Taking My Place in Medicine: A Guide for Minority Medical Students
This book is designed to help minority students thrive personally and academically in medical school, to make a realistic assessment of their strengths and weaknesses, to successfully confront societal myths and stereotypes and to develop healthy strategies to meet academic, personal, and relationship needs. Carmen Webb, having assisted countless medical students with these issues, has assembled an outstanding cadre of insightful professionals for advice, each highly qualified and devoted to promoting medical student well-being.
- Front Matter
- Back Matter
- Subject Index
- Section I: Navigating a New World
- Chapter 1: Medical Culture
- Exactly Who Am I?
- What is This Place?
- Taking My Place within the Culture of Medicine
- Sample Conflicts
- Chapter 2: Mastering the First Two Years
- Preparing Yourself
- In the Classroom
- In the Labs
- What If My Way Doesn't Work Anymore?
- Balance: How is it Possible?
- How Do I Not Feel Guilty for Relaxation Time?
- Managing Competition
- Maintaining Motivation
- The USMLE: Meeting “Standardized” Challenges
- Chapter 3: Life on the Wards: When All the Rules Change
- Part I: The New Rules
- Clinical Clerkships
- Who's Who
- The Daily Routine
- Student Responsibilities
- Part II: When Things Go Wrong
- Stumbling Blocks
- Effective Defensive Strategies
- Chapter 4: Now What Will I Do? Preparing for Residency
- Choosing a Specialty
- Mastering the Process
- Section II: Focus on Me
- Chapter 5: Do I Really Belong Here?
- Myths about Minorities
- Impact of the Myths
- Realistic Self-Appraisal
- Chapter 6: Taking Care of Myself
- Taking Stock
- Understanding My Needs
- Making a Plan
- Designing Personalized Methods of Coping with Stress
- Chapter 7: Building a Community
- The Problem: Isolation
- Choosing My Crowd
- The Role of the Office of Minority Affairs in My Community
- Finding Mentors in My Community
- The Family in Your Community: A Balancing Act
- Section III: Focus on My Culture
- Chapter 8: Focus on African American Medical Students
- History of African Americans in Medicine
- Current Status
- Special Challenges
- Secrets of Success: Advice from Fifty Black Physicians
- What African Americans Offer the World of Medicine
- Chapter 9: Focus on Native American Medical Students
- History of Native Americans in Medicine
- Current Status
- Special Challenges
- Secrets of Success for Native American Students
- What Native Americans Offer the World of Medicine
- Chapter 10: Focus on Mexican American Medical Students
- History of Mexican Americans in Medicine
- Current Status
- Special Challenges
- Secrets of Success
- What Mexican Americans Offer the World of Medicine
- Chapter 11: Focus on Puerto Rican Medical Students
- History of Puerto Ricans in Medicine
- Current Status
- Special Challenges
- Secrets of Success and Survival
- What Puerto Ricans Offer the World of Medicine
- Chapter 12: Managing Racism
- Historical Perspectives
- Psychology of Racism
- Racism on Campus
- Impact on the Victim
- Intervention Strategies
- Making Your Case
- Discussion Vignettes
[Page ii]This book is dedicated to my husband Jerry and my sons Jerry and Joel.
You are my world.
Copyright © 2000 by Sage Publications, Inc.
All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.
Sage Publications, Inc.
2455 Teller Road
Thousand Oaks, California 91320
Sage Publications Ltd.
6 Bonhill Street
London EC2A 4PU
Sage Publications India Pvt. Ltd.
Greater Kailash I
New Delhi 110 048 India
Printed in the United States of America
Library of Congress Cataloging-in-Publication Data
Main entry under title:
Taking my place in medicine: A guide for minority medical students / edited by Carmen Webb.
p. cm.—(Surviving medical school; v. 8)
Includes bibliographical references and index.
ISBN 0-7619-1809-4 (pbk.: alk. paper)
1. Minorities in medicine—United States. 2. Medical students—United States. 3. Medical education—United States. I. Webb, Carmen. II. Series.
R693 .M57 2000
610′71′173 dc21 00-008370
This book is printed on acid-free paper.
00 01 02 03 04 05 06 7 6 5 4 3 2 1
Acquiring Editors: Rolf Janke/Jim Nageotte
Editorial Assistant: Heidi Van Middlesworth
Production Editor: Astrid Virding
Editorial Assistant: Victoria Cheng
Copyeditor: Linda Gray
Typesetter: Lynn Miyata
Indexer: Kathy Paparchontis
Adapting to life as a medical trainee challenges any student. Minority students—African Americans, Mexican Americans, Native Americans, Mainland Puerto Ricans, and Hawaiians—whose backgrounds often differ from those who govern medical centers, need also to adapt to the values, beliefs, and customs of the dominant group. Mentors with similar backgrounds, who can serve as role models, are usually sorely lacking.
