Even with recent efforts to increase diversity among physicians, there is a deficiency in black, Hispanic, and American Indian or Alaskan Native representation in medical school matriculants, according to a recent article published in JAMA Network Open.

The authors of this study examined the demographic trends in medical school classes to assess the progress of new diversity accreditation guidelines set in 2009 by the Liaison Committee on Medical Education. These guidelines were made in an effort to diversify the physician workforce and were specifically centered on racial and ethnic groups that are underrepresented in medicine. Using data on US allopathic medical school applicants and matriculants from 2002 to 2017 as well as total enrollment by state from 2017 to 2018, the authors compared trends in the proportions of race/ethnic groups and sex within the student body and with respect to US and local populations of a similar age. The data used were publicly available from the Association of American Medical Colleges.

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Using representation quotients (RQ), the authors compared the makeup of racial/ethnic subgroups of medical students to the corresponding makeup of that racial/ethnic among the US population and in the corresponding states participants lived in. The results show that both the number of applicants and matriculants increased from 2002 to 2017 by 53.6% and 29.3%, respectively. In addition, the proportion of matriculants from most underrepresented race/ethnic groups (men and women who are black, Hispanic, and Native Hawaiian or Other Pacific Islander) increased, but their RQs were still considered to be underrepresented (RQ<1) among medical school matriculants. There was a decrease in the proportion of white men and women matriculants; however, white men still follow the trend of overrepresentation among medical school matriculants (RQ>1). Furthermore, the authors found that the proportion of Asian matriculants has increased for both sexes, and that both sexes have been consistently overrepresented (RQ>3) among medical school matriculants. On a state level, underrepresentation was still found in all race/ethnic groups, except for those who identify as white or Asian.

Study limitations include the fact that data collection methods changed in 2012, which may have resulted in inconsistent race/ethnicity categories. Furthermore, the data set was limited by categories set by researchers. This study also did not include contributions to healthcare by professionals without an MD degree.

The authors of this study concluded that there is “a persistently deficient representation of black, Hispanic, and [American Indian or Alaskan Native] medical students,” and that “most states do not train physicians who are demographically representative of the surrounding population.” As a response to their findings, the authors call for more effective policies to improve representation to create “high-quality, high-value, culturally effective care.”

Reference

Lett LA, Murdock HM, Orji WU, Aysola J, Sebro R. Trends in racial/ethnic representation among US medical students [published online September 4, 2019]. JAMA Netw Open. doi:10.1001/jamanetworkopen.2019.10490