Diversity in health care is not a new problem. Since the 2002 Institute of Medicine’s report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” universities have responded by increasing curricula designed to teach cultural competency. Since then we have learned in medical school about health care disparities and social determinants of health: how income and education inequality leads to poor health outcomes, how the race of the health care provider versus the race of the patient plays an important role in diagnosis and treatment.
But is it enough to know that disparities exist? While U.S. census numbers from 2012 show that 63 percent of the population is white, 13.1 percent is African-American, and 5.1 percent is Asian, the Association of American Medical Colleges reported in 2011 that 54.6 percent of all allopathic medical school applicants were white, 20.4 percent Asian, and 7.3 percent African-American. Similarly, AACOM reported that 60.3 percent of osteopathic student applicants were white, 22.2 percent Asian, and 5.4 percent African American. But what is way off is that only 2.9 percent of tenured medical faculty are African-American. A 2012 AAMC report on diversity in medical education found that 54.6 percent of African-American students were planning to practice in underserved areas, while only 21.4 percent of white students were planning on practicing in those areas.
The rising cost of medical school, today roughly $160,000 a student, is a major factor in deterring entrants. But for minority students, who carry a disproportionately larger amount of premedical school debt, this reality is an even greater deterrent. Is it any wonder that we still face diversity problems? Medical education needs to be accessible. Programs like National Medical Fellowships (NMF) and the Joint Admission Medical Program (JAMP) are making strides toward this goal. By providing scholarships to underrepresented minorities and economically disadvantaged students, they are making a serious dent in our diversity problem. But they are not enough. We need more.
We need to invest in the future physicians-in-training, the medical education pipeline, especially supporting high school “STEM” programs: those that promote science, technology, engineering and math.
It is important to realize that diversity is not solely about race. Diversity incorporates life experiences, economic and educational background, and so a holistic approach to the admissions process is also needed.
While the diversity of medical education has greatly improved over the past decade, there is still more to be done before direct impacts on the health care workforce are seen.
Dr. Nida Degesys, a recent graduate of the Northeast Ohio Medical University, is AMSA’s national president.