably already carrying a lot of student debt, and this is an opportunity to get the type of research experience they need to move ahead.”

In fact, Tanaka would like to see NIH broaden the definition even more to include students with backgrounds like that of Matthew Bruce, now a third-year graduate student in immunology at the University of California, Davis. In 2008, Bruce used a gun to rob a convenience store for money to support his drug habit. A few months, later he turned himself in, pleaded guilty, and served 4 years in a Pennsylvania state prison.

After his release, Bruce juggled work and a full load of courses at a local community college before transferring to Temple. There, Tanaka recruited him to the MARC program, which offers high-achieving, upper-level undergraduate students the type of research experiences they need to get into a good graduate program, the first rung on an academic career.

“It may sound corny,” Bruce says, “but being in the MARC program was everything to me. I was feeling the imposter syndrome times 100,” he says about the well-documented phenomenon of students from disadvantaged backgrounds underestimating their ability to make it in science.

“I didn’t come from the same background as my peers, and I hadn’t really paid much attention in school [because of his drug dependency],” Bruce continues. “When Dr. Tanaka told me that, as a scientist, I would essentially get paid to solve problems, I said, ‘That sounds phenomenal. Sign me up.’” In 2017 he graduated from Temple with a near-perfect academic record.

Bruce grew up in rural Pennsylvania, was the first in his family to attend college, and received a Pell grant, so he would likely qualify as disadvantaged under NIH’s new definition. But what really sold Tanaka on Bruce was how he had overcome a huge obstacle—incarceration—that is not included in the definition.

Lorsch says NIH is open to further revisions of the criteria for disadvantaged. “Our goal is to give students as many on-ramps as possible,” he says.

And money is not an impediment. Lorsch estimates that NIH could, without straining its budget, accommodate a 10-fold increase in the number of supplement applications that cite the disadvantaged category; in 2018 there were fewer than 11 such applications.

Given that NIH funds nearly two-thirds of the proposals it receives for diversity supplements, Drake doesn’t understand why more of her colleagues don’t apply. “I think [the diversity supplements] are one of the best-kept secrets at NIH,” she says. “And we’re doing everything we can at [Vanderbilt] to spread the word.”