A report from the Association of American Medical Colleges (AAMC) documents an overall trend toward increased diversity among students applying to medical school.

AAMC’s Diversity in Medical Education: Facts and Figures 2012 finds that nearly half of the applicants to U.S. medical schools in 2011 were non-White. Whites were the largest group of applicants, followed by Asians. “Compared with 2010, in 2011 the percentage of Hispanic or Latino applicants increased by 5.7 percent and the number of Black or African American applicants grew by 5 percent,” the report says.

But only 2.5 percent of medical school applicants in 2011 were Black men. Twice as many Black women as men applied to medical school that year, creating the biggest gender gap in medical school applicants among all racial or ethnic groups.

“We have a major, major problem in this country,” Marc Nivet, EdD, AAMC’s chief diversity officer, told American Medical News. “There is just simply an enormous amount of indisputable evidence that we’re not intervening as effectively as we’d like as a society to increase the talent pool of African-Americans who are capable of taking advantage of the science curricula available up and down the pipeline.”

This is part of a series introducing programs in the Robert Wood Johnson Foundation (RWJF) Human Capital Portfolio.

The Harold Amos Medical Faculty Development Program
is on the verge of a milestone: it will observe its 30th anniversary this year.  In 2012, the program achieved another notable distinction, as a third alumnus was selected to lead an institute at the National Institutes of Health: Gary Gibbons, MD, (’88) is now director of the National Heart, Lung, and Blood Institute (NHLBI). He joined Griffin Rogers, MD, MACP, (’83) Director of the National Institute of Diabetes and Digestive and Kidney Diseases; and Roderic Pettigrew, MD, PhD, (’83) Director of the National Institute of Biomedical Imaging and Bioengineering.

Formerly known as the Minority Medical Faculty Development Program, the Harold Amos Medical Faculty Development Program (AFMDP) was created to increase the number of faculty from historically disadvantaged backgrounds who can achieve senior rank in academic medicine or dentistry, and who will encourage and foster the development of succeeding classes of such physicians and dentists. AFMDP offers four-year postdoctoral research awards to historically disadvantaged physicians and dentists who are committed to developing careers in academic medicine and to serving as role models for students and faculty of similar background.

Practices that work within a particular framework of goals and priorities can become engrained in the work of institutions. But what happens when the framework shifts?  Regular review of practices and the assumptions that support them offers one of the best opportunities to enhance diversity and inclusion, which can in turn improve the effective results of Scholar and Fellow programs. 

The Robert Wood Johnson Foundation (RWJF) Diversity Matters Podcast Series features host Jacinta Gauda in conversation with leaders and subject matter experts on practical ways to support diversity and inclusion.  In the podcast, available now, W. David Brunson, DDS, Senior Director of the Policy Center for Access, Diversity, and Inclusion of the American Dental Education Association (ADEA), and Marc Nivet, EdD, Chief Diversity Officer, Association of American Medical Colleges (AAMC), discuss the practice of holistic review. 

Increasingly adopted by medical and dental schools, holistic review is sometimes misunderstood as affirmative action or as an initiative designed solely to increase diversity.  Nivet and Brunson will clear up these misconceptions, and explain what it is and what it is not.  Listeners will learn how the practice evolved, how it is applied equitably across the entire applicant pool, and how it aligns admissions policies, processes, and criteria with institution-specific goals.  Nivet and Brunson will also describe ADEA- and AAMC-sponsored workshops in which admissions deans, staff, and committee members learn how to integrate holistic review into their admission processes.  

Holistic review can help institutions to achieve the true culture of diversity and inclusion that they will need if they are to effectively address the nation’s challenges in health and health care.

Visit the Diversity Matters Community to download podcasts and summaries for practices that are working to increase representation in health and health care.

Two new studies show the nation’s younger primary care physicians may find it hard to recover from their medical school debt.

Primary care physicians who graduate with a median amount of debt and have a salary that is typical for the field can pay off their debt within 10 years, even if they live in a high cost residential area, according to a study from researchers at Boston University and the American Association of Medical Colleges, published in Academic Medicine. But young primary care doctors with debt that is above average—$200,000 or more—may have to employ “trade-offs and compromises” to support their repayment. These may include: extended repayment plans, increasing the interest repaid and the number of repayment years, living in a lower-cost area, or joining a federal loan forgiveness program that requires a service obligation such as practicing in a medically underserved area.

There are more sobering statistics for primary care doctors: a study in the Journal of the American Medical Association finds their earnings have grown more slowly than the salaries of other health care professionals. From 1987 to 2010, the average doctor’s earnings grew 9.6 percent; pharmacists’ earnings increased by 44 percent, and dentists earnings grew by 23 percent.

“It is possible that there are some specialties that have done extremely well in the past 10 or 15 years,” Amitabh Chandra, PhD, study co-author and Robert Wood Johnson Foundation Health & Society Scholars program faculty member at Harvard University, told Reuters Health. The slow growth for doctors—compared to other medical professions—is most likely due to lagging salaries of primary care physicians, he said. "If as a country we want more people to go into primary care, this anemic, jaundiced earnings growth is not going to be a motivator to get people to join primary care.”