This book is designed to help minority students thrive personally and academically in medical school, to make a realistic assessment of their strengths and weaknesses, to successfully confront societal myths and stereotypes, and to develop healthy strategies to meet academic, personal, and relationship needs. Dr. Carmen Webb, having assisted countless medical students with these very issues, has assembled an outstanding cadre of insightful professionals to address these important needs. Each contributor is highly qualified and devoted to promoting medical student well-being.
Carmen Webb, MD, Adjunct Assistant Professor of Psychiatry at MCP Hahnemann School of Medicine (MCPHU) in Philadelphia, is currently practicing [Page x]in Dallas, Texas. She established the first Medical Student Mental Health Service at MCPHU and teaches courses and workshops to help minority students develop the skills needed to survive medical school. As principal investigator of a multi-institutional study, she evaluated the psychosocial characteristics and skills that predict academic performance in medical school across race and gender.
Cheryl S. Al-Mateen, MD, a Forensic Child and Adolescent Psychiatrist at the Virginia Commonwealth University's Medical College of Virginia (VCU), is also a faculty associate at the Institute for Law, Psychiatry and Public Policy at the University of Virginia. Her publications and presentations focus on cultural competence, sexuality, identity development, and mental health of African American women. She has also conducted research on the effects of community violence on children and adolescents. She has long been adviser, supervisor, and mentor to premedical and medical students.
Kevin Bakeer Al-Mateen, MD, MSHA, a neonatologist at the Virginia Commonwealth University's Medical College of Virginia (VCU), also holds a master's degree in health administration. A member of the Committee on the Status of Women and Minorities in Medicine at VCU, he is a faculty adviser and mentor to residents and medical students.
Lori Arviso Alvord, MD, a board-certified surgeon and Associate Dean of Student Affairs and Minority Affairs at Dartmouth Medical School, is one of the most accomplished Native Americans in medicine today. She oversees admissions, financial aid, student affairs, and minority affairs. An enrolled member of the Navajo Tribe, she spent six years working with the Public Health Service among Navajo and Zuni tribes in Gallup, New Mexico.
Miguel A. Bedolla, MD, PhD, MPH, Associate Professor of Family Practice at the University of Texas Health Science Center in San Antonio and Charles Miller Professor of Medical Ethics at St. Mary's University, is the Director of the South Texas/Border Region Partnership for Health Professions Education. This program, with others, is dedicated to offering minority applicants equal opportunities to attend Texas medical schools.
George C. Gardiner, MD, board certified in internal medicine and psychiatry, has recruited, trained, and counseled medical students for 30 years. As Associate Provost of Minority Affairs at MCP Hahnemann School of Medicine at Allegheny University of the Health Sciences, his department recruited the largest number of minority students at any majority medical school. Most recently, he served as Clinical Director for the Dr. Warren E. Smith Health Centers in Philadelphia.
[Page xi]Margarita Hauser Gardiner, MD, board certified in Internal Medicine and Rheumatology, is on faculty at MCP Hahnemann School of Medicine where she advised, mentored, and served as clinical preceptor for second-, third-, and fourth-year medical students. Currently working with a pharmaceutical company as a drug safety monitor, she continues to supervise and mentor premedical and medical students.
Morris Hawkins, Jr., PhD, Associate Professor of Cell Biology and Molecular Genetics and Special Assistant to the Dean of Howard University College of Medicine, is a research adviser, mentor, and support to undergraduate, medical, and doctoral students. He coordinates the Liaison Committee on Medical Education Self-Study Accreditation site visits for the College of Medicine, was Vice Chairman of the Middle State University-wide Self Study for Accreditation, and Chaired the NCAA Self-Study for Athletics Certification.
Ann Hill, MEd, served as past Director of Minority Affairs at MCPHU, and past Assistant Professor and Assistant Director of Admissions at Cheyney University of Pennsylvania. In her role, she was responsible for recruitment and admissions of minority medical students and for assisting them in developing strategies for academic success. As director of the freshman studies program, she assisted students in developing strategies for academic success.
Juan C. Martinez, EdD, Senior Educational Planner at UMDNJ-New Jersey Medical School, has been involved in academic advising and curricular development for over 20 years. He coordinates support services, conducts cognitive development sessions for first- and second-year students, and performs follow-up evaluations on student examination performance, particularly for underrepresented minority students.
Ana Núñez, MD, Assistant Professor of Medicine, Assistant Dean for Generalism, and Director of the Women's Health Education Program at MCPHU, is a member of the National Advisory to the Robert Wood Johnson, Minority Medical Education Program. She edits a comprehensive women's health case study series, is principal investigator of a U.S. Department of Education grant, and has nationally recognized expertise in cross-cultural communication and cultural diversity issues.
