Thursday, January 10, 2013

Guest Post: Why Diversity Matters in Medicine

Earlier this fall, I had the opportunity to attend the 97th Annual Clinical Congress of the American College of Surgeons. It's the meeting of the bigwigs. Surgeons from across the country travel to Chicago to attend top-notch skill sessions, expert panels, and lectures on leading research. Speakers feature the premiere innovators and investigators in their specialties. As a medical student, I attended residency interview training sessions and resident panels. I also made sure I took the opportunity to take a step back and soak in the entire experience. I wrote down some of my first impressions...

#1 - There are lots of white men here.

I've written quite a bit about the importance of mentorship on my blog, specifically about how mentors have shaped my career trajectory. I'm not sure that I would've chosen General Surgery without the skilled and caring surgeons I worked with in Asheville and Linville, NC. I certainly wouldn't have considered rural surgery without briefly living the craft, getting to know surgeons who have worked in a rural area for many years and then moved back into academia. I cannot stress how important it has been that people like me are already doing what I want to do. With this knowledge, I believe I can accomplish as much as they have, and even push the boundaries.

Aspiring leaders want to know that their dreams are reachable. First, they must have access to the necessary resources (e.g. students of low socioeconomic status must have the educational and financial means to even get to medical school). Second, they want to see someone who has come from their position... and succeeded. Politics aside, it is no longer a question whether an African American can be the President of the United States. We now have a black Commander and Chief. It is no longer a distant dream of possibility; the path has been forged. Resources and mentorship: our youth need both to succeed.

So why is diversity a problem for medicine? I've focused quite a bit on rural disparities. One quarter of the US population lives in a rural area, yet only one out of every ten physicians works there. This population is in dire need of primary care physicians and general surgeons. Studies have shown that women are more likely than men to go into primary care and minority medical students are more likely to care for underserved and indigent populations. Yet only 6.3 percent of the American physician workforce is black. And women make up only a third of all physicians. 

Of course, in 1970, women made up less than one tenth of all physicians, so great strides have been made. But the progress is slow, and often the leadership lacks diversity. I guess this is to be expected, since the more experienced clinicians trained at a time when the medical profession was almost exclusively white men. And their mentors were probably white men, and their mentors were white men.  

To change this pattern we need to work on access to resources, and make sure there is an increasingly diverse group of mentors. In both regards, medicine can (and will) improve. 

Of course, I am another white man. So I guess I'm not helping the statistics. 

Robert Swendiman is an MD candidate at UNC School of Medicine and an MPP candidate at the Harvard Kennedy School, where he is also a Dubin Fellow at the Center for Public Leadership. You can read more on his blog The Language of Medicine.

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