To the Editor:
Progress in diversity recruitment has been made in the last 4 decades, with the number of medical graduates of color increasing by over 130% since 1974.1 However, further efforts are needed to increase diversity in our medical institutions. As 2 Latino medical students approaching graduation, we would like to contribute to larger recruitment efforts by sharing challenges we have faced as students.
Unfortunately, the annual costs associated with medical education often exceed $100,000 a year. Coming from low- or middle-income homes, with little financial literacy and an aversion to debt, costs were critical challenges for us. For one of the authors (J.A.H.), an MBA education has proved helpful in contextualizing medical debt. Although frightening, debt is manageable, and we encourage students to familiarize themselves with the economic concept of consumption smoothing.2 Consumption smoothing models the utility of spending in low-income states and saving in high-income states—seemingly contrarian. For debt-averse, low-income medical students, this model recommends borrowing educational loans relatively liberally. We do not encourage irresponsible debt, but rather relief in a financially difficult period of students’ lives.
As 2 underrepresented medical students, another challenge we have faced has been finding mentors with similar backgrounds at our institutions. We have managed this challenge by seeking mentors, regardless of medical specialty, with similar cultural backgrounds to our own. This solution has provided a wealth of support for us. As such, we encourage strong mentors to continue their commitment to minority students.
Finally, throughout our time in medical school, we have faced the expectation of becoming our family’s doctor. Many of our peers agree that family dependence on medical students for primary medical advice is often burdensome and potentially unsafe. From our personal experiences, supplemented by those of our classmates, we offer 2 recommendations: First, freely recommend that family members see physicians. Encouraging someone to reenter the health care system can be unbelievably impactful. Second, we have learned the importance of saying, “I don’t know.” This simple admission is powerful and underscores the significance of seeking further help.
Although these challenges have been difficult, we must highlight what we believe is many minority students’ biggest strength to overcoming them: grit. Grit is perseverance and passion for long-term goals.3 We believe everyone has much to learn from examples of such resolve in their personal lives and would like to show students with similar challenges that they are not alone. The ways in which we all overcome adversity should not be forgotten as we become community leaders and mentors for years to come.
J. Andres Hernandez
Fourth-year medical student, Perelman School of Medicine and the Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania; firstname.lastname@example.org.
Natalie M. Delgado
Fourth-year medical student, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
1. Association of American Medical Colleges. AAMC Facts & Figures 2016. www.aamcdiversityfactsandfigures2016.org/report-section/section-3/#figure-4
. Accessed October 17, 2019.
2. Morduch J. Income smoothing and consumption smoothing. J Econ Perspect. 1995;9:103–114.
3. Duckworth AL, Peterson C, Matthews MD, Kelly DR. Grit: Perseverance and passion for long-term goals. J Pers Soc Psychol. 2007;92:1087–1101.