As the population and diversity of our state and nation grow, the need for our physician workforce to expand and diversify is increasingly important for the health of us all. Our society is plagued by disparities in health and access to care along many dimensions, including socioeconomic and racial/ethnic lines. These disparities diminish economic productivity and increase the cost of health care borne by society. One contributing factor is the underrepresentation of minority physicians.
At UTMB Health we are proud of our legacy of training physicians whose diversity mirrors the society they serve.
Hispanics and African-Americans comprise over one quarter of the U.S.population but only about 7 percent of practicing physicians. While a diverse physician work force will not erase all health disparities, studies indicate that it can make a difference: minority physicians are more likely to treat Minority and uninsured patients and to practice in medically underserved communities than non-minority physicians.
The encouraging news is that Texas medical schools are among the leaders in promoting physician diversity. A variety of local and statewide programs for high school and college students have strengthened interest and opportunities in medical careers in the state. From 2000-2008, the four medical schools of the University Texas System ranked in the top 10 nationally for the number of Hispanic graduates, with UTMB ranked first and UT Medical School-Houston ranked fifth, UTHSC-San Antonio ranked third and UT Southwestern ranked eighth. During the same time span, UTMB ranked 10th nationally in the number of African-American graduates (excluding historically black universities).
But numbers are only part of the story. UTMB has implemented innovative educational approaches that have had a significant impact on all students' academic performance, with the greatest improvements being seen among underrepresented minorities, especially African-Americans.This documented academic success at UTMB opens opportunities to a wide variety of career options, from primary care or specialty practice to research and teaching on a medical school faculty. The latter is especially important. Because underrepresented minorities comprise only 7 percent of faculty membersnationally, minority students perceive a shortage of role models to mentor and encourage them through arduous training.
Another obstacle to student diversity is the cost of a medical education: students typically graduate with six-figure debt and face an additional three to eight years earning less than $50,000 per year as residents. This presents a sizable deterrent to a medical career for families of limited means. Moreover, high educational debt is a strong disincentive to entering primary care or practicing in an underserved area. Again, Texas medical schools do relatively well in this regard, with the four UT schools among the least expensive in the country. Nonetheless, median indebtedness among Texas graduates still exceeds $100,000. A new approach to physician education in Texas holds promise for breaking down the cost barrier.
The Transformation in Medical Education initiative involves 10 schools in the UT System, including UTMB, working in partnerships to revamp and shorten premedical and medical education to increase their effectiveness, efficiency and relevance to modern medical practice. These programs will focus on the professionalism and competence of graduates to ensure their preparation for residency training, while reducing student debt. Through these efforts and strengthening current pipeline programs, Texas should continue to be a leader in addressing health disparities through education.
In its accreditation standards for medical schools in the United States and Canada, the Liaison Committee on Medical Education requires that medical schools have in place programs to promote student diversity, citing the "collective responsibility for contributing to the diversity of the profession as a whole."
A diverse student body benefits all students — and their future patients — by facilitating greater understanding of and sensitivity to racial/ethnic differences. Our commitment and efforts to build upon the successes of the past promise to help reduce health disparities, lower medical costs and improve access to care for all Texans.
Dr. Steve Lieberman is vice dean for academic affairs and the John P. McGovern Distinguished Chair in Oslerian Medicine at UTMB.