Author Contributions: Dr Grumbach and Mr Chen had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design; critical revision of the manuscript for important intellectual content; obtained funding; study supervision: Grumbach.
Acquisition of data; analysis and interpretation of data; drafting of the manuscript; statistical analysis; administrative, technical, or material support: Grumbach, Chen.
Financial Disclosures: None reported.
Funding/Support: This study was supported by the Bureau of Health Professions, Health Resources and Services Administration (U79HP00004).
Role of the Sponsor: The Bureau of Health Professions, Health Resources and Services Administration had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript.
Acknowledgment: We thank Gwen Garrison, PhD, Division of Medical Student Services and Studies, Association of American Medical Colleges, for assistance with data analysis. We thank Mark Westlye, PhD, and James Litrownik, MA, Department of Academic Advancement, University of California Office of the President, Valerie Margol, MA, School of Medicine, University of California, San Francisco, Edward Dagang, School of Medicine, University of California, Davis, Eileen Munoz-Perez, Emma Ledesma, MA, and Ellena Peterson, PhD, School of Medicine, University of California, Irvine, and Sandra Daley, MD, and Saundra Kirk, MS, School of Medicine, University of California, San Diego, for their assistance in providing data used in this study. None of these individuals were compensated for their contributions to this study.