Black male doctors becoming endangered
When Vince Wilson, 44, was in his early 20s, he considered being a doctor, yet his own insecurities held him back.
“The bottom line is, I never thought I was smart enough,” he says.
Instead, he focused his interest on other fields in medicine, becoming an x-ray technician, an EMT, a certified nursing assistant and an Army and Air Force healthcare technician.
“I always had the impression that [only] the kids who were superior in math and science became doctors,” he says. Despite having good academic preparation, he adds that he didn’t think that his self-described “average” grades qualified.
That was the late 1970s and early 1980s, and right around the time that the number of black males applying to medical school began to decline.
Thirty years later, according to a new report from the American Association of Medical Colleges (AAMC), even fewer black males are applying to medical school and ultimately becoming doctors. While the applicant pool has grown, the number of black males applying is trending downward.
At the core of the problem
Dr. Marc Nivet, chief diversity officer at the AAMC is not surprised.
“Sadly, no. It’s been trending this way for a long time,” he says. “What we don’t have are good answers as to why. The ‘too cool for school’ mentality is probably playing a role, but it’s multifactorial.”
This trend does not, however, appear to hold true for black women.
Until 1983, black men applied, attended and graduated from medical schools at equal rates to black women, but since then, the gap has increasingly widened. Now, since the late 1990s, black women are outnumbering black men in medical schools two to one.
“We’re clearly not doing enough in terms of effective interventions anywhere along the pipeline,” says Nivet.
On a high school level, a disheartening number of black men are not graduating on time. Only 47 percent of black male students graduated on time from U.S. high schools in 2008, compared to 78 percent of their white counterparts.
Nivet adds that only 18 percent of black students completed a bachelor’s degree, compared to 35 percent of white students — an obvious prerequisite to getting into medical school.
Perhaps this is related to what multiple studies show — black male students are less prepared for competitive college-level work, let alone on how to get into medical school.
“Unfortunately, minority males aren’t properly prepared for the application process,” says Dr. Alden Landry, associate director of the Office of Multicultural Affairs at Beth Israel Deaconess Medical Center.
“Be it exposure to rigorous science courses or even going to college, black males just aren’t prepared.”
In one effort to combat such deficiencies, the AAMC has run the Summer Medical and Dental Education Program since 1989. It’s a six-week academic summer program for freshman and sophomore college students from low socioeconomic backgrounds.
The program, at 12 sites nationwide, focuses on basic sciences and math as well as exposure to the medical field. The goal is to provide solid preparation for college science courses, the Medical College Admissions Test and ultimately, medical school and dental school for students who don’t have the resources to otherwise get such preparation.
Needing an example
Landry, who is also the faculty assistant director of Harvard Medical School’s Office of Diversity and Community Partnership, sees students who count themselves out, much like Wilson did.
“Many students [incorrectly] feel that becoming a health professional requires a flawless transcript and the highest test scores,” he says.
Through the Tour for Diversity in Medicine, of which Landry is the co-director, doctors, dentists, medical and dental students visit colleges and talk to students about what it takes to get into medical school and dental school.
“Our mentors also share their personal stories, and most importantly, their struggles, so that students can see examples of successful individuals who likely have similar backgrounds, experiences and struggles as they do.”
Mentorship is a key piece of the tour, because, as Landry says, “[Among black males], there is a lack of mentorship. Having a role model and mentor in a position that you aspire to be is key for motivation and guidance. If you don’t have someone to look up to, how can you believe you can achieve your goals?”
Wilson agrees. He recalls that he didn’t see a lot of black doctors during his elementary and high school years, and thinks that was a factor in his decisions.
Catching them early
“Exposure to science, technology, engineering and math careers at an early age is also important, so students can learn the fun of careers in the field,” Landry says.
Agnes E. Perry, principal of Michael E. DeBakey High School for Health Professions in Houston, agrees that it’s a crucial time.
“Students should be exposed at a very young age to the types of careers that math and science would prepare them for, and also stimulate their interest,” Perry says. “I’m not sure that that’s taking place in the early years in black families.”
Perry often notices that her students will say they’re interested in the fields they readily have exposure to.
“Many kids will say, ‘I’m interested in being a vet or a pediatrician,’ because that’s their contact, with loving animals or having a pediatrician. Those are the only things they can relate to.”
Perry’s unique school curriculum provides opportunities for students to observe medical professionals, such as watching them perform surgery.
“It’s hands on, it’s immediate and they can get the feel of whether this is a field they want to get into.”
Debakey High School also runs a summer program called Camp Med for rising 6th graders, exposing them to health career possibilities as well.
Yet, both Nivet and Perry believe the efforts need to happen even younger.
“It begins as much as 3rd grade,” Nivet says. “You start to see gaps in ability.”
A National Science Foundation report showed that, upon entering kindergarten, gaps exist between white and black students and continue to widen in subjects such as mathematics. In fact, the report found that the average score of black fifth grade students was equivalent to that of white third graders.
The same was seen in science scores among third graders. White and Asian students scored higher than black and Hispanic students, and Hispanic students outscored the black students. This continued on the fifth grade level as well.
The education level of the children’s mothers were also important. Those whose mothers had more formal education performed better in science than those whose mothers were less educated.
Nearly 70 percent of black students who don’t finish college blame high student loan debt as the reason.
Of those who graduate with a bachelor’s degree, they too are burdened with high student loan amounts — 81 percent of black students leave with debt. More than one-fourth of black bachelor’s degree recipients graduate owing $30,500 or more.
In those cases, sometimes the long-term investment of medical school doesn’t seem feasible to them, says Perry.
“After four years of college, they can go work and get a more instant return on their investment in education,” Perry adds.
“It’s a little sticker shock,” says Nivet. “In their mind, they say, ‘it’s expensive to be a doctor,’ or ‘my parents can’t afford that.’ They know that it’s a very difficult and expensive pathway to become a physician.”
Some students then choose to take themselves out of the running before they’ve been informed about loan repayment programs or scholarships. Nivet is frustrated, because those are the students that he and others who mentor prospective health professionals never know about and subsequently, can’t help them in time.
He is hopeful that those students who are backing out of the medical field are choosing other successful fields. However, law schools, for example, are seeing similar challenges. And black men’s representation in graduate and professional schools falls behind their Latino and Asian-American male counterparts. So, it is unclear where they end up.
With medical school no longer on the horizon, Wilson has decided to combine his many years in healthcare with a master’s degree in pastoral ministry. He envisions himself as a healthcare chaplain.
“I can use many, if not all, of these talents to serve others on a spiritual level,” he explains.
Meanwhile, the AAMC has plans in the works for programs aimed at grammar school students, and the Tour for Diversity in Medicine has another tour planned for the fall.