Maria Soto-Greene, MD, Acting Associate Dean for Special Programs at the New Jersey Medical School, has more than a dozen years of experience with minority issues, especially among Puerto Ricans. She is board certified in Internal Medicine, Critical Care, and Emergency Medicine. She is principal investigator of a federally funded program to increase the number of Hispanic/ [Page xii]Latino physicians who can favorably affect the health and well-being of their communities.
Stephanie Smith, currently a third-year medical student at Virginia Commonwealth University's Medical College of Virginia, completed her first two years of medical education at MCPHU where she was honored as a Humanities Scholar and was involved in the Student National Medical Association (SNMA), the Holistic Medicine Society, Pen Friends, and several outreach programs.—Robert HolmanCoombsProfessor of Biobehavioral Science, UCLA School of Medicine, Series Editor—Carla CronkhiteVeraDepartment of Psychiatry, UCLA School of Medicine
In the early 1950s, I was elated when granted an interview at the University of Virginia College of Medicine. Although I was an A student and a native of Virginia, I was turned down for admission. The rejection was not surprising because in that era, African American admissions to Virginia medical schools were virtually nonexistent. I subsequently sought and was afforded admission to Meharry Medical College in Nashville, Tennessee. As a graduate, I still cherish the fact that Meharry, along with Howard University Medical School, Washington, D.C., was there for me and for thousands of other African Americans, many of whom were denied admission to publicly funded Anglo medical schools.
Twenty years later, as a busy physician practicing in San Antonio, I was greatly concerned that admissions rates for minorities remained dismally low. Therefore, I was delighted to accept an invitation by the University of Texas Health Science Center, San Antonio, to serve as an advocate for minorities on its medical school admissions committee. For some six years, I participated with other members of diverse ethnicity who shared the same urgency to [Page xiv]improve minority admission rates. We identified many excellent minority candidates who would otherwise have “fallen through the cracks” and not been granted admission.
It became obvious that the medical schools who are competitive in enrolling and graduating minority medical students must effectively meet two challenges: (a) to provide at the personal level a “user-friendly” environment for entering minority medical students and (b) to forearm them with sufficient insight, guidelines, and strategies to ensure their success in medical school, despite ethnic adversities. With the publication of this book titled Taking My Place in Medicine: A Guide for Minority Medical Students, both medical schools and their minority medical students are fortunate to have a powerful resource to help meet these challenges.
The book is a stellar work conceived by one author and made powerful by its diversity of coauthors. It is destined to have broad readership throughout the medical community and beyond. Written primarily to benefit minority medical students, this work will serve as an invaluable navigational guide as they embark on a formidable voyage in pursuit of excellence. It deals candidly with a broad range of expected concerns of minority medical students entering the medical arena.
This book begins by providing minority medical students with a comprehensive definition of the established medical culture, including the language, structure, traditions, and challenges this culture presents to minorities. Through the eyes of the authors, minority medical students will see medical school life in its stark reality. Without personal bias, the authors leave no stone unturned as they expose the “minefields,” “roadblocks,” and other hazards peculiarly encountered by non-Anglo medical students. Thought-provoking illustrations and vignettes provide dynamic realism as well as clarity to this work.
Early on, minority medical students are challenged to make a realistic self-appraisal of their inner strengths and to assess the medical and nonmedical support systems available. They are brought face to face with cultural myths with which they must deal, lest these myths become self-defeating.
As students progress from the classroom and labs of the basic science years to the bedside of the clinical years to local and national examinations and, subsequently, to matching for residencies, challenges vary but not the anxieties they bring. The varieties of difficulties are carefully presented as potential adversities that, with foreknowledge, can be largely attenuated. Available strategies for staying the course, surviving, and overcoming are carefully charted. The positive, can-do approach to managing challenges, small and [Page xv]great alike, is refreshing and, for the student, encouraging. Indeed, minority medical students are admonished to strive for excellence, to persevere, and to maintain an attitude of professionalism, despite adversity.
The chapters dealing with specific ethnic concerns are especially valuable as they provide an up-close look at each of the following cultural groups: African American, Mexican American, Native American, and Puerto Rican. Authors ethnically and culturally related to these groups provide the great wealth of information covered. Each author has taken pains to present a candid historical review of conflicts previously encountered in the medical school setting along with strategies for management. Thus, the minority student from any of these cultural groups is treated to a “customized” view of problems peculiar to his or her specific group. Challenges common to all groups are presented, but management strategies and “secrets” to success vary from group to group. It is made clear that not all conflicts can be managed simply as “Black versus White” issues.