What do you think? Should more be done to help medical students who go into primary care lower or repay their debt? Are slow-growing salaries a deterrent for medical students to enter this field? Register below to leave a comment.

Read the study in Academic Medicine.
Read the study in the Journal of the American Medical Association.

New data from the Association of American Medical Colleges (AAMC) finds a 3.1 percent increase in the number of students applying to medical school this year. First-time applicants also increased (3.4 percent), which helped bring first-time enrollment at the nation’s medical schools up to an all-time high.

AAMC’s enrollment and applicant data also finds that this year’s entering class of medical students is more diverse than last year. There was an increase in applications and enrollees in all major racial and ethnic groups, and record high numbers for African American and Latino students.

If this year’s trends continue, medical schools are on track to increase total enrollment 30 percent by 2016, AAMC says.

“Medicine continues to be a very attractive career choice for our nation’s best and brightest,” Darrell G. Kirch, MD, AAMC president and CEO, said in a news release. “Given the urgent need our nation has for more doctors to care for our growing and aging population, we are extremely pleased with the continued growth in size and diversity of this year’s entering class of medical students.”

Read the news release.
See the data.

Many elite medical schools — Columbia, Cornell, Harvard, Johns Hopkins and Yale, among them — have no departments of family medicine to train students who want to specialize in primary care. Students interested in that field are instead trained to take care of seriously ill patients and are sometimes even discouraged by professors if they do not pursue a specialty, NPR reports.

But Mount Sinai School of Medicine in New York is making a “fundamental change” in its mission. Previously ranked among the bottom 20 medical schools in the country when it comes to the number of primary care doctors it graduates, Mount Sinai had neither a department nor any family physicians on staff until this June.

Now, thanks to a partnership with the Institute for Family Health, the school employs primary care doctors from the Institute’s community clinics to teach students during all four years of medical school, offering primary care students a chance to learn the skills they’ll need in practice.

"I want to spend my career keeping people healthy rather than trying to bring them back from a very serious illness," Mount Sinai student Demetri Blanas told NPR. "I think it is what society needs right now, and that is important to me."

Neil Calman, president and CEO of the Institute for Family Health, called the partnership “a natural marriage.”

"I think people are finally realizing that the country will be bankrupt if we continue to admit people and readmit people for conditions that could be prevented with good primary care," he told NPR.

Listen to the story on NPR.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University. This is part of a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Alison Hernandez
Hometown: North Bergen, NJ
Rising senior at Rutgers University
Major: Pharmacy
Internship Research Project: The Influence of Patient Health Perceptions on Engagement in End-of-Life Discussions

Human Capital Blog: How does your Project L/EARN experience relate to or support your educational and professional goals?

Alison Hernandez: Before Project L/EARN I did not have appreciation for research the way I do today. As a prospective clinician, I think it’s important that clinicians know about research and improving health outcomes through programs and initiatives. And if clinicians don’t know about this research that’s going on, nothing’s going to change. So it’s important that I take these lessons I’ve learned at Project L/Earn and bring it to my fellow classmates.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University. This is part of a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Stephanie Jimenez
Hometown: Jersey City, NJ
Rising junior at Rutgers University
Major: Sociology
Internship Research Project: Breast Cancer Survivors’ Perceptions of Quality Cancer-Related Care from Primary Care Providers

Human Capital Blog: What aspect of the Project L/EARN internship has been most helpful and why?

Stephanie Jimenez: The most helpful part of my Project L/EARN experience this summer was the guidance that I received from my mentor as well as the things I learned from my instructional staff. The feedback I gained from my presentation helped me gain perspective.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University. This is part of a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Brandon McDonald
Hometown: Rochester, NY
Rising Senior at the University of Rochester
Major: Public Health
Internship Research Project: Marital Status as a Predictor of Dental Health Service Utilization

Human Capital Blog: What did you expect before you arrived? How different is the reality?

Brandon McDonald: When I first arrived at Project L/EARN, I expected there’d be a sense of difficulty as well as more independent-based projects. In actuality, I realized that there’s a broader sense of structure and a bigger support system than I would have ever expected. There are different segments when the papers are due so you have [more] connections with your mentor than what I would have thought as well.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University. This is part of a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Thomasina Anane
Hometown: Silver Spring, MD
Rising junior at Johns Hopkins University
Major: Public Health / Sociology
Internship Research Project: Goal-Striving Stress & Mental Health: Race and SES Variations

Human Capital Blog: Are there any insights about your Project L/EARN experience you’d like to share?

Thomasina Anane: Project L/EARN taught me two things. One: stop procrastinating and learn better time management skills and two: Project L/EARN is a lot like a 9 to 5. You can equate it to a work day. Having to wake up on time every day to be here has taught me the importance of how you present yourself as a professional who’s confident in what she’s doing. Just knowing what you’re doing and how people perceive you and your work. It’s added a sense of rigor to what I do. I’m definitely taking what I’m doing seriously. Project L/EARN has taught me the importance of what all this education means. In the future, being able to use what we learned and be confident and becoming the career person you want to be now. And I appreciate Project L/EARN for that.