Letters to the Editor
To the Editor:
In an environment in which there may be a lack of cultural sensitivity, a lack of shared experiences, and a lack of inclusion or like-mindedness, underrepresented minority (URM) students may feel isolated1,2 and not part of a social network. In our experience, such students may be mistakenly perceived as having a lack of knowledge, being unprofessional, or just not being interested academically and socially. Furthermore, evaluations of clinical rotations have a significant subjective component and are influenced by social interactions of students and faculty and the implicit expectations of both. We have seen the lack of social interaction of some URMs lead to misperceptions of their competencies and to their receiving less-than-deserved evaluations. This translates into lower class rankings, which, in turn, may reduce some URMs' competitive status during the residency selection process.
How can URMs' social isolation in medical school be eased? Although multiple factors including personal choices, biases, and discrimination are all targets for reform, achieving a “critical mass” of URMs in the student body would, we believe, most readily foster the social integration of URMs into the surrounding institutional culture. However, this is unlikely to happen any time soon, as indicated by the laudable but not sufficiently successful efforts of the Association of American Medical Colleges' Project 3,000 × 2000 initiative and others to increase the number of URMs attending medical schools. Nationally, URMs accounted for 14.1% of first-year matriculants in 2007 and only 7.4% of medical school faculty in 2008,3,4 resulting in a social environment in which racial discrimination, unconscious biases, or a lack of inclusion may exist.1
A feasible solution is curricular change. Part of our role as medical educators is to develop curricula focusing on diversity, professionalism, and cultural competency with the aim of inculcating these qualities into the professional fabric of all students, faculty, and staff. Such curricular efforts are already under way in some schools, but much more needs to be done. The ultimate goal is for URMs to be part of the culture of medicine as we develop a health care workforce that provides quality equitable care to a rapidly changing population.
Beatrice A. Boateng, PhD
Assistant professor, Department of Pediatrics, and education coordinator for pediatric residency and fellowship programs, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Billy Thomas, MD, MPH
Assistant vice chancellor, Center for Diversity Affairs, University of Arkansas for Medical Sciences, Little Rock, Arkansas; email@example.com.
3 Association of American Medical Colleges. Diversity in Medical Education: Facts and Figures. Washington, DC: Association of American Medical Colleges; 2008.