“Managing Racism” is masterfully addressed in the final chapter. Its scholarly definition of the issues in historical context shares much-needed wisdom regarding the perpetrators as well as the victims of racism in the medical arena. The appropriate response of the victim, depending on type of injury and local support structure available, is skillfully presented. These well-referenced pages are notably free of bias and have provided for minority medical students a splendid “road map” from victim to victory.
Dr. Webb and the contributing authors are to be congratulated for this valuable work so rich in insight and dedication to detail. It adds considerable depth to our understanding of an area of medical education that has previously been afforded far too little attention. The book stands out as a remarkable single-source reference for minority medical students, medical school deans, faculty, admissions committees, and medical career counselors. All are privileged to have this volume and are profoundly indebted to the authors.—Charles S.Thurston, MD, Department of Medicine/Dermatology, University of Texas Health Science Center[Page xvi]
Any student working to succeed in medicine navigates a whole new culture. You will be no exception. In addition to the academics, you must master the language, values, beliefs, and customs particular to medical school—because much of the medical world is based on historically White Western male values. Adapting to this culture can be challenging for any student, and particularly challenging for you who, as a minority student, often do not share these mores. Furthermore, for groups historically underrepresented in the field, knowledge about how to achieve in medicine may not be readily available. In other words, you may not have anyone to coach you in the “rules of the system.” However, your understanding of these expectations is critical to your success.
In addition to understanding the system, to thrive personally and academically in medical school, you must make a realistic assessment of your abilities. This includes screening out the myths and stereotypes imposed by society. You also must develop healthy strategies to meet your academic, [Page xviii]personal, and relational needs. Although minority students share many similar experiences within the medical school system, they are in no way a homogeneous group. African Americans, Native Americans, Puerto Rican Americans, and Mexican Americans differ significantly. In addition, there are critical cultural differences within each ethnic group. Understanding the possible impact of cultural heritage on your medical school experience, including the impact of racism, is extremely important.
Our purpose in this book is to help you to (a) understand the medical school culture and expectations, (b) identify strategies that will meet your personal and academic needs, and (c) address the specific challenges arising from the interface of your ethnic heritage and medical school culture.A Word about Language
The term minority is often used to include many groups (gender, age, sexual preference) who are not part of the majority in the United States. In this book, we use the word interchangeably with ethnic minority, and our focus will be ethnic groups historically underrepresented in U.S. medical schools. According to the Association of American Medical Colleges (AAMC), these groups include Blacks (African Americans), Native Americans, Mexican Americans, and Puerto Ricans. Certainly, there are many other groups who face challenges in medical school because of their nonmajority status (e.g., Asian Americans). However, because we are not able to address all ethnic groups effectively in one short book, we have chosen to focus on those who are historically underrepresented. (We suspect that much of the information will be useful to other students who are not part of the majority.)
We will use the terms Black and African American interchangeably. Using the Health Resources and Services Administration (HRSA) definition, these terms will refer to all Black Americans “having origin in any of the Black racial groups of Africa.” This includes all Black Americans of African descent, including Caribbean Americans. The term Native American will refer to an individual who is a member of a tribe of people (living in the United States) indigenous to the Americas. We use the terms Puerto Rican and Puerto Rican Mainland interchangeably. Puerto Rican Mainland refers to persons from Puerto Rico who reside in the United States. Mexican American refers to persons having origin in Mexico who are now American citizens. Hispanic or Latino will connote all Puerto Rican or Mexican American persons.
[Page xix]This book addresses the interface between medical culture, personal values and beliefs, and ethnic culture. We hope that it will be an invaluable tool for all minority students striving to take their places in medicine.A More Personal Word
I love practicing medicine. Psychiatry is the perfect match for me. But when I look around, I am lonely for more minority colleagues. Over the past 13 years, I've worked with students who are striving to get through medical school. I am constantly struck by how much not knowing the system contributes to their distress. You just don't want to waste time struggling with medical culture when you could be learning medicine (or otherwise living the rest of your life).
My personal hope for this book is that it will give you and other minority students a road map to navigate the system. Although we've told many of the stories of minority students here, we have undoubtedly left out some. If yours is yet unrecorded, take pen in hand. We need to hear your wisdom.
I want the minority student who reads this to be empowered to move through the medical world with confidence—not just surviving but thriving. As the title indicates, you have a place in medicine: It's your responsibility to step up and take it.Acknowledgments
My first and greatest thanks goes to God, who has given me this work, knowing that I would love it, knowing the timing was perfect. He provided me with the personal dedication and the editorial, emotional, and mentoring support that I needed and has guided me every step of the way.
