A Prescription to Revamp the Pipeline: Lessons From the Road and the Tour for Diversity in Medicine

Highways With Overpasses

Editor’s Note: For more on the topic of diversity, check out this AM Rounds post.

By: Brandi K. Freeman, MD, MS, Robert Trevino, MS, Kameron Mathews, MD, JD, and Alden Landry, MD, MPH

B.K. Freeman is an assistant professor in the Department of Pediatrics at the University of Colorado Anschutz School of Medicine, Aurora, Colorado, and a mentor for the Tour for Diversity in Medicine. R. Trevino is a mentor for the Tour for Diversity in Medicine and a medical student at Rush Medical College, Chicago, Illinois. K. Matthews is co-director for the Tour for Diversity in Medicine and an assistant professor of clinical family medicine in the Department of Family Medicine at the University of Illinois, Chicago, Illinois. A. Landry is co-director for the Tour for Diversity in Medicine and the faculty assistant director in the Office of Diversity Inclusion and Community Partnership at Harvard Medical School, Boston, Massachusetts.

In response to Justice Antonin Scalia’s recent comments regarding where he thinks minority students, specifically black students, might best be served in the educational system, social media was on fire with the success stories of minority college graduates with the hashtag #slowtrackblacks. Posts such as “BS Duke, MD Hopkins, JD U Chicago #slowtrackblacks” and “BS PVAMU, MD UAB, Now Harvard Faculty #slowtrackblacks” were all over social media. Scalia’s comments offended many, and undermined the academic success of a generation as well as the quality of institutions across the country. In medicine, his comments highlighted the fact that minority students succeed with the right environment and resources, but given the dearth of underrepresented minority (URM) health professionals, it’s clear that not all students are receiving this prescription and a revamp of the pipeline is needed.

The Association of American Medical Colleges’ recent publication “Altering the Course: Black Males in Medicine,” for example, was a call to action for the medical community about the stark disparity in the number of black males in medicine. Admittedly, many of the things highlighted in the report have been anecdotally appreciated by the Tour for Diversity in Medicine (T4D) directors and were some of the drivers for the T4D’s research division.

The T4D was founded by physicians who are former leaders in medical student organizations, rooted in their experiences, knowledge, and desire to help fuel the pipeline by educating, inspiring, and cultivating students interested in pursuing a career in the health professions. Specifically targeting URM students by visiting historically black colleges and universities, Hispanic serving institutions, and institutions in underserved areas, this program has met with more than 2,700 students in 25 states on 37 campuses. Driven by the passion of its leaders, the T4D seeks to make a difference through individual interactions with students that provide them with real-life examples of what can sometimes seem like an unattainable goal.

In our recent research report, where we conducted a qualitative study of students participating in the T4D, we sought to understand why driven URM students with an interest in becoming a health professional did not succeed—what barriers did they face and what could we do as a collective to help them succeed.

The challenges articulated by our URM students were numerous. Students spoke about educational issues, such as inadequate institutional resources, including sparse course offerings and clinical opportunities. Students also felt they had inadequate guidance and mentoring to assist with key career development decisions and societal barriers, and experienced issues related to personal and familial stress, including strained personal resources and challenges connected to being the first generation in medicine (or even in college for many students). For instance, many students faced concerned families who did not understand the long and sometimes convoluted path to becoming a physician. The question now is what can we do to help these students succeed?

Innovative programs like the T4D are just part of the solution. Organized medicine needs to play a large role—the Association of American Medical Colleges, National Medical Association, National Hispanic Medical Association, and others are going to be key to making a difference in the opportunities and guidance afforded to these students. Individual practitioners are also part of the solution. Repeatedly, our students reported difficulty with finding clinical experiences; an individual clinician can be the difference between a student finding a clinical experience or not finding one.

Lastly, we must remember that policy decisions being made at all levels of education will affect the health professions and therefore the health of our country.

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