Two news feeds came across my desk this past sunny Monday morning in ‘paradise‘, that sent me to my blogger dashboard with three thoughts to share with The UMHS Pulse readers.

Here at UMHS in beautiful St. Kitts, we are proud of the diversity of our medical student body and the valuable experiences and educational opportunites our students are exposed to, having come to learn the art and practice of medicine while living for 16-20 months in a country not their own. However, the sad reality of clinical exposure in the local Basseterre hospital is that UMHS medical students see many young male Kitticians with stab wounds and bullet holes, a reflection of the continuing undercurrent of “trouble in paradise.”

Reflections aside, I then noted among my tweets an AMED News article (American Medical Association News) by Kevin O’Reilly, dated February 25, 2013, entitled, “Black men increasing hard to find in medical schools” . The article is based on the latest statistics released in the Association of American Medical Colleges report on diversity in medical education (published February 4, 2013), and puts into focus some of the implications and repercussions impacting patients and indeed the future of the american healthcare system. The report revealed that “in 2011 a mere 2.5% of medical school applicants in the United States were black men.”

 “The shortage 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. Meanwhile, several studies have found that patients who are treated by physicians with whom they share racial or gender characteristics report greater satisfaction with their care and higher rates of medication compliance.”

Then I noted among my journal alerts a personal reflection just published in the Annals of Internal Medicine by one Baltimore trauma surgeon lamenting how many times he has had to break the awful news to a greiving family that their son has died from a gunshot wound. [Citation: Haider, A. H. (2013). Preventing Trauma Surgeons From Becoming Family Doctors. Annals Of Internal Medicine, 158(4), 291-292.  Access the full text with your UMHS EBSCO login.] Dr. Haider speaks of an “environment that leads to more than 51,000 violent deaths across America costing approximately $46 billion every year”, and calls for the need to further develop and establish violence prevention interventions along similar lines as programs for alcohol screening and intervention at level one trauma centers.

“When I decided to become a trauma surgeon [relates Dr. Haider], I never knew that I would be anyone’s family doctor. I didn’t expect to be recognized by grandmothers so familiar with the local trauma surgeons that they could call a death from across a room. When I am your family doctor we have a crisis on our hands.”

In spite of Dr. Haider’s understandable reluctance to be in the position he finds himself, he still tries to take advantage of what he calls the “teachable moment“, explaining to patients that although he doesn’t know why or how they got shot, he does know that the next time it happens they will probably die. In an attempt to do more he goes on to say,“As doctors, we have a role to play in calling for and creating interventions for violence prevention and we know that there are models that work.”

The intersections between these two stories can be made at many levels, but for me its the connection to caribbean medical schools and specifically with what UMHS St. Kitts is accomplishing.

“The AAMC report said the “persistent” problem of black male underrepresentation among medical school applicants speaks to a need for medical schools, which have stepped up minority recruitment efforts in recent years to try to get their student bodies to reflect the American population, “to institute plans and initiatives aimed at strengthening the pipeline.”

UMHS not only recruits but graduates men and women of diverse racial and cultural origins and varied socio-economic backgounds. Our medical graduates have gained an international perspective while completing a technically-advanced program of education with emphasis on primary care and prevention. They have been exposed to the medical consequences of youth violence; both on island and during their clinical rotations in the inner-city hospitals of Altanta, Chicago, New York, Detroit, and Baltimore. UMHS physicians are well prepared to deal with the current climate at the front lines of american medicine, and to face with innovation and compassion the “epidemic of violence” in the United States. I invite your comments.


Ann Celestine
Library Director


About UMHS:

Built in the tradition of the best US universities, the University of Medicine and Health Sciences focuses on individualized student attention, small class sizes and recruiting high quality faculty. For these reasons, UMHS is quickly becoming the school of choice among Caribbean medical schools.


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