I give special thanks to Diane Cohen, a wonderful friend, who has read every word, almost as many times as I have. She has been unyielding in her standards for excellence as we tightened the language of this manuscript. Equally important, she has given her moral support and encouragement.
Thanks to all the contributing authors, who are marvelous writers and who provided much of the content that made this book possible. I count them among my most respected colleagues. Special thanks to Kevin Bakeer Al-Mateen, MD, who reviewed the entire manuscript.
This book reflects the support of many other family members and friends. For helpful editorial comments, I thank Drew Alexander; Cynthia Baker; [Page xx]Rickie Baker; Davida Bolger; Patti Cooper; Lonnie Fuller, Sr., MD; Benjamin Gallman, Esq.; Lisa George, Esq.; Linda Hiner, MD; Kempton Ingersol; Romaine Johnson, MD; Linda Mitchell; Reggie Moore, MD; Renee Moore; Kim Mueser, PhD; Liz Noll; Valerie Patton; William Sedlacek, PhD; Jerry Webb, MD; and Vincent Zarro, MD; and for motivation, Rev. Steven Lawrence. I am very appreciative of the insightful comments shared by College of Medicine students at Howard University. I would also like to thank the students with whom I have worked over the years for sharing their lives and innumerable experiences with me.
I thank Bob Coombs, PhD, whose vision and care for medical students made this happen.
My loving gratitude goes to Jerry Webb, MD, my husband, who was my greatest support through medical school. He has patiently supported me in this work also, giving me excellent ideas and sacrificing often so that I might complete this manuscript. I am deeply indebted to Cynthia and Rickie Baker; Patti and Paul Cooper; Renee Moore; Reggie Moore, MD; Tracy, Kelly, Jennifer, Jessica, Paige, and Michelle; Gertrude and Lee Snell; Tonya Ingersol; and Lucille Lawrence, all of whom helped simplify my life so I could get the work done.
I especially thank my in-laws, Joseph and Betty Culberson, Tricia Webb (whose own book is coming out soon), Tangela Pollack, Brian Shields, Walter and Doris Reed, Egypt Allen, Terry Webb, Theresa Enoch, and all the other Webbs by birth or marriage who worked tirelessly to help us relocate while I worked on this book.
Finally, I thank my parents. Marie Thurston, now pursuing her own doctorate at the age of 68, is my model of a strong and courageous woman. I savor her unwavering support and encouragement. Charles Thurston, MD, the first physician I ever met, has provided me with an example of a smart and compassionate doctor. Because of him, I've never had to question whether African Americans have a place in medicine.
How to Use This Book[Page xxi]
As you open this book, you will encounter the challenges and joys that you as a minority student face in medical training. Remember, however, that this is not meant to be an exhaustive manual. It is one in a series of books that provide in-depth looks at life as a medical student. You may choose to read this volume cover to cover or to use it as a reference for the issues that arise during your journey. If you plan to take it a few chapters at a time, the following may help you find the sections most pertinent to your needs.
Premedical and First-Year Students. To ready yourself for the medical world, begin with the chapters “Medical Culture” (Chapter 1), “Mastering the First Two Years” (Chapter 2), and “Taking Care of Myself” (Chapter 6). These will give you a leg up on managing first encounters with ease.
Second-Year Students. You will want to focus on “Life on the Wards” (Chapter 3) and to reread the USMLE section of Chapter 2. These chapters will help you to position yourself for the boards and for the clinical years ahead.
[Page xxii]Third- and Fourth-Year Students. You will find it useful to read “Now What Will I Do” (Chapter 4) and the “Realistic Self-Appraisal” section of Chapter 5. Reread “Life on the Wards” (Chapter 3) and the “The Rules” section of Chapter 1. These chapters will remind you of the new expectations in the clinical years and prepare you for the challenge of finding the best residency for your own career.
All Years. When you are having doubts about your abilities, your potential or your future, read “Do I Really Belong Here?” (Chapter 5). When racist attitudes or cultural hurdles arise, read “Managing Racism” (Chapter 12) and the appropriate “Focus on My Culture” sections. As you struggle with maintaining a fulfilling life while dealing with medical school, pick up “Taking Care of Myself (Chapter 6) and “Building a Community” (Chapter 7); also, reread the section on “Balance” in Chapter 2.
Faculty. To understand the challenges of your minority students in the classroom and on the floors, peruse the chapters “Mastering the First Two Years” (Chapter 2) and “Life on the Wards” (Chapter 3). Those of you teaching classes in cross-cultural issues or medical culture will find a wonderful resource in “Medical Culture” (Chapter 1) or the chapters in “Focus on My Culture” (Section III).
