Enriching Medicine Through Diversity
What is the Problem?
Having a diverse physician workforce is a critical component in making health care available to those who need it most. The lack of diversity of medical students, coupled with ineffective cultural competency education, continues to produce training and treatment environments that are biased, intolerant and contributory to health disparities.
- Racial and ethnic minorities comprise 26% of the total population
of the United States, yet only roughly 6% of practicing physicians are
Latino, African American and Native American.*
- Under-represented minority (URM) faculty account for only
about 4% of U.S. medical school faculty members, and approximately 20%
of URM faculty is located at six schools-Howard University, Meharry
Medical College, Morehouse School of Medicine, and the three Puerto
Rican medical schools.*
- Black physicians were found to practice in areas where the
proportion of Black residents was nearly five times as high as where
other physicians practice. Likewise, Hispanic physicians worked in
communities with twice the proportion of Hispanic residents when
compared to their non-Hispanic colleagues.*
- Nearly half of patients seen by African American physicians
and one-third of patients seen by Asian and Pacific Islander and
Hispanic physicians are Medicaid or uninsured patients.*
- URM physicians are also more likely than their non-minority
counterparts to conduct research to help reduce racial disparities in
health care.*
* For more information, see
Minorities in Medical Education: Facts and Figures 2005,
a publication of The Division of Community and Minority Programs, AAMC,
for students, medical educators, and policy makers that provides
detailed racial and ethnic statistical information on medical education
in the U.S. Additionally, Facts and Figures contains data related to
the pre-college part of the education pipeline leading to the M.D.
degree, medical school graduates, and medical school faculty, as well
as data from the 2000 U.S. Census.
How Did We Reach This Point?
Historical Background
As late as 1969, minority matriculation in medical schools nationwide
totaled 292, or three percent of the total number of enrollees. In
1970, the AAMC recommended that the number of medical school
matriculants from URM increase to 12 percent of the total by 1975 and
that a central loan program be created for URM students. By 1976, these
goals had not been reached, however, enrollment of URM students had
increased to nine percent. Low minority representation was perceived as
an issue of equal opportunity. New minority representation issues
surfaced in the 1980s when research showed that minority physicians
were more likely than were their non-minority colleagues to practice in
underserved areas. Attempts to increase minority representation in
medical school now had two motivations: 1) equal access to education,
and 2) improving health care in medically underserved areas.
Under-Represented Minorities
There are four racial and ethnic groups defined by AAMC as
under-represented minorities (URM) in medicine: African Americans,
Mexican Americans, mainland Puerto Ricans, and Native Americans. In
2001, however, AAMC appointed an advisory committee to examine their
definition of URM. The results of a revision of the definition could
have serious repercussions for scholarship programs, recruitment
efforts and academic enrichment programs. For more information on the
possible revision of the URM definition, check out the AAMC website and the facts compiled on the issue by the Student National Medical Association (SNMA).
Affirmative Action Past and Present
In the 1978 landmark case Bakke vs. University of California-Davis School of Medicine,
the Supreme Court ruled that race quotas were unconstitutional but that
race may be used as a "plus-factor" in admissions as long as the policy
serves a "compelling state interest" and is "narrowly tailored" to
achieve that goal. But beginning in the mid-1990s, a series of lawsuits
have challenged affirmative action policies and have posed a new threat
to achieving diversity in medicine. In the same period, URM enrollment
in medical school has seen significant decreases.
AMSA Endorses Sullivan Commission Report
The
Sullivan Commission is named for Dr. Louis Sullivan, former secretary
of Health and Human Services and chair of the commission. The
nationlly-recognized panel issued 37 recommendations to improve
diversity in the healthcare workforce. AMSA was present at the release
of the findings and has enthusiastically endorsed this report as a
roadmap to increased diversity in medicine.
Sullivan Commission Report
On June 23, 2003, the U.S. Supreme Court ruled in Grutter v. Bollinger, et. al. that schools may use race in admissions decisions to support the recruitment of a diverse student body. In Gratz et al. v. Bollinger et al.,
the Court held that while race is one of a number of factors that can
be considered in undergraduate admissions, the automatic distribution
of points to students from underrepresented minority groups should not
be standard, without further consideration of their other individual
attributes.
Now more than ever, it is crucial to make minority enrollment in medicine a priority.
What Can We Do About It?
AMSA strives to cultivate a tolerant, accepting and culturally
diverse physician workforce, which can effectively serve our
multi-cultural society.
AMSA houses a wide array of resources to educate you and your
colleagues about Diversity in Medicine and to equip you to make
positive change for a brighter health care future through:
- Advocating for increased representation of underrepresented minorities in medicine to increase applicants and acceptances
- Educating medical students, health professionals, and the public about the relationship between diversity and disparities
- Advocating for cultural competency curricula in medical education