Enhancing the pool of underrepresented minorities may help alleviate healthcare disparities

The number of underrepresented minorities among U.S. medical school faculty remains low, even as the U.S. population becomes increasingly diverse.

And the level of underrepresented minorities currently being trained in medicine is unlikely to reverse those trends, according to a U-M analysis and commentary published this month in the journal Gastroenterology.

Underrepresented minorities that were primarily addressed include Black or African Americans, Hispanics or Latinos, American Indians, Alaskan or Hawaiian natives and other Pacific Islanders.

"The low representation and the stagnation of the numbers of Black and Hispanic faculty in U.S. medical schools is troubling," said Juanita Merchant, M.D., Ph.D., professor in the departments of Internal Medicine and Molecular & Integrative Physiology at the University of Michigan.

"We need to plug the leaky pipeline that allows underrepresented minorities to escape before they can complete the process that allows them to go on to becoming medical or research faculty," says Merchant, who co-authored the study with M. Bishr Omary, Ph.D., M.D., chair of the Department of Molecular & Integrative Physiology.

The underrepresented minority categories mentioned above only comprise about 7 percent of practicing physicians in the U.S., but those populations make up about 27 percent of the U.S. population. Similarly, in 2008, only 7.3% of all medical school faculty are underrepresented minorities.

A national effort led by the Association of American Medical Colleges sought to enroll 3,000 underrepresented minorities annually into U.S. medical schools by the year 2000. As of 2007, the number of admitted underrepresented minorities in medical schools was only 2,500. Of those, 6.4 percent were black, 7.2 percent were Hispanic and 0.5 percent were American Indians, Alaskan or Hawaiian natives and other Pacific Islanders.

"Academic medical faculty who are training the next generation of physicians as well as those delivering health care should reflect the diverse populations they will be serving," Merchant says.

Another important point is that the percentage of male faculty outnumber female faculty dramatically. The percent of female faculty also declines from the instructor to professor rank, Merchant says.

"We have a huge number of women at the entry level, who just don't make it up the ladder," Merchant says.

Some of this is a preparation problem, Merchant says, and students in underrepresented communities need to be encouraged to study science and pursue biomedical fields. Once that pool has increased, strategies must be developed to retain trainees and potential faculty members.

"We know that Black physicians care for significantly more Black patients, and the same holds true for Hispanic physicians," Merchant says. "We also know that minority populations may be more likely to have more serious health care problems, either because they delay care because of financial constraints or access to providers.

"So enhancing the pool of underrepresented minorities among faculty and physicians will likely help alleviate some of the disparities in the quality of care among those populations. Medical schools and government officials need to make this a priority."

The article by Merchant and Omary provides detailed data from a variety of sources and also includes specific recommendations to both institutions and the underrepresented minorities themselves on how to reverse the current situation.

"We made a strong effort not only to highlight the problem but to also highlight specific recommendations that were assembled after consultation with several thought leaders nationally and locally," Omary says.