Premed Advisers, Faculty Advisers, Summer Program Directors, Student Affairs Personnel, Student Support, and Mental Health Personnel. As you work to understand and guide students of all ethnicities through their daily hurdles, use this book for your own reference or recommend pertinent sections to your students. The chapters “Medical Culture” (Chapter 1) and “Building a Community” (Chapter 7) may be especially helpful during orientation periods. When preparing students for the changing expectations of the curriculum, you may recommend “Mastering the First Two Years” (Chapter 2), “Life on the Wards” (Chapter 3), and “Now What Will I Do?” (Chapter 4.) When helping a student to adjust to the rigorous demands of medical school, you may find especially helpful the chapters on “Taking Care of Myself (Chapter 6) and “Do I Really Belong Here?” (Chapter 5). The “Focus on My Culture” section (Section III) may help students to place their challenges in context and to prepare for a diverse medical world.
The gray of that cool October morning was a perfect complement to the sense of gloom I felt as I entered the rather stark, sparsely furnished room. Seated behind a wooden table were two elderly gentlemen, one of whom beckoned to me to be seated. I knew the numbers. Of 160 students admitted to the medical school, a very limited number would be non-White. Would I be one of the “chosen?” As I approached the wooden chair, I sensed that a moment of truth had arrived.
During that medical school admissions interview over 40 years ago, I was asked if I thought that I might go to the rural South to take care of “poor colored people” when I completed medical school. That the institution was located in the urban North says volumes about the perspectives of the interviewers. Those were the behaviors and attitudes of the times. There were no advocates, no mentors, no affirmative action, and no minority affairs offices or personnel. “Quotas” were magical numbers representing the maximum (not minimum) number of minorities that could be admitted. Racism was alive and well.
[Page 214]There are those who would now deny the present reality of racism. After all, aren't there many more minority physicians these days? But one need only note the disparity in health care accessibility for members of the defined underrepresented minority groups to realize that the attitudes that reflect racism, both individual and institutional, still very much influence the manner in which we, as a nation, do business. And that reality, more than any other single factor, underscores the necessity for Taking My Place in Medicine: A Guide for Minority Medical Students.
Although this volume has been written primarily for minority medical students, nonminority students, faculty members, and administrators have much to gain from reading it as well. It is time for all of us, and particularly physicians, to recognize that our learning must include more than a passing knowledge of the many cultures in a diverse society. And where do we go from here? Perhaps the next volume of this book should outline techniques that would specifically address diversity training and multicultural competence within medical education. As a start, the Association of American Medical Colleges has recently established a task force to structure a Liaison Committee of Medical Education Standard on Diversity. Changing the medical education system to emphasize the treatment of diverse patient populations would necessarily help to change the culture of the health care system. The time is right. The social and economic imperatives are present. The health and well-being of all patients are at stake.—Leonard E.Lawrence, M.D.Associate Dean for Student Affairs and Professor of Psychiatry, Pediatrics and Family Practice, University of Texas Medical School at San Antonio
About the Editor[Page 225]
Carmen Webb, MD, is Adjunct Assistant Professor of Psychiatry at MCP Hahnemann School of Medicine (MCPHU) and is currently in private practice in Dallas, Texas. She received her BS at Yale University, her medical degree from Southwestern Medical School, and her residency training at Hahnemann University. Throughout her career, she has been devoted to promoting medical student well-being. From 1992 to 1999, she served as Assistant Professor of Psychiatry and established the first Medical Student Mental Health Service at MCPHU. As director, she ensured the provision of confidential individual, group, and psychopharmacological treatment. She also codeveloped a curriculum and teaches courses and workshops to help minority and other students develop tools needed to survive the medical school culture. She recently assisted in building a framework for the service's expansion to a comprehensive well-being program.
Dr. Webb is the Principal Investigator of a multi-institutional research study evaluating the psychosocial characteristics and skills predictive of improved academic performance in medical school across race and gender. The research has been supported by grants from the Healthcare Resources Foundation and the Christian R. Mary F. Lindback Foundation. She served for [Page 226]seven years on the Admissions Committee at MCPHU and has been a consultant to a U.S. Medical Licensing Exam Preparation Program and to the Minority Affairs Program, assisting them in determining predictors of performance and support needs for minority students. She has made multiple presentations and published articles regarding predictors of medical school performance beyond standardized tests.
Very active in her community, Dr. Webb chaired the Board of Exodus to Excellence for six years (since its inception). This program stimulates minority students' achievement in math and science. She is married to a fine physician and is the mother of two wonderful boys.
