US medical schools should consider race in admitting students

Medical schools should continue to consider race when admitting students despite recent US court decisions against “affirmative action” (positive discrimination), said Dr Jordan Cohen, president of the Association of American Medical Colleges, which represents all 125 medical schools in the United States.

Affirmative action benefits the profession and patients and is particularly timely because of efforts to make it unlawful to consider race when making admissions decisions, he wrote in an article in Health Affairs (2002;21:90-102)

A more diverse medical profession would improve cultural competency (understanding the beliefs and language of patients), increase patients' access to good health services (as doctors from minority ethnic groups often choose to practise in their own communities), strengthen medical research (addressing health issues important to minority communities), and improve diversity in health managers (executives and policy makers).

Among the under-represented minority ethnic groups in US medical schools are African-Americans, Native Americans, Mexican Americans, and mainland Puerto Ricans. In 1999, African-Americans and Hispanics each made up about 12% of the US population but only 2.6% and 3.5% of physicians.

Populations of minority ethnic groups are increasing rapidly in the United States. Between 1980 and 2000, the white population increased by 9% the African-American population by 28% the Native American population by 55% the Hispanic population by 122% and the Asian population by more than 190% By the middle of this century, more than half of Americans will be members of minority ethnic groups.

For the past 30 years the Association of American Medical Colleges has encouraged diversity in doctors in training, Dr Cohen said. Its programme—Project 3000 by 2000—aimed to raise the number of students from minority ethnic groups entering medical school to 3000 (of 16000 annual first year students).

The programme helped promising students from minority ethnic groups through “health science” high schools; improved science programmes in poorly equipped schools; summer programmes; and mentoring and counselling for university students considering medicine. (In the United States, medicine is a postgraduate course.)

Until the educational system is improved, medical schools must make efforts to enrol promising students from minority ethnic groups, Dr Cohen said. The number of such students was increasing until 1994, when more than 2000 entered medical school. Since then, the number has fallen because of challenges to admissions based on affirmative action. If the percentage had held steady, there would be more than 1400 additional minority doctors in the United States.

The notion that students from minority ethnic groups will become inferior doctors is “simple nonsense,” Dr Cohen said. Twice as many students apply to US medical schools as there are places available, and almost all are very well qualified.

Dr Eddie Ochoa (above) is the only doctor in his clinic at the Arkansas Children's Hospital, Little Rock, to speak Spanish fluently. The hospital appointed seven translators last year because of the growing Hispanic population

(Credit: AP PHOTO/MIKE WINTROATH)