by Arsene Frederic, Jr., editor in chief
Grappling with the COVID-19 crisis and response has pivoted attention to another key area of concern facing the scientific community: the lack of diversity in the medical community.
Diversity in the medical community is critical for ensuring that treatments and medical practices continue to serve the changing demographics of America. According to a family medicine physician at Michigan Medicine, “minority patients can benefit from having minority doctors, which is referred to as patient-provider racial and ethnic concordance. However, this is a hard match to make because diversity is limited.” This lack of diversity, coupled with institutional racism and inequality in the healthcare sector, results in disease and death.
The latest figures on diversity in medicine emphasize the lack of minority physicians in the medical community. This disparity is particularly concerning now, at a time when the politics surrounding COVID-19 vaccine trials and other treatments has engendered widespread mistrust among the general public. This, compounded with the existing mistrust of medical professionals among communities of color—influenced by both present disparities in medical care and the disproportionate impact of COVID-19 on minority communities—means that it’s even more important for doctors to reflect the populations they serve.
Empowering minority serving institutions (MSIs) to improve the proportion of minorities in the medical community is relevant in this context. Minority serving institutions make up a category of educational establishments (federally recognized Title IV colleges and universities) based on either historical origin or enrollment criteria. Recently, Bloomberg pledged $100 million to medical schools at 4 HBCUs (Historically Black Colleges or Universities). These medical schools are: Meharry Medical College, Howard University College of Medicine, Morehouse School of Medicine and Charles R. Drew University of Medicine and Science. The article adds that “the four schools were selected in part due to their high graduation rates among Black medical students and for their proven track records of increasing economic and social mobility.”
The cultural competency embedded in the minority serving institution framework is fundamental to fostering a secure and stable pipeline for minority students to enter into STEM careers, specifically careers in medicine. For example, MSIs infuse minority experience into the curriculum via well-rounded personal development programs, which focus on academic and social competencies as well as emotional and spiritual development. However, the rising costs of medical school erects barriers for minorities to access medical training. A 2018 report from the U.S. Department of Education notes the average physician now graduates with $246,000 in loans. These numbers have more than doubled since 2000, with median debt at $90,000. In another report, nearly 70% of Black students who drop out cite debt as a factor—and that was before the pandemic struck. These findings emphasize the importance of investing in minority serving institutions, whether public, private or philanthropic, to increase the diversity of minority representation in medicine.
Nonetheless, recommendations issued in Minority Serving Institutions: America’s Underutilized Resource for strengthening the STEM workforce, a report from National Academies of Sciences, Engineering, and Medicine, provide a path forward for increasing diversity in medicine. For example, public and private funding agencies can offer grant programs that implement incentives for non-MSIs to partner with MSIs on areas related to STEM education, research, and teaching, including the facilitation of student transfer (e.g., from two-year to four-year institutions), mentorship programs for junior faculty, and student access to graduate education. This option is targeted towards specific efforts to support evidence-based strategies and promising programs that serve MSIs. Additionally, increasing the presence of minority providers who are part of a team-based model of care, including registered nurses, doulas, certified nurse midwives and nurse practitioners, can serve as a solution to holistically increase diversity within the medical community.
Research confirms that diversity in the STEM workforce can have a positive effect on both a company’s culture and revenue. Additionally, implicit bias is decreased when physicians and patients share the same race or ethnicity. The practicality of these proposals are complex and require a broader commitment to diversity and inclusion in the U.S. Although the road ahead is long, further support of minority serving institutions provides some glimmers of hope that suggest that the diversity gap will eventually be narrowed.