Stephen C. Shannon, DO, MPH
The Face of Osteopathic Medicine: I
A Look at Diversity and Medical Education
t’s a truth seen time and time again across the face of our nation’s history, from immigration to women’s suffrage to the ending of Jim Crow law and the desegregation of public facilities, schools, and sports teams: when diversity is introduced, the new ideas, fresh outlooks, and unique talents that come from a pool of varied social and cultural experiences and backgrounds generate the expanded capacity for outcomes of nearly limitless invention, innovation, and progress. As stewards of the osteopathic profession and advocates for the health of the population that we treat, it is our responsibility to recognize this and appreciate that the promotion and effective fostering of diversity is one of our chief priorities. While diversity has been a cornerstone of AACOM’s mission for decades, the recent rash of media coverage on minority-related injustices and civil unrest has presented a unique opportunity to highlight the topic of diversity and discuss what it means to osteopathic medical education and the broader medical profession as a whole.
The number of underrepresented minority (URM)1 osteopathic medical students does not come close to reflecting their proportion of the nation’s population. In 2014-2015, around 13 percent of applicants—and only 8 percent of matriculants—were URM (see AACOM’s reports web page for more details). However, according to the U.S. Census Bureau, around 36 percent of the U.S. population in 2010 was URM and projected to grow to around 45 percent by 2050. This disparity is a microcosm of the lack of diversity seen throughout the medical education continuum, an unfortunate trend that is echoed across the health professions.
There are a number of socioeconomic factors contributing to the disproportionate number of URM medical students and physicians, yet an important issue is the U.S. educational system’s inadequate response to the need for enhanced STEM (an acronym referring to the science, technology, engineering, and mathematics disciplines) educational efforts and pipeline programs among diverse populations. Without an answer to effectively address this issue, the health professions will be unable to meet the current and future health care needs of a growing diverse population (for example, see the recent AAMC report, “Altering the Course: Black Males in Medicine”). However, this is more than an issue of equity; it is also an important factor in reducing disparity in the quality of health care for disadvantaged populations.
As highlighted in the HHS Action Plan to Reduce Racial and Ethnic Health Disparities:
“diversity in the health care workforce is a key element of patient-centered care”—a key component of osteopathic medical education and practice.
Now more than ever, the landscape of medicine is changing. Advances in technology are advancing the way we train physicians and deliver care, the way in which graduate medical education (GME) programs receive accreditation is evolving, the need for primary care physicians is surpassing the number of available trained physicians, and the issues most straining on our country’s health care system—including research and GME funding, and costly public health issues such as obesity—are all part of what is now a rapidly-altering reality in which we must maintain solvency, adaptability, and resiliency.
A key element to successfully navigating through this time of immense and complex change is the expansion of efforts to promote and grow diversity within the osteopathic medical continuum. This can be achieved by tailoring medical education recruitment efforts to target disenfranchised and underrepresented communities, and by making access to osteopathic medical education more practicable by creating more and better pipeline programs starting at the K-12 education level.
At the same time, AACOM upholds an expanded definition of diversity, which comprises gender, racial, and ethnic impartiality as well as socioeconomic background, religion, language and nationality, geography, gender identity and sexual orientation, religion, disability, and age. These characteristics serve an important purpose in medicine as a way to differentiate individuals at risk of disease or experiencing other potential determinants that can inform clinical care and health care policy, but they should not create barriers to the pursuit of an education in medicine. Unfortunately, many talented individuals who identify as a minority in one or more of these categories often don’t receive the opportunity they need to fulfill their potential, and great minds and potential future leaders can sometimes fall between the cracks in our society.
I propose that rather than view diversity as a problem, inclusion should be seen as an untapped resource—an ingredient necessary for success. Sourcing skilled individuals from diverse populations is an effective way for institutions to grow the talent pool, gaining fresh perspectives and new ideas that in turn enhance their abilities to meet the challenges that lay ahead.
In the spirit of this newsletter issue’s focus on diversity, and in the wake of AACOM’s 2015 Sherry R. Arnstein Minority Student Scholarship Program—which granted scholarships to nine underrepresented minority students this year—I thought it was also important to highlight the person for which the scholarship program was established: Sherry R. Arnstein, former AACOM Executive Director, community planning and public policy icon, and unsung civil rights hero. Read more about her work and her legacy.
I will close this article with a final thought: Where diversity fails to take root excellence cannot thrive. So let it be a foundational element of our work toward better health care and health education systems to further plant the seeds of inclusion and equality and nurture the growth of diversity across the osteopathic medical education continuum.
1 AACOM follows the federal guidelines defining underrepresented minorities as members of the following groups: African-American; Native American, Alaska Native, and Hawaiian Native; mainland Puerto Rican; and Hispanic.