Letters to the Editor
To the Editor:
Barr and colleagues highlight the inherent problems and high attrition rates at the undergraduate level of the academic pipeline. However, they failed to note the very complex upstream problems that exist at the K–12 level. The importance of K–12 programs in identifying, nurturing, and exposing students from underrepresented minorities (URMs) to science, technology, and math cannot be overemphasized.1 Many URMs are either first- or second-generation students from environments that may not provide the exposure, educational guidance, and support needed to help them excel academically. It is no surprise that Barr and colleagues reported that URMs, who may have had limited past experiences and information, had a higher degree of interest in becoming physicians but lost interest at a higher rate when compared to non-URMs. The starting points are not the same. A lack of past experiences (fewer URMs know or have relatives who are physicians) and a lack of a working knowledge of what it takes to become a physician places many URMs at a distinct disadvantage in making well-informed career choices.
We agree that the lack of an accessible quality advising system can lead to low undergraduate retention rates; this is particularly evident at the community college level. Due to multiple factors (location, flexibility, affordability), a large number of URMs enroll in community colleges. Although many two-year institutions do provide excellent student support services, in some cases there may not be adequate guidance and faculty support.2 Perhaps the need to improve premedical advisory input and structure is greatest at community colleges; not meeting that need could result in the loss of many potential students. Individual institutions and local, state, and national organizations must pay attention to and continue to foster partnerships and support services that will identify, prepare, and propel this large pool of students into health care.
Identifying and nurturing students upstream are key to our success in increasing the number of URMs who develop an interest in, enter, and matriculate through medical school. For these are the students who can increase racial and ethic diversity in the health care workforce, ultimately reducing health care disparities.
Beatrice A. Boateng, PhD
Assistant professor, Office of Educational Development, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Billy R. Thomas, MD, MPH
Professor, Department of Pediatrics, and Assistant Dean, Minority Affairs, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 512B, Little Rock, Arkansas; (email@example.com).
1Cohen JJ, Steinecke A. Building a diverse physician workforce. JAMA. 2006;296:1135–1137.
2Blumenstyk G, Sander L, Wasley P. Talk at the community colleges’ meeting. Chron High Educ. April 8, 2008:1–4.