When applying to medical school, applicants are asked whether they consider themselves to be disadvantaged, which usually means meeting specific criteria as defined by the Association of American Medical Colleges. Those requirements include living in underserved areas and belonging to certain groups that have been traditionally underrepresented in medical education. However, there are other minorities in medicine whose circumstances are not always reflected in AAMC statistics.
How do those minorities, whether they are recognized in the application process, cope or blend in during medical school?
[Read about med schools' admission of neglecting gay applicants.]
A recent essay on the plight of lesbian, gay, bisexual, or transgender (LGBT) trainees and physicians was published in the journal Academic Pediatrics. The author of this essay, Mark Schuster, studied pediatrics at Harvard Medical School in the 1980s, and describes his view of the plight of LGBT and other minority medical students when he was a student. He acknowledges that the medical landscape has largely changed, though he says minorities still don't generally feel comfortable in medicine.
The topic was explored further in a subsequent piece in The New York Times by Pauline Chen, a surgeon, who reflected on the essay and her own experiences in training on the topic of LGBT medical students. Chen recalls a particular incident in which a fellow colleague, who already seemed uncomfortable about his identity, was confronted by a question from a senior surgeon that seemed to the team to equate homosexuality with incompetence: "Which of you idiots gave my patient a homosexual dose of diuretic?"
While Chen notes that strides have been made in making minorities feel more comfortable, she, like Schuster, adds that there is still work to be done, particularly within the culture of medical education and training.
[Check out the M.B.A. tool box for minority applicants.]
The struggles of minorities in medicine have been getting a lot of attention recently, but they are not new. A report from the Joint Center for Political and Economic Studies' Health Policy Institute stated that African-Americans and Hispanics, who represented a third of the U.S. population in 2008, accounted for just 15 percent of U.S. medical students and 8.7 percent of physicians during that same time period.
Unfortunately, this problem is not unique to the United States. A 1995 entry in the British Medical Journal highlighted the struggles that British-born ethnic minorities pursuing a career in medicine faced in all stages of their training. The entry highlighted results from various studies that found differences in scores between "subjective" clinical examinations, where the examiner assesses the student in person and could potentially make ethnic judgments, and written examinations.
Other studies showed that ethnic minorities faced a rejection rate up to 46 times higher than that of ethnic English applicants in the United Kingdom, and that résumés with ethnic names were significantly less likely to be shortlisted than those with English-sounding names, according to the entry.
Both the articles above suggest that ethnic and underrepresented medical students and doctors need to feel more welcome and accepted in the medical establishments in order for there to be a push toward increased patient empathy and cultural understanding.
The AAMC has implemented programs to try to enhance the experience of underrepresented minorities in medicine. It holds career fairs, which are open to the public, provides resources for students, and launches initiatives that advocate on behalf of applicants and medical students who hail from backgrounds traditionally underrepresented in medicine.
Fortunately, medicine has become increasingly inclusive from both a patient and physician standpoint. And while significant improvements have been made in the past two or three decades, these publications, particularly the most recent ones, seem to indicate that a lot more work still needs to be done to make minorities feel more welcome in medicine.
Ibrahim Busnaina, M.D. is a graduate of the University of Pennsylvania School of Medicine and coauthor of "Examkrackers' How to Get Into Medical School." He has been consulting with prospective medical school applicants, with a special focus on minority and other nontraditional candidates, since 2006.