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Diversity in Healthcare and PharmacyResearchers for the American Journal of Pharmaceutical Education and the American Association of Colleges of Pharmacy marvel at the irony of a rise in the number of college-educated racial and ethnic minorities and stagnation in their enrollment in medical schools and the schools of the health professions.

They make recommendations for increasing the number of minorities into the health professions by approaching them at the college level. Health industry investors and stakeholders may embrace these approaches because of the short time period between intervening at the college level and the turnaround time for the results of such efforts.

Such interventions can pay off in boosting the number of minorities in the health professions despite the serious challenges posed by disparities in minority grade school and high school education, researchers say.

After years of executing diversity programs at the college level, a body of work has proven the effectiveness of these interventions, calling into question the soundness of making substantial cuts in federal funding programs for such health professions diversity programs as the Health Careers Opportunity Program.

Most funding for college-level interventions has come from the federal government, though foundations have provided some support. The greatest source of funds is the Health Resources and Services Administration’s (HRSA)’ programs — the Health Careers Opportunities Program and the Centers of Excellence Program. (The federal government cut spending for these programs in 2006 by 89 percent and 65 percent, respectively of each of the two programs, perilously compromising the educational pipelines for its participants in the process, researchers say.)
To implement interventions at the college level, stakeholders will partner with medical schools and vocational healthcare schools to strive to achieve structural diversity, informal interactional diversity and classroom diversity — the three main types of diversity identified and addressed by colleges and universities nationwide.
Researchers define “structural diversity” as “the number of diverse groups represented, to increase the probability that students will be exposed to others of diverse backgrounds.”

They describe “informal interactional diversity” as the “frequency and quality of interactions among diverse groups of students outside the classroom setting.” They also identify “classroom diversity” as “the experience of learning about a diverse group of people from a curriculum content and classroom interactional standpoint.”

They will focus on the benefits of such strategies, specific issues to take into account when developing and implementing diversity programs and guidance on best practices to foster, manage and lead these initiatives.
According to researchers, program coordinators will share best practices in “student outreach, admissions procedures, mission statements and strategic plans on diversity” and how they can fortify diversity frameworks in non-health professions college and university settings. They will seek to create stronger bonds between regional and national networks of diversity stakeholders to unify advocacy, communications and implementation efforts and make national policy more receptive to diversity.

In an article titled “Fostering and Managing Diversity in Schools of Pharmacy” in the American Journal of Pharmaceutical Education and the American Association of Colleges of Pharmacy, researchers Nancy T. Nkansah, Sharon L. Youmans and Mitra Assemi discuss the benefits of diversity not only in eliminating healthcare disparities among underserved populations but also in guiding program administrators and college and university faculty in developing and maintaining diversity programs.

The researchers used the limited volume of data available from the field of pharmacy, experience from other academic disciplines and both national and international diversity reports in their work. This includes a statement published in 2007 by the American Society of Health-System Pharmacists (ASHP) on the importance of diversity towards reducing racial and ethnic health care disparities and the 2006 Accreditation Council for Pharmacy Education (ACPE) standards and guidelines on diversity goals in pharmacy college/school settings, consideration in hiring faculty, staff and students and in influencing curriculum and learning strategies.

They incorporated research on a study of a summer program by the Robert Wood Johnson Foundation that supported minority college students in preparing for medical school, finding that these program participants had a 70 percent greater chance than nonparticipating minorities in attending medical school. Another study found that other pre-medical bachelor-degree programs enrolling minorities found program participants were two times as likely as non-program students to register for medical school.

UCSF’s, Duke University’s Schools of Medicine

For example, the University of California’s School of Medicine in San Francisco and Duke University’s School of Medicine in North Carolina are considered among the premier medical schools in the country and the best at enrolling racial and ethnic minorities. They emerged from being predominately white institutions in 1960 to being racially and ethnically diverse in the present.

At USCF’s medical school, local advocacy and collegiate leadership enabled the student body to integrate in the early 1960s. These efforts began with a group of African Americans who worked support staff jobs at the USCF hospital and advocated for the university to allow for more minority students to register with its medical school.

At the time, Philip Lee, who became chancellor of the school in 1968 after serving as assistant secretary of health in the Johnson administration, received these demands warmly. Lee and other faculty leadership at the time commissioned USCF to reach out to minority students in the Deep South for its medical school.

As a result, USCF ended up having enrolled more racial and ethnic minorities than any other medical school in the nation, except for the historically black medical schools such as Howard, Meharry and Morehouse universities.
Meanwhile, the Duke University’s School of Medicine welcomed its first African-American medical student in 1966, being one of the last Southern medical schools to racially integrate.

At the time, students campus-wide called for greater integration and sensitivity to race and racism in the 1960s, hosting demonstrations and protests in 1969 to support their cause. Consequently, enrollment of minorities grew overtime.

By 1993, Nannerl Keohane was named president of Duke University. Keohane was tasked with creating an Institutional Commitment to Diversity for the campus.

Once a student protester, Brenda Armstrong, was chosen to become director of admission for Duke University’s School of Medicine and started to reform the admissions policy to stress more qualitative and comprehensive reviews of college candidates with less emphasis on quantitative aspects such as GPAs and admissions test scores.
By 2004, about 29 percent of the registering class of Duke’s medical school were racial and ethnic minorities—the highest percentage of the nation’s medical schools.

Other Medical Schools

Progress at USCF and Duke University was replicated in medical schools throughout the country in the 1960s when minority enrollment tripled from 3 percent in 1968 to 9 percent in 1973. In 1991, after minority enrollment remained flat for years, the Association of American Medical Colleges (AAMC) launched Project 3000 by 2000 to increase the number of minorities by 50 percent by 2000.

The number of minority enrollments was on the upswing in the early 1990s, with medical schools examining their admissions policies and implementing educational pipeline partnerships with local schools and colleges.
The history and background of such efforts by health professions schools and colleges show that improving workforce diversity is possible despite minority youth being lost in the educational pipeline at the grade school and high school levels.


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Last updated January 2014