Features
Diversity Evolution
The United States is becoming more diverse . Is the medical education system adapting quickly enough ?
The need for increased diversity in the medical profession is not breaking news . In 2004 , the Institute of Medicine ( IOM ) called for a more diverse health-care workforce for the good of the nation . In its report , “ In the Nation ’ s Compelling Interest : Ensuring Diversity in the Health-Care Workforce ,” IOM argued that “ increasing racial and ethnic diversity among health professionals is important because evidence indicates that diversity is associated with improved access to care for racial and ethnic minority patients , greater patient choice and satisfaction , and better educational experiences for health profession students , among many other benefits .” 1
The report suggests that , while the U . S . healthcare system would clearly benefit from the increased participation of underrepresented minority students , too little attention is paid to methods of reducing the institutional- and policy-level factors that impede such participation .
Yet , more than a decade later , the consideration of race in the academic admissions process was again a topic of debate , when the Supreme Court upheld an affirmative action program in Fisher v . University of Texas ( see SIDEBAR on page 31 ). 2
Commenting on the Fisher decision , Association of American Medical Colleges ( AAMC ) President and Chief Executive Officer Darrell G . Kirch , MD , wrote : “ In light of this decision , U . S . medical schools may continue their institution-specific efforts to ensure that graduating physicians are prepared to practice medicine in an increasingly diverse society , and to address the disparities that exist in today ’ s health-care system .” 3
President Donald Trump ’ s recent executive order temporarily banning citizens from seven Muslimmajority countries from entering the United States – and its potential negative implications for medical research – have thrust this topic into the spotlight again . “ The benefits of scientific collaborations are amplified by our diversity ,” the American Society of Hematology ( ASH ) wrote in a joint statement with the American Association for Cancer Research , the Association of American Cancer Institutes , the American Society for Radiation Oncology , the American Society of Pediatric Hematology / Oncology , and the LUNGevity Foundation . “ For [ scientific ] progress to continue , it is going to require an even greater commitment to collaborations among international organizations , governments , public and private institutions , and individuals dedicated to this cause .” 4
ASH Clinical News spoke with representatives from AAMC and other experts to learn more about efforts to boost the number of underrepresented minority students and faculty in the U . S . medical education system , as well as what is being done to foster diversity and inclusiveness in medical education .
Defining Diversity
Data from the 2015 U . S . census show that nearly 40 percent of Americans identify as “ non-white ,” a 2 percent increase from the 2010 U . S . census . 5 In medical education , though , white students continue to represent the majority of graduates , according to 2012 AAMC data . 6 The same is true for medical school faculty : A 2013 study published in JAMA found that the percentage of underrepresented minorities ( including African-Americans , Hispanics or Latinos , American Indians or Alaska Natives , and Native Hawaiians and other Pacific Islanders ) in full-time faculty positions has seen only a slight increase – from 6.8 percent in 2000 to 8 percent in 2010 . 7 Additionally , the authors reported that a faculty development program targeting underrepresented minority faculty did not succeed in increasing representation , recruitment , or promotion of these groups at U . S . medical schools .
“ If you look nationwide at diversity in medical schools , it is shocking that fewer than 10 percent of all medical school faculty are from underrepresented minority groups ,” Belinda R . Avalos , MD , chair of the ASH Committee on Promoting Diversity and vice chair of hematologic oncology and blood disorders at the Levine Cancer Institute in Charlotte , North Carolina , told ASH Clinical News .
Of course , the issue of diversity extends beyond that of just race and ethnicity . The National Institutes of Health ( NIH ) defines diversity as “ the range of human differences , including but not limited to race , ethnicity , gender , sexual orientation , age , social class , physical ability or attributes , religious or ethical value system , national origin , and political beliefs .” 8
This definition has evolved greatly in the past 30 years , according to André L . Churchwell , MD , chief diversity officer at Vanderbilt University Medical Center in Nashville , Tennessee . “ We have begun to
30 ASH Clinical News March 2017