Disparity in Education
I became aware of the disparities in education at an early age. Even though my high school was about 50% Latinx, it was not unusual for me to be the only person of color in my advanced placement math and science classes. I often found myself wondering how that could be possible. Why couldn’t my friends, who also identified as Latinx, also be placed in college prep classes? What systems dictated the options my peers had in high school, ultimately having a profound impact on their future educational endeavors? Hadn’t Brown versus the Board of Education declared that “separate but equal” was no longer legal in our educational system? Yet, it was clear that my white peers were expected to take the advance placement classes and the rest of us, students of color were to be in the remedial classes, and I for no apparent reason was an exception to this rule.
It is no surprise that these educational disparities at an early age impact higher level education. Medical schools continue to matriculate students that do not represent the patient populations they will eventually serve. In 2015, the AAMC came out with a report titled Altering the Course: Black Men in Medicine which showed that the number of black men entering medical school in 2015 was less than in 1978[1]. There were less black men entering medicine in 2015 than in 1978, despite having larger class sizes and more medical schools. In 2016, there was one medical student from Washington that matriculated into medical school who identified as American Indian/ Alaska Native. Only 5% of students matriculating in medical school from Washington identified as Hispanic or Latino and only 1.7% of students matriculating in medical school from Washington identified as Black or African American[2].
A contributing factor to the lack of (Underrepresented in Medicine) URMs matriculating into medical school, can be traced back to what I was witnessing as a high school student. URM students are less likely to graduate from high school with a foundation solid enough in science and mathematics to do well in college level courses. By the National Assessment of Education Progress, less than 3% of African American 17- year olds were proficient in science and math in 2000[3].
How can medical schools increase the number of URMs matriculating into their schools when such a large gap in educational opportunities exist for students of color? It has been shown that medical schools with pre-admission or pipeline programs have more URM students matriculating to their school[4]. One such program, formerly called Minority Medical Education Program (MMEP), then Summer Medical Educational Program (SMDEP) and now called Summer Health Professions Education Program (SHPEP), has shown to increase the probability of medical school matriculation among the undergraduate participants of the program[5]. SHPEP is a free summer program that provides URM students with a wide variety of academic and career experiences with the goal to strengthen the academic proficiency and career development of students underrepresented in the health professions and prepare them for a successful application and matriculation to health professions schools.
Through varies studies, it is known that URM medical professionals are more likely to practice in under- resourced settings than their white counterparts[6]. Therefore, by increasing the number of URM health professionals we can also reduce the gap in health disparities that impact racial minorities the most. URM patients also have a higher likelihood of selecting health care providers of their own racial or ethnic background[7].
Medical schools interested in increasing the number of URM students matriculating into their schools cannot solely blame the gap in educational achievements tracing back to primary education and believe they are too late in reaching URM students. Medical schools truly interested in increasing the racial diversity of their classes can create and support pipeline programs aimed to better prepare students from disadvantaged backgrounds. Medical schools have the option to lead the work in decreasing the health disparities by increasing the racial diversity of their students.
Sources:
1. Association of American Medical Colleges. Altering the Course: Black Men in Medicine. (2015).
2. Current Trends in Medical Education. (n.d.). Retrieved May 19, 2019, from https://www.aamcdiversityfactsandfigures2016.org/report-section/section-3/
3. Association of American Medical Colleges. Minority students in medical education: facts and figures XII. Washington, DC: Association of American Medical Colleges. 2002. https://services.aamc.org/publications/showfile.cfm?file=version12.pdf&CFID=1934460&CFTOKEN=27e1178-d3de50c6- 3715–4deb-b6b7–177b654ec649.
4. Strayhorn G. Preadmissions programs and enrollment of underrepresented minority students before and during successful challenges to affirmative action. J Natl Med Assoc. 1999.
5. Cantor JC, Bergeisen L, Baker LC. Effect of an intensive educational program for minority college students and recent graduates on the probability of acceptance to medical school. JAMA. 1998.
6. Grumbach K, Hart LG, Mertz E, et al. Who is caring for the underserved? A comparison of primary care physicians and nonphysician clinicians in California and Washington. Ann Fam Med. 2003.
7. Smedley BD, Butler AS, Bristow LR, et al. In the nation’s compelling interest: ensuring diversity in the health-care workforce. Washington, DC: National Academies Press; 2004.
