Even as US diversity initiatives try to increase the representation of minority ethnic groups in science and medicine, the proportion of black men pursuing such careers is reaching historic lows. In 1986, 57% of African American medical-school graduates were men — but by 2015 that share had dropped to just 35%, even as the total number of black graduates had increased.
Given the extent of racism and discrimination, “it’s difficult for black males to be able to progress”, says Cato Laurencin, a surgeon-scientist at University of Connecticut in Farmington. Laurencin chaired a workshop on the issue that was convened last November by the US National Academies of Sciences, Engineering, and Medicine and the Cobb Institute, a non-profit organization in Washington DC that develops strategies to eliminate health disparities and racism in medicine.
A report1 on the event, released on 18 May, examines factors that contribute to the growing absence of black men in science and medicine, as well as current models and strategies for boosting participation.
Although more African American students attend medical schools today than 30 years ago, the increase is due to greater numbers of black women training to be physicians. The proportion of men among African-American medical students decreased by more than 20% over the same period. Data from the Association of American Medical Colleges shows that, in 2015, 41% of black male applicants were accepted into medical school — the lowest rate across all genders and ethnicities. “This is a crisis that affects not only blacks, but also our national ability to have excellence in science and medicine,” Laurencin says.
Racial diversity in medical professions can help to address health inequalities. A number of studies have shown2 that people from minority groups receive better care when their physicians have similar backgrounds.
“Having racial diversity leads to not just more doctors, but also better-prepared doctors who go into communities of colour,” says Liliana Garces, an education researcher and legal scholar at the University of Texas at Austin. She adds that one promising strategy for increasing diversity in medical schools is reducing the admission process’s emphasis on standardized tests, which “don't end up capturing the student’s potential, and only contribute to more racial inequities in the student body”.
To avoid this, Ross University School of Medicine in Portsmouth, Dominica, accepts students from under-represented minorities with lower standardized test scores and grade point averages than white applicants. The university — which has campuses in Dominica and the United States — then places the students in a programme that provides educational support during the first semesters of medical school. It also connects them with a mentor from a similar background. “Mentors and role models can really help young black men see themselves in that profession,” Garces says.
Environments where black men can build a community help to improve graduation rates, Laurencin says. And programmes that give financial support to undergraduate students of colour financial and provide early exposure to research are successful at increasing representation in science, technology, engineering and mathematics (STEM) PhD programmes.
But Freeman Hrabowski, president of the University of Maryland, Baltimore County, which runs one such programme, notes that universities and medical schools need funding to scale up these efforts. Hrabowski hopes that US government agencies will develop programmes to advance black men, similar to those devised for increasing women’s participation in STEM fields. “Without funding,” he says, “there is no serious commitment.”
Nature 557, 621-622 (2018)