Friday, May 27, 2022

New med schools are planned as the need for black doctors continues

When Xavier University in Louisiana announced last month that it plans to open a medical school, it was welcome news in the higher education and medical fields. The announcement followed a similar statement from Morgan State University in Maryland, which last year announced it would open a college of osteopathic medicine. In doing so, the two historically black institutions would bring the total number of HBCU medical schools to six – still a small fraction of the 170 medical schools in this country, most of which are predominantly white institutions.

Given the small number of black doctors in the United States, the new HBCU medical schools represent a significant development. Despite making up just 2.3 percent of the total number of medical schools in the US, HBCUs produced 9.8 percent of black medical school graduates in 2019, according to the Association of American Medical Colleges. Before the wave of new medical school openings began in 2002, that number is less than 27 percent, increasing the total number of graduates.

Efforts by several major predominantly white institutions, or PWIs, to enroll and graduate more black students are also expected to increase the number of black doctors over the next decade, eventually leading to more access to health care for black people. Can improve accessibility and quality. , Meanwhile, according to the AAMC, first-year enrollment in medical school by Black students rose 21 percent in the 2021-22 academic year, from 2,117 over the previous year to 2,562.

Those positive signs do little to mitigate the many other challenges that remain in the case of increasing the number of black doctors. A 2015 report from the National Institutes of Health forecast an imminent shortage of 33,000 primary care physicians by 2035. Black medical teachers say the black community will bear the brunt of those shortages.

“While we may be excited and happy as I am, HBCUs with the ability to do this are starting to [medical schools]”We can’t afford to put pressure on existing medical schools to do a better job at training a diverse student body,” said James Hildreth, president of the historically black Mehriy Medical College in Tennessee.

“There’s no way in the world — if Morgan starts a school, if Xavier starts a school — that’s still not going to provide the number of diverse medical trainees we need,” Hildreth said. “Other existing schools have to do a better job. This means paying more attention to how they evaluate students for admissions, but also the pipelines they attract students to. ,

Morgan State and Xavier, which plan to open their medical schools in 2023 and 2025, respectively, will join Mehri; Howard University College of Medicine in Washington, DC; Morehouse School of Medicine in Atlanta; and in Los Angeles, Charles R. Drew University of Medicine and Science, as a historically black medical college in the United States.

Xavier and Morgan State are also part of a wave of nine institutions that have announced plans to open medical colleges. The list includes Marist College in New York; Duquesne University in Pennsylvania; University of California, Merced; and the University of Texas at Tyler, among others. Between 2001 and 2019, 29 medical colleges opened in the US, according to the AAMC’s count in early 2020.

Ensuring that new and existing colleges attract diverse applicants, and admit and graduate them, is the challenge. Historically black colleges still produced the most black graduates; According to the AAMC, between 2009 and 2019, Howard and Morehouse each graduated more than 400, while no white institution graduated more than 300 during that time frame. Two of the four undergraduate institutions that supplied medical colleges with the most black students this academic year were HBCUs—Howard (1st) and Xavier (4th). (The University of Florida was second and Georgia State University third.)

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Frederick, Harvard President and Professor of Surgery in the College of Medicine, believes bias in medical school admissions to PWIs is a problem and helps explain why they produce fewer black doctors.

“While the news of increasing diversity in medical school classrooms was certainly welcome, it was largely greeted with cautious optimism,” he wrote in an op-ed in March when the AAMC asked Black first-year medical schools. An increase in enrollment was reported. “There is great concern that these numbers may ultimately reflect an anomaly rather than the beginning of a longer-term trend. Additionally, after successfully enrolling Black medical students, we need to provide financial and emotional support to ensure There’s more to be done that they graduate.”

Frederick wrote that Howard’s medical school received a record 7,502 applications for the fall of 2021 and offered admission to 4.3 percent of applicants, and 122 enrolled.

“Despite how competitive our school has become and the limited number of positions available to us, 79 of our new enrollees were admitted to only one medical school – ours. Whether they were rejected from other schools or finances allowed them to apply to other institutions Most of our students would not have attended medical school this fall if we had not accepted them. We are proof that with the right admissions process, even specialized and selective institutions are accessible to anyone. Maybe, not just the privileged.”

A 2020 survey of medical school admissions officers clarified Frederick’s point. The survey found that while medical schools were largely supportive of the Black Lives Matter movement, less than half of the schools had programs to enroll black students. Of the medical schools polled, 88 percent said they issued statements expressing solidarity with the Black Lives Matter movement, but only half (48 percent) said they had specific programs in place to recruit black applicants. “At the time, the population of black residents in my city did not guarantee a specific stream for black applicants,” said an admissions officer without a program.

