Physician Valerie Montgomery Rice is president and dean of Morehouse School of Medicine in Atlanta and member of the Council of Deans of the Association of American Medical Colleges.
In this piece, she examines the dearth of black men in medical school.
By Valerie Montgomery Rice
As president and dean of Morehouse School of Medicine, I am proud of Davon Thomas, M.D., for many reasons.
Dr. 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, Dr. Thomas sat quietly with his mother, wife and two 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.
Dr. Thomas is viewed as an anomaly in this country 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 black males in American medical schools. He is also among a very small percentage of young black males who maintain interest in science and math from elementary school through college.
This week, the Association of American Medical Colleges 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 – black 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 40,000 applicants to U.S medical schools, only 8.8 percent – or 3,537 – were black. Of those 3,537 black applicants, only 37.8 percent – or 1,337 – were men. The nearly 2-to-1 gender gap between black 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, black males represented 58 percent of black applicants to medical school. Moreover, despite overall increases in the number of black male college graduates over the last 20 years, the year with the highest number of black 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 black 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 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 Dr. Davon Thomas – do not get interviews. Consequently, hundreds of aspiring physicians each year are effectively denied access to medical school, which disproportionately impacts Blacks 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 four 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' 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 black 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 Black 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 Dr. Davon Thomas, our recent MD graduate. Instead of pursing high-paying medical specialties, which many young physicians are doing as medical school debt rises, Dr. 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.