Nicole Redmond knew immediately that she'd spotted a fellow Aventis Minority Scholar at the AAN Annual Meeting in San Francisco this past spring. “I didn't know her, but she was the only other black person I'd seen the entire day!” recalled Ms. Redmond, now a fourth-year student at the Medical University of South Carolina. “I'm sure there were other black participants at the meeting outside our group, but in such a large crowd, the presence really gets diluted.”
Like Ms. Redmond at the Academy meeting, minorities in neurology are few and far between. According to data from the AAN Member Demographic and Practice Characteristics for 2000, only 4.8 percent of AAN members are Hispanic or Latino; 14 percent, black or African American; and 0.7 percent, American Indian or Alaska Native.
And the pipeline through medical school doesn't look much better. According to statistics from the Association of American Medical Colleges, only 33 of the 1,197 residents in accredited US neurology programs in 1999 were black, and just 75 were Hispanic. In 2003, 26 of 1,339 residents were black, while 97 were Hispanic. (The high-water mark for black neurology residents came in 2000, with 48 out of a total of 1,292.)
CLOSING THE GAP
That gap is the impetus for the Aventis Minority Scholars program. Initially founded in 1993 as a pilot program aimed solely at students from the nation's four historically black medical schools – Howard, Meharry, Morehouse, and Drew – it proved so successful that in 1996, Aventis and the Academy doubled the number of scholars from four to eight and opened it up to minority students at any US medical school. The program now provides eight scholarships annually for minority students to attend the Academy's Annual Meeting, covering their hotel costs, airfare, and registration fees.
“We wanted to give these students an opportunity to talk to practicing neurologists, see what the Academy was like, and expose them to what we do as they went to sessions and poster presentations and the exhibit hall,” said Morehouse School of Medicine's Patrick Griffith, MD, a Trustee of the AAN Foundation. “We also wanted them to have the chance to network among residency programs, program directors, and faculty.”
STUDENTS CHOOSE NEUROLOGY
Of the 56 students who have gone through the program so far, 15 of them – more than 25 percent – have decided to pursue a neurology residency. Nicole Redmond, who wanted to combine her interest in neurology and psychiatry with a more general practice, chose internal medicine, but many other participants have been convinced by their experience at the Academy meeting that neurology is for them.
Felesia Jones might well have steered clear of the specialty had she not attended the 2003 meeting in Hawaii. “I had talked with physicians in other fields about neurology, and they were very skeptical,” said Ms. Jones, a fourth-year student at Howard University School of Medicine. “They said, ‘Neurologists just diagnose disease, but they can't do anything about it, since many neurological disorders have few, if any, treatment options.’”
Drawn to medicine by the desire to improve people's quality of life, Ms. Jones was disheartened by that assessment – and delighted to find, as an Aventis scholar, that it was inaccurate.
“Going to the meeting enabled me to see for myself all the current research, new technologies, and new medicines in the field,” she said. “There were so many new options, like botulinum toxin to treat cerebral palsy and Tourette syndrome, and all the new imaging tools,” she said. “I talked to neurologists who'd been to other meetings in the past and they told me how much things have advanced. By the time I left the meeting, I was sold!”
She is now waiting for word on her neurology residency match and plans on a career in academic medicine that will allow her to explore her passions for teaching and clinical research.
Fourth-year Johns Hopkins student Namath Hussain, who attended this year's meeting in San Francisco, found that it spurred her interest in pursuing an allied specialty: neurosurgery.
“It was such a great experience to be able to listen to and learn from the giants in the field,” she said. “Neurology and neurosurgery need to start working together more than they have in the past. To be a great neurosurgeon, you have to be a great neurologist, and you can't leave one job to one specialty and one to the other. The meeting taught me that.”
VISITING PROFESSOR PROGRAM
Another aspect of the Academy's partnership with Aventis to advance minority involvement in neurology is a visiting professor program. Named after pioneering black neurologist Calvin L. Calhoun, MD, currently the oldest living black neurologist, the Calhoun Visiting Professorships sponsor four neurologists each year for two-day visits to the historically black medical schools.
“The school chooses someone to invite whom they feel would be a role model – the professor does not have to be a minority – and during their visit, they give conferences, attend lab sessions, answer questions, and otherwise help to educate the students about neurology,” Dr. Griffith explained. One of those professors, Richard Benson, MD, who participated in the program at Meharry in 2000, was originally an Aventis Scholar himself in 1994, when the program was known as the Hoechst Marion Roussel Scholars.
“We'd like to expand the visiting professorships in the future, bring more structure to the program, and do more to promote it,” said Linda Kay Morgan, Senior Manager for Corporate Relations with the AAN Foundation. She added that the Academy would also like to expand the program by adding summer mentorships in neurology for minority students.
