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Diversity standards have helped more minority students get accepted into medical school. But the real success of the decade-old effort has been the increase of women entering medical school, Yale researchers say.
The standards, introduced 10 years ago by a committee that accredits education programs in U.S. medical schools, called for significant efforts from medical schools to create educational and pipeline programs that increase gender, race and ethnic diversity. The report was released Tuesday in a letter by Yale researchers in JAMA.
Medical schools "must engage in ongoing systematic and focused efforts to attract and retain students, faculty, staff and others from demographically diverse backgrounds,” the committee's 2009 executive summary said.
Disparities in the physician work force have long existed, so the standards were put in place to offset the decline of minority, specifically African-American, and female medical school students.
“I knew there were accreditation standards for medical school, but I wasn’t aware of what those standards entailed,” said Dr. Dowin Boatright, assistant professor of emergency medicine at the Yale School of Medicine and lead researcher of the study.
Boatright's team set out to evaluate the effect of the standards by analyzing data on the sex, race and ethnicity of matriculants provided by the Association of American Medical Colleges at different time intervals from 2002 to 2017.
The research team found that in the years after the diversity standards were introduced, the percentage of female, black and Hispanic medical school matriculants increased, with the largest gains for women.
From 2002 to 2009, before the standards were introduced, the proportion of women entering medical school was decreasing by 0.29 percent a year, Boatright said. That changed to an increase of 0.85 percent from 2012 to 2017. For blacks, the proportions went from an annual decrease of 0.09 percent to an increase of 0.27 percent over the same time periods. Hispanic matriculation was already increasing by 0.18 percent a year in the earlier period, and almost doubled to 0.35 percent, he said in an email.
“The standards are a great start," Boatright told NBC News. "Reports of women and black matriculants were decreasing until 2009, but once the standards were implemented we saw those trends reverse."
However, the increases were modest. "The next element is to look at the programs that have produced a more diverse class and to look at their practices and gold standards of recruitment. Other institutions can use them as a model to promote diversity,” said Boatright.
This report supports other findings that more women are entering medical school. In fact, last year the medical school organization reported that more women entered U.S. medical schools than men for the first time in history.
According to a report released earlier this year by the National Academies of Sciences, Engineering and Medicine and the Cobb Institute, a nonprofit organization that works to eliminate health disparities among racial and ethnic groups and racism in medicine, more African-American students attend medical schools today compared with 30 years ago, but the increase is due to greater numbers of black women training to be physicians. The proportion of men among African-American medical students decreased by more than 38 percent over the same period.
“They don’t see enough of us out there. If you don’t see us you don’t know what’s out there,” said Dr. Dale Okorodudu, president and founder of Diverse Medicine Inc. and Black Men in White Coats, which promotes black doctors through a series of videos.
“We have to connect students with mentors. The mentor doesn’t have to be a black male or female necessarily, but he or she has to be someone who has the student’s best interest at heart.”
Boatright welcomed the increased diversity in medical schools, but said more needs to be done.
“These standards are not perfect, and gender and racial/ethnic disparities in physician representation persist," Boatright said.
Future research aims to look at diversity more broadly, as sex, race and ethnicity were the only quantifiable identifiers with available data.
“In the future we might want to look at sexual orientation and religion to see if medical schools are becoming more diverse along those parameters as well,” said Boatright.