Medical Schools’ Shrinking Admittance of Black and Indigenous Students

According to a report published in the New England Journal of Medicine, 40 years of data revealed that admittance of students from Black, Native American and Alaskan Native backgrounds – groups who are severely underrepresented in medicine – are on the decline in medical schools. Many have called medical schools’ efforts to improve diversity in their student body a “persistent failure”.

The number of Black medical students consisted of 3.1% of national medical school enrollment in 1978; by 2019 that number has decreased to 2.9%, a number that includes historically black medical schools. For Native Americans that number is even lower at barely 1%. To highlight the disparity, as of 2019 Black/African Americans account for approximately 13.5% of the US population; Native Americans and Alaska Natives comprise 1.7% of the population.

Medical schools are aware of their poor showing and acknowledge more needs to be done. The reasons cited by medical schools for the lack of diversity in their student body range from lack of a diverse admissions committee to over-reliance on MCAT scores at the expense of other criteria in their review of applicants.

Black Americans die of COVID-19 at nearly twice the rate of their white counterparts. The Indian Health Service (IHS), a federal agency that provides medical care to American Indians and Alaska Native people, reports that the age-adjusted death rate for adults exceeds that of the general population by almost 40%, with conditions like diabetes, chronic liver disease, and accidents occurring at least three times the national rate. Poor access to health care and a lack of cultural understanding lead to poor health outcomes as well as higher rates of chronic disease for people of color.

Lack of representation is found time and again to be at the heart of these health disparities. Studies show that access to care and health outcomes improve when physicians more closely represent the patients they care for, in part due to increased trust.

To counter this decline, the Association of American Medical Colleges (AAMC) and the National Medical Association partnered to take meaningful action to fight what they believe is deeply ingrained systemic racism that excludes black and brown people from medical school ranks. “Even the National Academies have called this an American crisis and that’s not an overstatement,” said Norma Poll-Hunter, the senior director of equity, diversity, and inclusion for the AAMC. “… We now have so many allies and we need to leverage this moment for the long haul.”

Some of the steps by medical schools across the country to improve the number of students of color who matriculate include diversifying their admissions committees, looking beyond MCAT scores in favor of a holistic review of applicants, and making every effort to ensure that applicants of color feel welcomed at their institutions. Some schools are even providing underrepresented students with mentoring, help with improving their MCAT scores, and engaging in outreach to high school and undergraduate students to consider a medical career.

“Ultimately, if you want to go to medical school, you have to start in high school,” said Devin Morris, the first medical student in his family and one of the study authors. “That’s something I wish I’d known.”