Diversity in Medical Schools

Structural Diversity

Patients prefer physicians with whom they share a common background. When such concordance exists, patients report higher levels of trust in their physicians and demonstrate better adherence to treatment recommendations, both associated with better clinical outcomes. To create a physician workforce that more closely matches the patient population, medical schools have sought to broaden participation by students from all socioeconomic, racial, and ethnic backgrounds by developing academic enrichment or “pipeline” programs to prepare students from groups typically underrepresented among medical professionals to effectively compete for admissions to medical school. Another strategy to extend participation by a diverse group of students has been to establish community-based medical schools in medically underserved areas with the mission of improving the health of such communities. Such schools have demonstrated the ability to attract students into medicine who understand local culture and remain to practice in the targeted community. A third strategy to increase structural diversity has involved the consideration of diversity in admitting medical school applicants. The use of race and ethnicity in admissions remains controversial in the United States, although the Supreme Court of the United States upheld the “narrowly tailored” use of race in the case of Grutter v. Bollinger (2003) as a compelling interest based on the demonstrated effect of a diverse student body in preparing graduates who understand the viewpoints of others in a multicultural society.

Strategies to diversify the physician workforce are in place in countries around the world. Efforts at increasing numbers of students from the nomadic Sami population have been in place in Norway since 1963. The Northern Ontario School of Medicine was established in Canada in 2005 to train socially accountable physicians for this culturally diverse rural and aboriginally populated region. All medical schools in Australia must have [Page 697]specific recruitment and admissions policies for indigenous students. Medical schools in India consider caste and gender representation in medical school admissions.

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