Today is Martin Luther King, Jr. Day in the USA, a national holiday when we reflect on equality for all Americans. One sensitive topic is why there are not more African-American medical students at American and Caribbean medical schools.
In the latest installment of our Doctors and Diversity series, the UMHS Endeavour looks at the need for more African-American medical students in the USA. Citing the online sources Amednews.com, AAMC.org and ScienceDaily.com, we will examine some of the reasons why there is a disparity in the number of African-American medical school applicants compared to other minorities, particularly the lack of black males studying medicine, what this means for the growing physician shortage, and what can be done to correct the situation.
African Americans Needed for Growing Physician Shortage
Although the 2012 re-election of President Barack Obama, the first African-American U.S president, proved that America is truly a nation of many cultures and races—and also preserved affirmative action, which some Republicans threatened to eradicate--there is still an alarming lack of black applicants, particularly black males, at U.S. medical schools.
The Association of American Medical Colleges predicts a major physician shortage in the USA by 2025 of 130,000 doctors “of all racial and ethnic backgrounds,” according to a 2013 article on Amednews.com.
The U.S. Census Bureau projected years ago that nonwhites will be the majority by 2050. Here at UMHS, we already know that America’s future doctors reflect our nation’s diversity, with more and more women and people of color entering medicine.
The Amednews.com article by Kevin B. O’Reilly, “Black Men Increasingly Hard to Find in Medical Schools,” gave copious details about why so few African-American men pursue medicine. Following are highlights:
- Few African-American men major in traditional “premed” areas as undergraduates. Frank A. Clark, MD, an African-American psychiatry resident at Palmetto Memorial Hospital in Columbia, South Carolina, is quoted as saying he saw few black men “on the premed route” when he was an undergraduate biology major, with a minor in chemistry.
- “Black men are notable in that their numbers are lagging even as other minorities and women are continuing a long-term trend of gaining greater representation among medical school applicants and students,” the article says, citing a recent AAMC report on medical education diversity.
- “The report said 2.5% of medical school applicants were black men in 2011, a drop from 2.6% in 2002. That compares with 9% and 11% increases in the share of Asian and Hispanic male applicants, respectively, during the same period. A 10% greater share of matriculating students were Asian men in 2011 than in 2002, and Hispanic men made up a 24% larger proportion of new medical students. The share of white male applicants and matriculants was stable.”
- “Growth in the number of African-American women applying for — and attending — medical school has been comparatively weak as well, with their representation, as a percentage of all applicants and graduates, also in decline. However, their numbers are still enough to create, as they have for some time, the biggest gender gap among all racial or ethnic groups.”
- “Twice as many African-American women as men applied to medical school, and black women accounted for nearly two-thirds of black students who were accepted and eventually matriculated. That disparity translates into graduation rates, with 63% of new black MDs in 2011 being women.”
2014 AAMC Stats: Numbers Slowly Rising, But Room for Improvement
The number of minority applicants to medical schools increased in 2014, according to a report published on AAMC’s website on October 29, 2014, “More Students Going to Medical School Than Ever Before”.
“The diversity of the nation’s medical students showed signs of progress again this year,” the report said. “The number of Hispanic or Latino enrollees increased by 1.8 percent to 1,859 in 2014, with the number of applicants increasing by 9.7 percent to 4,386. African American enrollees rose 1.1 percent to 1,412, while the number of applicants increased by 3.2 percent to a total of 3,990.”
‘Gains in enrollment among African Americans are attributable to a 3.1 percent increase in male enrollees,” the report continued, adding that the largest growth for minority applicants was shared by American Indian and Alaska Native enrollees, “increasing almost 17 percent, from 173 enrollees the previous year to 202 in 2014.”
Problems with Lack of African-American Male Med School Applicants
The dearth of black men pursuing careers in medicine creates many problems for a nation in need of doctors to work in medically underserved areas, the Amednews.com article pointed out.
“This has huge implications,” Rahn K. Bailey, MD, president of the National Medical Association., promoting African-American physicians and the interest of black patients, told the website.
