How to Boost Diversity in Medical School

The United States is growing more diverse. According to new data from the U.S. Census Bureau, nearly four in ten Americans identify as non-white. That's almost double the share from 40 years ago.

Unfortunately, the racial and ethnic makeup of the country's medical schools has not followed suit. The share of medical students who identify as racial or ethnic minorities is growing more slowly than their share of the overall population, according to a study from the Journal of the American Medical Association.

Medical schools must make diversity a bigger recruiting priority. Doing so won't just open doors for underrepresented students – it'll also improve public health.

Black and Hispanic Americans account for nearly one-third of the country's population. Yet they comprise just 11 percent of current medical students.

Med schools lack diversity on other fronts, too. One-fifth of Americans live in rural areas, but just 4 percent of medical students hail from rural communities.  The number of rural medical school applicants dipped nearly 20 percent between 2002 and 2017.

Med students also tend to be wealthier than the average American. According to the latest data from the Association of American Medical Colleges, nearly 80 percent are from families in the top 40 percent of earners. 

This lack of diversity directly impacts public health. A study from Stanford found that Black men who received care from Black doctors were far more likely to seek preventive screenings for diabetes and cholesterol. These screenings could "reduce mortality from cardiovascular disease by 16 deaths per 100,000 per year, accounting for 19 percent of the black-white gap in cardiovascular mortality."

The lack of geographic diversity also contributes to America's rural physician shortage. That's because doctors tend to practice in areas similar to those where they grew up. According to research published in American Family Physician, students from rural counties are four times likelier to work in rural areas than students from urban counties. 

Sixty percent of the country's federally designated "health professional shortage areas" are rural. Increasing the number of rural students in med schools could be the most effective way to address these shortages. 

Fortunately, there are concrete ways to make medical school a reality for underrepresented students – and thereby improve access to care for their future patients.

Peer-to-peer mentorship programs can help students who aren't sure if medical school is right for them. Schools can encourage students and alumni from non-traditional, minority, or rural backgrounds to connect with prospective applicants and offer guidance on the admissions process or MCAT.

Guaranteed medical-school admissions programs, which allow high school students to secure admission to an undergraduate program and medical school simultaneously, can also boost diversity. Admitted students typically have to keep up their grades as undergrads to retain their spots in medical school. If they do, they may not have to take the MCAT.

Making medical school more affordable is another way to attract and enroll a more diverse group of students. More than 75 percent of students at St. George's University, the school I lead, receive scholarships. Dozens of students have benefited from our CityDoctors scholarship program, which provides aid to students from the New York metropolitan area who commit to working in the city's public hospital system upon graduation. Many CityDoctors scholars have been the first in their families to go to college.

It may seem counterintuitive, but international medical schools are a key source of diversity for the U.S. physician workforce. That's because in reality, "international" is a bit of a misnomer. Many internationally trained doctors hail from the United States but chose to venture abroad for their education.

Three-quarters of St. George's students are U.S. citizens. Our student body represents 49 states and 103 countries. This summer, more than 1,000 St. George's graduates will begin residencies across the United States. Many will return to the states and localities where they grew up.

To bring about a more accessible, more equitable healthcare system, we must cultivate a more diverse physician workforce. That's a task medical schools must take on.

Dr. G. Richard Olds is President of St George's University (www.sgu.edu).