Xavier’s president, Reynold Verret, said the over-reliance on HBCUs as a feeder to black med students is a sign that barriers exist in the pipeline, not only at the entry level but through and out of medical school.

“Med schools themselves don’t run the pipeline,” said Verrett, a biochemist and immunologist. “It’s four-year colleges, and four-year colleges don’t even run those pipelines. It’s K-through-12.”

Most medical colleges still have low numbers of black applicants, enrolled students, and graduates. The percentage of black medical students and black doctors has stayed for several years at around 5 percent, which is well below the 13 percent black population in the US.

Verret said he and other university leaders start a medical school as a core part of HBCU’s mission.

“Representation and trust are fundamental to equity in reducing the inequalities we know about health in the United States,” he said. “Especially with the Covid pandemic – if there was any doubt about it, it got in your face.”

But Verret and many others in the medical community believe that HBCUs alone cannot produce enough doctors to close the racial gap.

“What’s important in this entire American crisis is the perceived shortfall that can’t just happen on HBCUs,” said Norma Pole-Hunter, AAMC’s senior director for workplace diversity. He praised Xavier’s and Morgan’s plans but said, “It doesn’t leave responsibilities to all the other medical colleges. They really need to move the needle.”

That needle is indeed spinning in some institutions. New York University’s Grossman School of Medicine took arguably the most dramatic step in diversifying the demographics of its classes when it began offering free tuition in 2018. Applications grew 47 percent in the first year, and 102 percent–142 percent for applicants from underrepresented groups. For Black applicants.

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According to Dr. Reena Thomas, the university’s associate dean for diversity in medical education, black enrollment at Stanford University School of Medicine has more than doubled in the past 10 years, from 28 students to 67, and by 3 percent over the past 10 years. has increased to 5 percent. Overall, the proportion of students from underrepresented groups increased from 15 percent to 24 percent over that time frame. She said the numbers were the result of deliberate, across-the-board efforts that did more than pay lip service to diversity, equity and inclusion.

“What I’ve felt is that the pace of change picked up because everyone was focused on it,” said Dr. Thomas. “It wasn’t a single office or a single group. It was a collective, unified front advocating this change together. That’s why we’ve been so lucky. And I have to admit, I don’t think every single academic institution is near.”

Dr. Thomas, a neurologist and neuro-oncologist, began work in his current position in August 2020, when the COVID-19 pandemic was still in its early stages and created racial and health care disparities, particularly among people of color. It was starting to appear. African Americans and Hispanics began to get sick and die at disproportionate levels. He noted that Stanford’s initiatives to advance diversity were already underway, such as a research partnership with Meharry since 2017, and dedicated support groups for black students, graduates, residents, peers, faculty and staff, and HBCUs. A planned program for medical school. Students are doing research and clinical work at Stanford over the summer.

“The history of medicine has been tragic,” she said. “These issues haven’t just come out of the blue — they’ve been embedded within medicine throughout its history. And I think the pandemic brought it to the surface in a way that no one can deny, no one talks about it.” Can’t turn.”

In some cases, colleges have tried various strategies to attract black students to the medical profession at an early age. Hildreth pointed to Mehri’s pipeline programs, including outreach and mentorship programs targeted at middle school students.

“Kids can’t get really excited about something they don’t know about, and they can’t believe it’s possible for them,” he said. “It’s easy to believe that something is possible for them if they see people who already look like them in those roles.”

Verett notes the importance of colleges wanting to work with black students, who come without the educational backgrounds of some of their white peers, and with first-generation students who are navigating unfamiliar territory.

“Students come with all kinds of precollegiate gaps, so we’ll meet you when Xavier comes over, and we’re going to fill those gaps. We know talent isn’t divided socio-economically, “They said.

Advice and support for black students is to continue throughout medical school and beyond, Dr. Thomas said, linking the core principles of diverse medical education—recruitment, retention and inclusion—with the latter being the most important.

“I think inclusion is definitely the most challenging. We don’t want to just bring students here to Stanford and not push them. Succeed, thrive, get mentored, feel that inclusion on every level . And it’s something we’re constantly working on.”

Increasing the number of historically black medical colleges to six over the next few years will increase the number of black doctors—but not by as much of a difference as all other colleges are weighing in and diversifying their student bases. The poll-hunter said Xavier and Morgan State are leading in that area.

“Nationally, we see this as a good thing, because it is needed.”

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