Despite efforts by medical schools to increase diversity among applicants, the numbers for one demographic—black men—have remained stagnant for nearly 40 years. In 1978, 1,410 black men applied to U.S. medical schools. In 2014, that number was 1,337, according to a new AAMC report, Altering the Course, Black Males in Medicine.
Presented Aug. 3, 2015, at the National Medical Association’s (NMA) 112th Convention in Detroit, the report details the decline of black men in medicine, analyzes reasons for the low volume, and addresses strategies that could increase the nation’s black male doctors.
“We’ve actually lost ground in terms of the number of black men in medical school,” said Marc Nivet, EdD, AAMC chief diversity officer. “We’re suffering from continued challenges that black men face up and down the continuum of education. Even though we have more black men in college and graduating college than we’ve ever had, we don’t have enough of them studying in disciplines that traditionally lead to medicine.”
Along with applicants, findings also show that black male matriculants have made little headway in the past four decades. In 1978, there were 542 black male matriculants to MD-granting institutions. In 2014, that number was 515. In addition, despite an overall increase in the number of black male college graduates, the proportion of male to female medical school applicants is lowest for African-Americans.
Through interviews with 11 black premedical students, physicians, researchers, and education leaders, the report provides perspectives on issues that contribute to the problem. Major drivers include unequal K–12 opportunities, the absence of mentors, negative public perceptions of black men, and lack of financial resources. Medical school leaders say it has never been more critical to tackle these obstacles head-on and strive to raise the number of black men pursuing medicine as the nation faces rapidly changing patient demographics and a predicted shortage of between 46,000 and 90,000 physicians by 2025, according to AAMC estimates.
“We’re suffering from continued challenges that black men face up and down the continuum of education.”
Mark Nivet, EdD, AAMC
A key factor in the absence of black male doctors is the disproportionate number of black male role models in underperforming K–12 public schools, according to the report. Data also show that fewer black males than white males pursue higher education.
The country appears to be moving back in time and toward the separate and unequal educational opportunities that Brown v. Board of Education tried to overcome, according to Brian Smedley, PhD, co-founder and executive director of the National Collaborative for Health Equity.
“Kids of color are more likely to be in low-performing schools that are underresourced,” Smedley said in the AAMC report. “You have issues of physical infrastructure crumbling, outdated textbooks, and teachers not credentialed to teach in the subjects they’re teaching. All of these problems compound, and I suspect that they have a disproportionate impact on males of color, particularly black boys.”
Black men frequently have complex challenges as they grow up, added M. Roy Wilson, MD, MS, president of Wayne State University and a member of the AAMC Board of Directors. Too often, other activities take priority over school, he said.
Wilson also believes an overreliance on test scores hinders the success of talented black men. Admissions committees at some medical schools emphasize scores on the Medical College Admission Test® (MCAT®) too much, he said, adding that high cutoff scores can “preclude very talented minorities” from gaining admission at some institutions.
Another pervasive theme in the report is the lack of role models to encourage black men in their medical career aspirations. “Many physicians will say they decided to become a physician because of someone they saw or met,” said Wayne A.I. Frederick, MD, MBA, president of Howard University. “That is something we have to be cognizant of and create more systems [that will] provide that mentoring and exposure.”
Public perceptions of black men also play a role in the educational advancement of young black males. A combination of negative media portrayals and lower expectations for males—particularly young black boys and men—directly and indirectly perpetuate stereotypes and systemic biases, interviewees said.
“From the perspective of black boys, when they first come into school, [they] have very similar aptitudes and aspirations to all other students, but somewhere between ... third grade and the fifth grade, there is something that occurs to them, [and] they become consciously aware of how they’re being treated or how they’re not being treated, which then starts to change some of their expectations and even their aspirations for what they feel that they can achieve,” Cedric Bright, MD, said in the report. Bright is assistant dean of admissions, director of special programs, and associate professor of medicine at the University of North Carolina School of Medicine.
Report authors recommended greater focus on institutional policy and administrative practices, increased support for programs, across the medical education continuum, and stronger community engagement.
Meanwhile, the AAMC plans to partner with the NMA to launch a task force that will suggest new solutions to the problem. The associations will work together to collect and report data on the progress of black men in medicine.
Collaboration with other medical schools within a state and joint efforts by undergraduate schools also are key to addressing the disparities, Nivet noted. “What needs to happen is greater leveraging of the assets that exist at our medical schools and teaching hospitals within a particular state.”
This article originally appeared in print in the September 2015 issue of the AAMC Reporter.