About the Contributors[Page 227]
Cheryl S. Al-Mateen, MD, is a Forensic Child and Adolescent Psychiatrist on the faculty at the Medical College of Virginia at Virginia Commonwealth University in Richmond. She is also a faculty associate at the Institute for Law, Psychiatry and Public Policy at the University of Virginia. She received her undergraduate and medical degrees from Howard University and completed her psychiatric training at Hahnemann University in Philadelphia. Her research interests include the effects of all forms of violence on children and adolescents. She has publications and presentations related to this area as well as in the areas of cultural competence, sexuality, and the identity development and mental health of African American women. She is married to her coauthor and is the mother of two great children.
Kevin Bakeer Al-Mateen, MD, MSHA, is a Neonatologist on the faculty at the Medical College of Virginia at Virginia Commonwealth University (MCV of VCU) in Richmond. He did his undergraduate work at the University of California at Davis and received his medical degree from Howard University College of Medicine. He completed his Pediatric residency at St. Christopher's Hospital for Children in Philadelphia and his Neonatology fellowship at MCV of VCU. He has also received a master's degree in health administration from VCU. His research and publications relate to the treatment of respiratory disease and illness in newborns. He is also interested in the history and development of [Page 228]physician managers. He has been a member of the Committee on the Status of Women and Minorities in Medicine at VCU as well as serving as faculty adviser to residents and medical students. He is married to his coauthor and is the father of two great children.
Lori Arviso Alvord, MD, is Associate Dean of Student Affairs and Minority Affairs at Dartmouth Medical School and an Assistant Professor of Surgery. She did her medical training and residency/chief residency in general surgery at Stanford Medical School. Prior to this position, she worked six years with the Public Health Service as a surgeon for the Navajo and Zuni tribes in Arizona and Gallup, New Mexico. She is an enrolled member of the Navajo Tribe and lived in Navajo communities growing up (through high school). She is the first woman surgeon of her tribe. One of the most accomplished Native Americans in medicine today, she has oversight responsibility for the Offices of Student Affairs, Admissions, Financial Aid, the Registrar, the Advising Dean's Program, and Minority Affairs.
Miguel A. Bedolla, MD, PhD, MPH, is Associate Professor of Family Practice at the University of Texas Health Science Center in San Antonio and is also the Charles Miller, MD, Professor of Medical Ethics at St. Mary's University. He is the Director of the South Texas/Border Region Partnership for Health Professions Education, the South Texas/Border Region Partnership of Magnet High Schools/Programs for the Health Professions, and the Health Career Opportunities Program. He is a consulting ethicist with the University Health System. He does research on the historical and philosophical foundations of medical ethical codes, which has been published in Insight: A Journal of Lonergan Studies and Médico Interamericano. He has a B.A. in history from St. Mary's University, an MD from the Universidad de Nuevo Leon, a PhD from Ohio State University, and an MPH from the University of Texas. He is especially committed to creating opportunities for minority applicants to attend the medical schools of Texas.
George C. Gardiner, MD, FAPA, has most recently served as Clinical Director of the Dr. Warren E. Smith Health Centers in Philadelphia, a community-based comprehensive health center. A graduate of Tufts University School of Medicine, he is board certified in internal medicine and in psychiatry and has been involved in recruiting and retaining medical students over the last 30 years. His experience has included recruiting medical students; teaching them internal medicine and psychiatry; offering them academic counseling, career counseling, [Page 229]and psychotherapy; and organizing and maintaining support services for them. From 1989 until 1998, he was Associate Dean for Minority Affairs in what is now the MCP Hahnemann School of Medicine. In addition, during that time, he held the position of Associate Provost for Minority Affairs of Allegheny University of the Health Sciences and was responsible for establishing a complex set of programs designed to recruit minority students into the health professions. Much of this work entailed the individual career counseling of minority students interested in the health professions.
Margarita Hauser Gardiner, MD, is currently employed by a major pharmaceutical firm as a drug safety monitor. She is an honor graduate of Howard University and of the Medical College of Pennsylvania and is board certified in Internal Medicine and Rheumatology. She is a member of the American College of Physicians and is a fellow of the American College of Rheumatology. She was Assistant Professor of Medicine at the Medical College of Pennsylvania, now MCP Hahnemann School of Medicine, for six years and is now a member of the volunteer faculty. Her teaching responsibilities have included introductory courses in clinical medicine, third- and fourth-year medicine clerkships, fourth-year rheumatology electives, bioethics, and problem-based learning. She has been a clinical preceptor for second-, third-, and fourth-year medical students and was an academic adviser for five years. She continues to mentor premedical and medical students.