“Society does better with balance all the way around,” Dr. Bailey said. “And we don't have balance if we have disproportionately twice as many females as males applying to enter the profession, or twice as many from California as from New York, or twice as many people who want to go into surgery as into pediatrics. We need everybody. We need all hands on deck.”
The article said the lack of black medical students “could worsen access to care in low-income communities, because black medical students are likelier than any other group to have a firm commitment to practicing in underserved areas, with 55% saying they plan to do so.”
Countless studies have shown that patients in minority communities’ greater satisfaction with physicians with whom they share common race and/or gender.
Roots of the Disparity
Many agree the low numbers of African-American men in medical school has little to do with institutions not accepting applicants. Perhaps the problem, as Mr. O’Reilly noted in Amednews.com, can be traced to not enough black men on a premed track as undergraduates. He pointed out that just 3% of college graduates are black men, while women “account for nearly two-thirds of black students to earn bachelor’s degrees” and “nearly three-quarters of African-Americans majoring in biology or biomedical sciences are women,” citing 2009 data from the U.S. Department of Education.
Mr. O’Reilly said it is crucial to reach African-American men at an earlier age than college or high school. He writes about such schools as Duke University School of Medicine in North Carolina. Duke “works with the local public schools as early as the third grade, offering field trips to Duke health care facilities. Starting in the fifth grade, 25 students from underrepresented minority groups or low-income families are selected from each participating school to join Duke's BOOST program, which offers extra math and science instruction, overnight field trips and summer workshops.”
“A lot of this has to do with giving [male African-Americans] the academic tools to work with at an early stage, and you have to reinforce those successes and keep them in the system,” Dr. Armstrong, a professor of pediatrics, told Amednews.com in a 2013 interview.
Dr. Frank Clark, the African-American psychiatry resident from South Carolina also quoted in the article, added that black male doctors should help promote the importance of medicine in the black community.
“As physicians, we have an obligation to not only serve our community in terms of providing good patient care, but also to be mentors, to reach out to those people who look up to us,” Dr. Clark said. “People do look up to us. We may not be Michael Jordan or Kobe Bryant. We may not have won championships, but we still have a role in the community to play, and a role that's vital to the community.”
‘STEM’ Careers for All Minorities
Fifty underrepresented minority students participated in a retreat at prestigious Brown University in 2014, discussing what would increase interest in science, technology, engineering and mathematics (known by the acronym STEM). ScienceDaily.com wrote about the students’ findings in a December 2014 article “Why Don’t Minority Students Choose STEM Careers?”. The article also quoted the authors of a study in the journal CBE-Life Sciences Education.
Students at the retreat made the following eight suggestions to improve interest in science, technology, engineering and mathematics among minorities:
- ‘Including a social justice component in STEM education. For example considering biomedical research in the context of health disparities.”
- “Training to help them better explain science to nonscientists, including family members who may be generally supportive but aren't always familiar with research.”
- “Connecting STEM with other disciplines, including the humanities and the arts.’
- “Learning sooner than well into graduate school about the career paths that become available with an advanced STEM degree.’
- “Gaining guidance for achieving work-life balance. Older students may need this for child care, but even undergraduates may need it because they may be helping to raise siblings or supporting other family members.”
- “Reconsidering evaluation metrics that fail to account for the diversity or that reflect a misunderstanding of cultural differences.”
- ‘Ensuring access to ‘invested mentors,’ who show a genuine interest in their careers.’
- “Creating more opportunities for ancillary training, including parallel graduate degree programs, that allow for studies to evolve with changing or broadening interests.”
(Top photo) NOT ENOUGH AFRICAN-AMERICAN DOCTORS: One reason is fewer black men study premed majors as undergraduates, statistics show. Photo: Deposit Photo.
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Scott is Director of Digital Content at UMHS and editor of the UMHS Endeavour blog. When he's not writing about UMHS students, faculty, events, public health, alumni and UMHS research, he writes and edits Broadway theater reviews for a website he publishes in New York City, StageZine.com.