An Idea Whose Time Has Come: The Need for Increased Diversity in Medical Practice and Education

Introduction A growing and abundant literature testifies to the fact that race is a central and determining factor for health disparities in the United States (Benz et al, 2011; LaVeist et al, 2008). Moreover, African Americans have long been denied equal access to medical education and careers in high level health industries. In this article, we will examine the relationship between access to medical school for students with diverse life experiences and the availability of medical professionals who can effectively practice in medically underserved communities as primary care physicians. It is possible, that in the near future, it may become even more difficult to admit medical students committed to practicing in medically underserved communities due to legal challenges that could potentially weaken or eliminate the use of holistic review, a multilayered approach utilized by many admissions committees wherein an applicant's unique skills and experiences are taken into consideration (Addams et al, 2010; Steinecke et al, 2007). Medical education programs that incorporate holistic review will be highlighted in the results and discussion sections. Legal challenges have hampered the use of holistic review as it pertains to medical school admissions, specifically within the State of California (Barr, Matsui & Berkeley, 2008). Admissions committees, once thought of as gatekeepers, are beginning to embrace modern methods supported by the Association of American Medical Colleges (AAMC) when reviewing applications (Yzquierdo, 2012). Medical school admissions determine the makeup of the future physician workforce. The cultural competence and makeup of this workforce will either reduce or perpetuate health disparities in the coming years. Access to Medical Education The AAMC has published a number of reports on unequal access for minorities to medical school and the medical profession. In Minorities in Medical Education, Castillo-Page (2005) discusses how the AAMC laments that the numbers of minorities in medical schools are alarmingly low. Historically speaking, access to medical education in the United States has been elusive for underrepresented minority students (Reede, 2003). In the past, medical schools relied primarily on an applicant's undergraduate grade point average and MCAT (Medical College Admission Test) scores in order to determine which students to invite for an interview. As a result of the U.S. Supreme Court's decision in 2003 (Grutter v Bollinger), graduate schools may utilize holistic review if a diverse student body contributes to the school's mission and overall educational experience for all students. The decision was not unanimous. Chief Justice William Rehnquist devoted a considerable amount of space in his written dissent to point out that at the time, the percentage of applicants belonging to each racial demographic matched the percentage of those who were accepted to attend law school at the University of Michigan (Grutter v Bollinger, 2003). One of the driving research questions that led to the development of this study was, what if the Rehnquist Admissions Test were to be applied to overall medical school admissions across the United States using both AAMC and AACOM (American Association of Colleges of Osteopathic Medicine) data? Methods This quantitative study will analyze both AAMC and AACOM data on medical school acceptance rates using two-tailed chi-square tests with Yates correction to establish significance. The number of African American, Latino, White and Asian American applicants and matriculants will be compared to one another using contingency tables, disaggregated by gender. In the case of AAMC data, overall acceptance rates will be examined using overall numbers and also, with HBCU medical schools removed. The results of a unique and innovative medical program in California, UC PRIME, will also be discussed. Results According to the AAMC data (Castillo-Page, 2012a), African American applicants had the lowest acceptance rate of any group in 2011. …