Opinion
We need more African American men in medicine. How do we get them there?
By Valerie Montgomery Rice
As president and dean of Morehouse School of Medicine, I am proud of Davon Thomas, M.D., for many reasons.
Davon Thomas recently graduated from Morehouse School of Medicine at the top of his class with a 4.0 grade-point average. His step 1 and step 2 national board exams were the highest in the class, surpassing national averages.
At our award ceremony, Thomas sat quietly with his mother, wife and 2 younger siblings and received virtually every academic award we present to medical graduates. His mother, Denise, glowed as her son placed each award – all 13 of them, one by one – gently in her lap.
Thomas is viewed as an anomaly in this country – the United States – for a number of reasons. In medicine, as a 25-year-old African American man, he earned a medical degree amid a troubling shortage today of African American males in American medical schools. He is also among a very small percentage of young African American males who maintain interest in science and math from elementary school through college.
This week, the Association of American Medical Colleges (AAMC) released a critical report titled, “Altering the Course: Black Males in Medicine.” The report shines light on a crisis in American medicine that should compel the nation’s 144 medical school leaders and those in the entire educational continuum in the United States to think differently.
At risk is our ability to build diversified health care teams that can adequately address the complex health needs of all Americans, particularly the most vulnerable among us. This risk is dramatically compounded by the millions of new Americans, many from disadvantaged groups, with health care access as a result of the Affordable Care Act.
“While the demographics of the nation are rapidly changing and there is a growing appreciation for diversity and inclusion as drivers of excellence in medicine, one major group – African American males – has reversed its progress in entering medical school,” said Marc Nivet, chief diversity officer at the AAMC and author of the report.
“No other minority group has experienced such a decline in applications to medical school. The inability to find, engage and develop candidates for careers in medicine from all members of our society limits our ability to improve health for all.”
In 2014, of the nearly 40,000 applicants to U.S medical schools, only 6 percent – or 3,537 – were African American. Of those 3,537 African American applicants, only 37.8 percent – or 1,337 – were men. The nearly 2-to-1 gender gap between African American female and male applicants was the largest gender disparity of any racial group.
Almost all other racial groups had close to an even balance of female and male applicants. By contrast, in 1978, African American males represented 58 percent of African American applicants to medical school. Moreover, despite overall increases in the number of African American male college graduates over the last 20 years, the year with the highest number of African American male applicants to U.S. medical schools was more than 30 years ago.
There are many reasons for this crisis. Among them are tremendously leaking pipelines throughout the education continuum for African Americans in general and African American males in particular. Too many African American males drop out before graduating from high school. Of those who stay, too many lose interest in science, technology, engineering and math (STEM) disciplines before or during high school. Of those who succeed in entering college with STEM majors, many will change their majors. Then, of those who succeed in taking the Medical College Admission Test or the (MCAT) exam, most will not apply to medical school for reasons we do not yet understand. And finally, of those who take the MCAT exam and apply to medical school, 61 percent are not accepted.
This leads us to another reason for this crisis: the enormous value placed on MCAT scores in our admissions criteria to U.S. medical schools. Often, students with scores 2 or 3 points below the national average – like Davon Thomas – do not get interviews. Consequently, hundreds of aspiring physicians each year are effectively denied access to medical school, which disproportionately impacts African Americans and other underrepresented minorities.
The MCAT exam is but one piece of quantitative data that should be considered in assessing a student’s ability to be successful in medicine. Undergraduate grade-point average is another. However, qualitative markers that help measure perseverance, persistence, and a commitment to serve others are also critically important in assessing an applicant’s ability to bring value to a team of health care providers. And those characteristics, coupled with quantitative measures, should be assessed through a very systematic and holistic interview process.
That is why the nation’s 4 historically black medical schools – Morehouse School of Medicine, Meharry Medical College, Howard University College of Medicine, and Charles R. Drew University of Medicine and Science – continue to enroll and graduate a disproportionate number of underrepresented minorities in medical school.
According to AAMC data, of the top 17 U.S. medical schools who graduated African American physicians over the last 32 years, Morehouse School of Medicine, Meharry and Howard alone graduated nearly half of them.
At Morehouse School of Medicine, we purposefully accept students with a range of MCAT scores because we value cognitive diversity and see each day the limitations of the MCAT score in predicting success. And despite accepting some students with MCAT scores below the national average, our students’ United States Medical Licensing Examination (USMLE) Step 1 first-time taker board pass rates and scores consistently meet or exceed the national average.
To be sure, the historically black medical schools are doing their part to diversify the health care workforce. But they must not be the only medical institutions charged with this profoundly critical mission. This is a national – indeed an American – issue, and the health of our country weighs delicately in the balance.
The AAMC report calls on “leaders across the education continuum, from kindergarten through professional school, to rise to the challenge of increasing the number of African American males in medicine.” I join that call. As education, business and policy leaders, we must address both ends of the pipeline.
On the front end, we must increase funding and strategic collaborations in K-12 pipeline programs to attract and sustain more young African American males to STEM disciplines as we fiercely address stunning drop out, jobless and incarceration rates. On the back-end, we in academic medicine must think differently about the admissions and enrollment process, using both quantitative and qualitative measures to gauge one’s ability to succeed and add critical value to health care teams.
The research is clear that physicians who are members of underrepresented minority groups disproportionately chose primary care fields that have the greatest impact on vulnerable populations and creating health equity.
Which brings me back to Davon Thomas, our recent MD graduate. Instead of pursing high-paying medical specialties, which many young physicians are doing as medical school debt rises, Thomas has chosen family medicine, the purest form of primary care and the area of greatest need in this country.
And we should all be proud.
Valerie Montgomery Rice is a physician, President and Dean of Morehouse School of Medicine and member of the Council of Deans of the Association of American Medical Colleges. The original version of this article was originally published in the Atlanta Journal Constitution.