Getting More Minority Students in Medical Schools


February 25, 1993|By DONALD E. WILSON

In 1969, African-Americans made up approximately 6 percent ofthe freshman class in U.S. medical schools. In 1991, that percentage had risen to only 6.6 percent. For nearly 20 years, the number of African-American students entering medical school has remained static, with almost one-third concentrated in 10 medical schools.

Last year, the Association of American Medical Colleges launched ''Project 3000 by 2000,'' an effort to nearly double the number of minority students enrolled in medical schools by the turn of the century. Because the African-American applicant pool is just over 3,000 each year, the pool must expand significantly to meet this new goal.

The situation with medical-school faculty is even bleaker. In 1982, minorities accounted for only 2.6 percent of medical school faculty. By 1990, this figure had increased slightly, to 3.2 percent. If you remove from these calculations the six traditionally minority medical schools then the minority faculty representation in the remaining 120 medical schools falls to about 1.7 percent.

What difference does all this make? Is it important that there be more minority faculty, department chairs and deans in U.S. medical schools? First, we are becoming a more heterogeneous nation with a larger minority population. Consider that by the year 2015 all ethnic minorities combined are expected to account for more than 50 percent of the U.S. population. Second, regardless of how we assess health, underrepresented minorities have poorer health than Caucasians in the U.S. Third, after completion of their medical training, minority physicians are more likely to provide health-care services to minority communities.

The reasons for the low minority enrollment in U.S. medical schools are unclear and controversial. The availability of ''qualified'' candidates is always raised: Perhaps the determination of ''qualified'' needs rethinking. Surely there are important determinants of ''the future good physician'' other than MCAT scores. Certainly the cost of medical education places it out of reach for the vast number of minority students who must see medical school as an unaffordable luxury. Another significant factor is the lack of role models for minority students.

At current rates, the representation of minorities in medicine, particularly academic medicine, will worsen over the next 20 years. Somehow we must increase the motivation and preparation of minority students for careers in science and medicine. We must go into the junior high schools, the high schools and colleges to improve the pipeline. In order to increase the overall pool of minority medical students and physicians, we need many more effective role models than are currently available. I believe a special understanding is generated when one's mentor is also a member of a minority.

Access is paramount. It is essential to determine how minorities will obtain access to health-care delivery, including medical education, teaching and biomedical research, areas in which minorities are not appropriately represented -- to the detriment not only of those minorities but of the welfare of the country as a whole.

We must recruit minority physicians into postgraduate training programs that will enhance their entry into academic medicine, research and leadership positions in health care. Minorities are usually encouraged to enter primary-care training programs and then return to their communities to provide health care. Minorities are grossly underrepresented in other specialties, particularly those subspecialities of internal medicine that may lead to positions in academic medicine.

Recruitment of minorities to medical colleges must be encouraged without preconceived ideas as to the appropriate professional activity for the student after graduation. Academic postgraduate training programs should seek out minority candidates, and these candidates should be encouraged to apply for positions based upon their desires and qualifications, rather than what they believe is available to them.

It is appropriate for government and private foundations to provide support for minorities in academic fellowship and research development programs. All these approaches will ultimately fail unless our medical colleges reach out and recruit minority faculty, and unless our prestigious medical and scientific societies include such faculty in their membership and administration.

Dr. Wilson is dean of the University of Maryland School of Medicine.

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