News and Commentary George Thibault on Diversity in Medical Education

In recognition of National Minority Health Month, Dr. Thibault discusses how the changing demographics of the country are impacting health professions education and what medical schools need to be doing to keep pace.

Are health professions schools doing enough to increase diversity in medicine?
We’ve made great progress but we can’t be complacent. We need to do much more to make the health professions student body more diverse in terms of race, ethnicity, income, and gender so that our health care workforce is more representative of patients. For example, the criteria for admissions need to be more holistic and not focused so heavily on test scores. Schools need to consider things like a person’s contributions to their community, their personal characteristics, and their attitudes toward serving.

There is also an economic challenge that cannot be ignored. Student bodies are more socioeconomically homogeneous because of the pressures of loan debt. We need to think more creatively about how to reduce the debt burden of health professions students. This is a particular concern for medical students because the prospect of enormous debt undoubtedly deters any person of low socioeconomic means from even thinking about a career in medicine.

We also need to make the student experience more appealing to people of different backgrounds. We need new models of education that are more community-based and more flexible to allow students to go through school at different schedules and with less of a financial burden. We also need to do more to diversify faculty so that students will be mentored and taught by people from different backgrounds. A more diverse faculty will make certain that students are taught how to care for patients from all walks of life.

Are there certain schools that are doing exemplary work in this area?
The historically black medical schools have done a lot. We can learn from their experiences. The 2010 report we supported on the Social Mission of Medical Education: Ranking the Schools, co-authored by Dr. Fitzhugh Mullan, is a good reference point. It showed that three historically black colleges had the highest social mission rankings, and that more could be done at the medical school level to increase the proportion of doctors who practice primary care, work in underserved areas, and are underrepresented minorities.

One of the biggest challenges that we still face is increasing the number of black men applying to medical school. An AAMC report found that in 2011, first-time African-American applicants were surpassed by Asians and Hispanics. This is very much a pipeline problem because there are not enough black men who attend and graduate college. This is also a problem for our Hispanic population. Although there isn’t a decline in the numbers of Hispanics applying to medical school, the number of applicants isn’t growing anywhere near the pace of growth in society.

What has Macy done to foster more diversity in health professions education?
We have supported a number of organizations promoting diversity in medicine. We continue to broadly encourage changes in culture and curriculum in health professions schools that will make them more attractive to minority students and those who might be considering careers to serve underrepresented populations. We are hoping that our push for curriculum reform produces a culture that minority students find more appealing and broadly improves health professions education so it is more oriented toward community needs and promotes diversity. In addition, both through grants and supporting Macy Scholars, we are promoting the teaching of cultural awareness and cultural competence.

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