Maria Soto-Greene, MD, is Acting Associate Dean for Special Programs at the New Jersey Medical School and principal investigator of a federally funded program whose ultimate goal is to increase the number of Hispanic/Latino physicians who in turn will affect the health of their communities. This program also addresses the need for increased representation of Hispanic faculty members in medical school as well as the development of culturally competent curricula. She is responsible for the implementation of this and other pipeline education programs designed to increase the number of minority and disadvantaged students entering all of the health professions, including medicine. Her work with pipeline programs at the New Jersey Medical School was recently published in a recent issue of Academic Medicine. Board certified in internal medicine, critical care, and emergency medicine, she has 16 years experience as a faculty member involved with minority issues. She feels uniquely qualified to address issues related to Puerto Rican medical students as a Puerto Rican herself and because of her experience in providing the academic and nonacademic support to these students for so many years.
[Page 230]Morris Hawkins, Jr., PhD, is Associate Professor of Cell Biology and Molecular Genetics and Special Assistant to the Dean of the College of Medicine at Howard University. He received a PhD in Genetics from Howard University, and his postgraduate training includes Somatic Cell/Human/Neurogenetics at Yale University School of Medicine, Neurobiology at the Marine Biological Laboratory, health professions education leadership development at the University of Illinois Health Science Center, health management education at the Association of American Medical Colleges, and human molecular genetics at the National Cancer Institute. He has published articles in the fields of Biochemical and Somatic Cell Genetics dealing with gene mapping and regulation as well as recent works investigating the treatment of breast cancer. He has also published several articles on issues related to medical student matriculation, and he continues to serve as research adviser to undergraduate, medical, and doctorate students. He is president of the Shiloh Church Family Life Center Foundation Board of Directors and Faculty Athletics Representative to the National Collegiate Athletic Association and Mid-Eastern Athletic Conference for Howard University. He is very active in community service and is a life member of Alpha Phi Alpha Fraternity, Inc. He is involved in physical fitness, photography, and the cultural arts.
Ann Hill, MEd, obtained her BA from West Virginia University and her MS in guidance and counseling from Ohio University. As past Director of Minority Affairs at MCP Hahnemann School of Medicine, she was an advocate for minority students, providing personal and educational support and counseling. As an Assistant Professor and Assistant Director of Admissions at Cheyney University of Pennsylvania, she directed the Freshman Studies Program, in which she assisted students in developing strategies for academic success. She also directed the program for high-risk undergraduate students, and taught a seminar in “How to Be Successful in College.”
Juan C. Martínez, EdD, is Senior Educational Planner at UMDNJ—New Jersey Medical School where he conducts individual and group cognitive development sessions, particularly with first- and second-year students, and coordinates support services such as individual tutorial services and the Biochemistry Group Tutorial Program. He also contributes to the planning and implementation of the Medical Educators in Training (METs) program in physiology and the Freshman Introduction to Resources, Skills and Training (FIRST) summer program. A graduate of Boston University, Graduate School of Education, he has over 20 years of experience in student academic advisement and development. [Page 231]Before bringing his expertise to medical education, he served as Program Specialist for the New Jersey Department of Higher Education. His community involvement includes presentations at local colleges and community educational centers to promote health and science professions and academic excellence. He is the secretary of the statewide Hispanic Association for Higher Education of New Jersey (HAHENJ, Inc.) and is an English as a second language (ESL) volunteer teacher in his community.
Ana E. Núñez, MD, is Assistant Professor of Medicine, Assistant Dean for Generalism, Director of the Women's Health Education Program, and Medical Director for the Physician Assistant Program at MCP Hahnemann School of Medicine. She received her medical degree and residency training at Hahnemann University in Philadelphia, Pennsylvania. Her postgraduate training includes a medical education fellowship in the Primary Care Faculty Development Program at Michigan State University in 1993 and a Health Services Research fellowship at the Association of American Medical Colleges in 1995. She is currently the principal investigator in a U.S. Department of Education Fund for Improvement of Post-Secondary Education Disseminating Proven Reforms Grant in Women's Health Education and a grant for health provider cultural competency for women of color who have HIV disease within the Institute of Women's Health Center for Excellence. She also serves as the editor of comprehensive women's health case studies series titled, Healthy Women, Healthy Lives: Women's Health Across the Lifespan. As a nationally recognized expert on cultural diversity and cross-cultural communication, she has presented at numerous conferences and served on national advisory's addressing cultural diversity training and its impact on health care. She is currently an invited member to the National Advisory to the Robert Wood Johnson Minority Medical Education Program.
Stephanie Smith is currently attending her third year at Virginia Commonwealth University's Medical College of Virginia. She completed her first two years of medical education at MCP Hahnemann School of Medicine, where she received recognition as a Humanities Scholar. At that institution, she participated in activities such as the SNMA, Holistic Medicine Society, Pen Friends, and several outreach programs. She is also the principal investigator of a project examining the academic and personal guidance that practicing physicians of color might offer to minority medical students to help them succeed in medical school.