“Just walking through the conference, I was very aware that there are few minority clinicians,” said Adama Frye, a participant in this year's conference who is now in her third year at Morehouse School of Medicine and is considering neurology “in the forefront” of her specialty choices. “This is such a great opportunity for minority clinicians to gain access to clinical neurologists and researchers and learn more about the field. It really opens up neurology and makes it much more accessible.”
“I think it's very important for minority scholars to see that it's important to the Academy and to sponsors like Aventis that we're represented in the field, and to know that they recognize that there are issues affecting minorities who want to pursue neurology,” said Ms. Jones. “I think those issues might be overlooked otherwise, and it was very good to see that they're giving us that kind of attention. I felt very welcomed.”
OLDEST LIVING MINORITY NEUROLOGIST TELLS ALL
When Calvin Calhoun, Sr., MD, entered his neurology residency at the University of Minnesota in 1962, there were perhaps four or five African-American neurologists in practice or teaching in the United States. He had gone to medical school in his native south, at Meharry Medical College, after getting his master's degree at Atlanta University on the GI Bill.
“I came from a poor family. My father didn't finish elementary school and worked on the WPA roads project during the Depression,” Dr. Calhoun told Neurology Today. “I can remember using kerosene lamps to do my homework through several grades of school.” He spent about a year in the Army before an injury forced him out on disability, and it was then that a vocational rehabilitation counselor with the Veterans' Administration asked if he was interested in medicine.
“I said that I'd thought about it. I had always loved biology. They informed me that the VA could help pay my way, and I told them if they helped me get through college, maybe I could get myself through medical school,” Dr. Calhoun said. So the VA, along with hard work on tobacco farms, helped to pay his way to an undergraduate degree at Morehouse College – where he often had lunch with classmate Martin Luther King, Jr. – and an masters degree at Atlanta University.
MEDICAL SCHOOL EXPERIENCES
When he was admitted to Meharry for medical school, Dr. Calhoun had an “easy out” scholarship opportunity. “At the time, the southern regional educational board would pay you to go to Meharry or Howard, or Tuskegee for veterinary school, to keep you from applying to the segregated state schools,” he said. “But I had been taught at Morehouse to have a certain kind of pride, and I felt I'd be losing some of my freedom if I took them up on that.” So he found other scholarships, and taught part-time to earn the rest of his tuition, teaching nursing classes in the afternoon after attending medical classes in the morning.
He graduated first in his medical school class – but despite his achievements, a medical residency in the south was out of the question in those pre-Civil Rights Act days. “They were all segregated,” Dr. Calhoun recalled. “But some in the east and the north would take black students.” One of his mentors, Bertram Sprofkin, MD, a white neurologist from Vanderbilt who gave lectures at Meharry on occasion, suggested that Dr. Calhoun apply to the University of Minnesota.
RESIDENCY IN MINNESOTA
There were far fewer blacks in Minneapolis than Atlanta then, but Dr. Calhoun felt at home at the frigid northern University, where the Chief of Neurology at the time was the legendary A.B. Baker, one of the founders of the Academy. “It was one of the few places where I felt that people didn't look at my color,” he said. “Dr. Baker said that we didn't have any affirmative action in neurology, and it was either get it or be gone.”
Dr. Calhoun got it, becoming only the second African-American to complete a neurology residency at the University of Minnesota, and then returning to Meharry to teach neurology in the medical department.
“The school didn't have a department of neurology at that time, so the president of the college asked me to come back and help them get the department set up,” he said. So Dr. Calhoun established Meharry's Department of Neurology, which he chaired for the next 25 years. He also helped to organize the first group of African-American neurologists within the Academy.
MORE WORK TO BE DONE
Since those early days, he said, there has been considerable improvement for minorities in neurology, but much remains to be done. “Our participation in neurology still doesn't add up to what's reasonable on a percentage basis,” Dr. Calhoun said. “The number of African-Americans in medical school is already disproportionately low, and then a lot of the young people in medical school have to be persuaded to look at neurology. Part of it may be a self-esteem issue: they think it's too complicated, that they can't do it. But they can.”
It's incumbent upon leaders in the field of neurology to work to expand the number of minorities in the field, said Dr. Calhoun. “We need to push this kind of exposure, stimulation, and motivation approach in college and medical school to get minority students to look more seriously at neurology,” he said. “Programs like the Aventis scholars are very important as a pipeline into the field. They're a genuine effort not to spoon-feed these students, but to let them understand that we want to see them successful. If these programs could be expanded, we'd see more minority practitioners in the field. I'm always hopeful.”
ARTICLE IN BRIEF
✓ Participants in the Aventis Minority Scholars Program discuss the benefits of exposure to the neurology field. The program, administered by the AAN Foundation, now provides eight scholarships annually for minority students to attend the Academy's Annual Meeting, covering their hotel costs, airfare, and registration fees.