Medical, dental, and veterinary schools and nonprofit organizations work to address the lack of diversity in the field and create a workforce that better represents the nation’s demographics
As the U.S. population continues to grow, so do the numbers of underrepresented minorities (URMs), paving the way for a true melting pot of backgrounds, ideas, and perspectives. Yet this rich and diverse demographic makeup is largely unaccounted for across the medical, dental, and veterinary professions.
While 2010 census data show that URM populations — African American, Hispanic or Latino, American Indian or Alaska Native, and Hawaiian or Pacific Islander — make up 30 percent of the U.S. population, that number is less than representative of the U.S. physician workforce.
According to the Association of American Medical College’s (AAMC) “Diversity in the Physician Workforce: Facts & Figures 2014” report, approximately 13.5 percent of the physician workforce is composed of people from URM populations. While this number is increasing, it is not keeping pace with the nation’s changing demographics. For instance, African Americans represent 13 percent of the population but only account for 4 percent of physicians.
This disparity, however, is not confined to this corner of the healthcare arena. In the dentistry field, URMs account for only 13 percent of all dental school students, according to data from the American Dental Education Association (ADEA).
Veterinary medicine statistics are even worse. A November 2013 article in The Atlantic, titled “The 33 Whitest Jobs in America,” listed the veterinary profession as the whitest profession in the country, at 96.5 percent. And while the percentage of URM students in veterinary medicine has nearly doubled since 2005 — to 14.6 percent — there is still much room for improvement.
Tackling the Issue
For Jorge Girotti, dean of admissions for the University of Illinois College of Medicine (COM), increasing the number
of URMs in medical professions is critical to addressing the specific needs of different populations, as well as creating a level of ease and comfort for all patients.
“This is not just a matter of statistics — increasing the number of doctors because the population is increasing,” Girotti says. “There’s pretty solid research that shows that when the patient feels comfortable, culturally and linguistically, with their doctor, they’re more likely to follow the doctor’s advice, they’re more likely to use the medical services more often, and therefore end up with better health outcomes.”
Unlike other, non-healthcare careers, those in the medical, dental, or veterinary fields require a breadth of prior training and experience — with the need for recruitment efforts that begin long before college.
“I think we need to engage and encourage students at high school and even at middle school levels,” says Todd Ester, director of diversity and inclusion for the University of Michigan School of Dentistry. “So many students from underrepresented minorities or diverse backgrounds do not even consider dentistry as a potential option for their career because they either haven’t seen a dentist who looks like them or they never had anyone suggest to them that this could be a great career path.”
Compared with their white peers, students from URM populations often experience an unprecedented number of obstacles on their path toward receiving a medical, dental, or veterinary degree, says Topaz Sampson, national president of the Student National Medical Association (SNMA). The SNMA is an organization dedicated to supporting underrepresented minority medical students and addressing the needs of underserved communities.
These obstacles can include gaining exposure to and knowledge of healthcare professions, preparing for and applying to schools, and getting accepted into a program — along with completing their studies and receiving their degree.
“Those who I find are successful at getting into medical school have either a family member who is a physician or someone who was kind of preparing them since they were very young — in terms of allowing them to get exposure through shadowing or preparation through advanced courses or summer programs,” Sampson says. “So when you get to the point of applying to medical school, you have tangible experience and years of preparation to be successful on your MCAT and get in. If you don’t get this type of experience, it can be very daunting if you’re just taking the MCAT and hoping to do well.”
Another large obstacle for any student, especially those from lower-income or disadvantaged backgrounds, is the medical school price tag. “I think many people shy away from even applying because when they look at the cost, they feel it’s overwhelming,” says Girotti.
Finding a Solution
As dean of admissions for the University of Illinois COM, Girotti knows something about attracting, recruiting, and retaining a diverse set of students. According to the AAMC’s report, Illinois’ COM rises to the top in many categories. Based on data collected between 1980 and 2012, the university ranks third in the U.S. for graduating African American physicians and fourth for graduating Hispanic/Latino physicians.
Girotti attributes the COM’s success in attracting, supporting, and retaining underrepresented students to “strong institutional commitment and leadership.”
“We’ve been very fortunate, going back several decades, that regardless of who the dean of the college is, there’s been very strong and consistent support of these activities,” he says. “So that creates a very important stability, and in a way, it kind of sends the message to prospective students that this is a place that they would
The University of Illinois COM focuses its efforts on providing much-needed support to URM students — specifically those who weren’t admitted. Each year, faculty meet with these students to review ways to improve their chances of being admitted the next year and provide them with opportunities to gain more experience — a practice Girotti calls “conditional admissions.”
Another practice called “holistic admissions” is being used by colleges and universities across the country to admit a diverse set of students. As opposed to focusing solely on academic credentials, holistic admissions considers the whole person.
Kim D’Abreu, senior vice president for access, diversity, and inclusion with the ADEA, is an advocate of this process. The ADEA conducts a workshop to help dental schools make more conscious admissions decisions by looking at a variety of factors. This workshop, which can be tailored at the local school level, looks at how these schools admit students and considers ways to enroll a more diverse class.
“The workshop has been offered now at about 38 of our dental schools; there are 65 dental schools in the U.S. and 10 in Canada,” D’Abreu says. “I think most of our schools say they are doing some type of holistic review.”
At the Association of American Veterinary Medical Colleges (AAVMC), Lisa Greenhill, associate executive director for institutional research and diversity, takes a more direct approach. She studies how the academic climate affects students’ experience and makes recommendations to AAVMC veterinary schools aimed at creating a more inclusive environment where all students feel welcome.
“I provide certain consultations on what the data means, what kinds of trends there are, how [it] stacks up to the national average or to other institutions in their region, and then [I]make some recommendations on what things they might want to focus on,” Greenhill says.
Recommendations have included ways to make LGBTQ students feel safer and more comfortable on
campus — such as improving access to gender-neutral bathrooms.
After 10 years, the AAVMC is slowly starting to see results and also recognizing the need for improvement. “We’ve almost doubled the number of students of color; however, because enrollment has also gone up about 27 percent during this time, the percentage is not as high as we would like for it to be,” Greenhill says. “This year, I think that we’re looking at — as far as student enrollment — about 13.5 percent students of color.”
Texas A&M University College of Veterinary Medicine addresses diversity by holding departments accountable for their efforts. Every year, each department sends a report detailing their diversity efforts to university leadership, says Eleanor Green, the Carl B. King dean of veterinary medicine. Every other year, they must present these to the university’s diversity council.
“Each [department] is rated and then resources are distributed according to that rating,” Green says. “So it’s not only that you demonstrate what you’re doing, but you’re actually rewarded if you’re doing well. And there will be a very direct conversation if you’re doing poorly.”
While the need for increasing URM populations in the medical, dental, and veterinary fields is clear, equal representation across all spectrums is the goal of many schools and organizations. According to Yasmin Williams, diversity officer at the University of California, Davis School of Veterinary Medicine, increasing overall diversity is the best way to ensure competent, sensitive care for all.
“We need to create a workforce that will mirror the future of our society in regard to demographics, abilities, multicultural populations — people who speak different languages, people from different socioeconomic classes, different sexual orientations,” Williams says. “So by creating a more diverse pool of applicants, it’s a step in serving these different populations.”●
Alexandra Vollman is the editor of INSIGHT Into Diversity.