Medical school leadership urges race-based consideration

September 05, 2002

In the face of legal challenges to affirmative action, leaders of the U.S. medical school establishment are calling for the use of race-conscious decision making as "the best means available for closing the diversity gap" in medical school admissions.

Writing in the September/October edition of Health Affairs, Jordan J. Cohen, president of the Association of American Medical Colleges, and colleagues Barbara A. Gabriel and Charles Terrell argue that attaining greater diversity in the health care workforce will advance cultural competency among providers, increase access to high-quality health services for minorities, strengthen the medical research agenda and ensure better management of the health care system.

"Given the rapidly changing U.S. demography, it is axiomatic that the majority of future health care professionals will be called upon to care for many patients with backgrounds far different from their own," the write.

"To do so effectively, health care providers must have a firm understanding of how and why different belief systems, cultural biases, ethnic origins, family structures and a host of other culturally determined factors influence the manner in which people experience illness, adhere to medical advice and respond to treatment."

Citing 1999 statistics, the article says that while African-Americans and Hispanics each made up about 12 percent of the U.S. population, they made up 2.6 percent and 3.5 percent of the physician workforce, respectively.

The most important solution, the authors say, is to address disparities in primary, secondary and undergraduate education so that minorities would have equivalent academic credentials when applying to medical school. "In the interim ... the best means available for closing the diversity gap is to use affirmative action, race-conscious decision making in higher education in general and in medical and other health professions schools in particular."

The authors argue that such a practice will not result in a lowering of standards. "Given the numerous academic hurdles that must be cleared in medical school, in residency training and in acquiring a license, the chances that an unqualified person will make it into practice are exceedingly small," they write.
Terrell is vice president of the AAMC's Division of Community and Minority Programs, and Gabriel is senior writer and editor for the AAMC.

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