Disparities in Healthcare
Disparities in access to health care and the quality of care received by racial and ethnic minorities in the United States are widely documented. A key part of this problem is the lack of diversity among practicing physicians. Despite more than a decade of efforts by medical schools to recruit under-represented students, little has changed. For example black doctors still account for only 6% of practicing physicians in the United States and the percentage of black male physicians has declined over time. In our own department of over 100, for example, there are only 2 black male surgeons.
This should come as no surprise. Black students are less likely than white students to attend college and more likely to drop out, either due to financial problems, social issues or poor high school preparation. Thus, the pool of high-performing black college seniors applying to medical school is woefully small and efforts that start at this level are sure to miss the boat. This problem requires building a leak-free pipeline that extends to pre-college students and provides a clear pathway to medical school.
Doctors of Tomorrow
To that end, in 2012 we started Doctors of Tomorrow (DoT), a collaboration with Cass Technical High School in Detroit. Each year, nearly 100 medical students partner with 35 9th graders in a program that combines mentorship, clinical enrichment and social action. The participants are brought to the medical school each month for activities such as clinical skill development, physician shadowing and hands-on learning in the anatomy lab and clinical simulation center. Each student is also assigned a first year medical student mentor who works with them during the year and onward throughout high school. Moreover, the students work in groups on capstone projects designed to address public health issues in Detroit. Participants also compete for funded summer internships in Detroit and participate in our college prep program for upper classmen as they progress through high school.
Two Cass Tech students, who participated in DoT as seniors in 2012, completed their undergraduate education at Michigan and are now 2nd year medical students at Michigan State and Wayne State. In addition, there are 18 DoT participants who are now undergraduate students at Michigan, many of whom remain bound for careers in medicine, dentistry, nursing and science. Most students have joined DoT Succeed, a structured program of clinical immersion and professional development activities. We also provide scholarship funding for many of these students to cover non-tuition expenses.
Looking Toward the Future
Our focus is on disseminating the DoT model through publications and presentations at national meetings. We have also developed an online toolkit to allow other medical schools to easily replicate our curriculum. Programs like this can be run on very limited budget, as they rely most heavily on human capital. Through replication of DoT on a national scale, we hope to move the needle on diversifying the physician workforce in the United States.
Article by Jonathan Finks, MD
Reach out to join the conversation or to learn more about how to implement the Michigan Promise. Connect with the Department of Surgery or our faculty on Twitter to share your ideas or get in touch with the Office of Faculty & Resident Life to schedule a Michigan Promise presentation at your institution. You can also fill out our Michigan Promise Inquiry Form with any questions or comments.
Department of Surgery Office of Faculty & Resident Life
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Ann Arbor, MI 48109