TheMi ssi onVi si onPr oj ectFuel st he Bl ackPhysi ci anPat hwayf r om Ki nder gar t ent hr oughMedi calSchool DATABRI EF
I NTRODUCTI ON
TheHumani t yBehi ndt heNumber s I t ’ snosecr ett hatpeopl eofcol orf ar e di spr opor t i onat el ywor set hanwhi t eswheni t comest oheal t hout comesf orchr oni c di sease, mat er nalheal t h, andover al laccess t oqual i t yheal t hcar e. Amongt hekeydr i ver s oft hesepoorheal t hout comesar edi st r ust f orheal t hcar epr ovi der sduet oahi st or yof i nappr opr i at er esear chandpr ocedur esusi ng Bl ackandBr ownbodi esassubj ect s, andl ack ofcul t ur al l ycongr uentcar et hatof t en mani f estconsci ousandunconsci ousbi ases. ThenumberofBl ackphysi ci anshasgr ownby onl y4%si nce1 940. Butt her ei sast or ybehi nd t hatnumber . Thi sr epor t , Fuel i ngt heBl ack Physi ci anPat hwayf r om Ki nder gar t en t hr oughMedi calSchool ,depi ct st he humani t ybehi ndt hewhy, andt hesyst emi c bar r i er st hatper si stmaki ngt her oadt o medi ci neal ongar duousonef ormanyBl ack st udent s. I nspi r edbyDr . Mi chaelWeaverandwi f e Jami l aWeaver , ofTheMi ssi onVi si onPr oj ect KC ( MVPKC) , t hi sdat abr i ef , i npar t , i s nar r at edbycar di ol ogi stDr . Anez iUz enduand medi calst udentHar monySander s. Bot har e MVPKC al umni , whi chai mst oi ncr easet he Bl ackandBr ownenr ol l mentr at ei nt heheal t h sci enceswi t haf ocusonmedi ci ne. Theyspeakt ot hechal l engesofmedi cal schoolpr epar at i on, chal l engest hatper si st whi l eat t empt i ngt oear nanunder gr aduat e degr ee. Uz enduwasbor ni nSt . L oui s, Mi ssour i t oi mmi gr antpar ent s. Hegr ew upi nbot h Ni ger i aandt heUni t edSt at esbef or e compl et i ngacombi nedB. A. / M. D. pr ogr am at t heUni ver si t yofMi ssour iSchoolofMedi ci ne. Hi si nt er nalmedi ci net r ai ni ngcamef r om t he Uni ver si t yofAl abamaatBi r mi ngham ( UAB) , car di ol ogyt r ai ni ngf r om TheOhi oSt at e Wex nerMedi calCent eri nCol umbus, and i nt er vent i onalcar di ol ogyatMassachuset t s Gener alHospi t al( MGH) . Uz enduex per i enced car di acar r estasani nt er nalmedi ci ne st udentandf oundedMakeBL SBasi ci n201 9 t obr i dget heknowl edgegapaboutbasi cl i f e suppor tandpr ovi deeducat i onand awar enessaboutCPRandaut omat ed ex t er naldef i br i l l at or( AED)use.
“ Iwantever yonei nt he communi t yt of eell i kebasi cl i f e suppor tt r ul yi sbasi c, andI cr eat edawhol epr ogr am ar ound t hat . I ' mr eal l yt r yi ngt oengage wi t hcommuni t i es. Al otof nei ghbor hoodsl i ket heonest hat Igr ew upi nandt heoneIhadmy car di acar r esti nhavet hel owest r at esofbyst anderCPR. SoIwant t ot ar gett hosecommuni t i esand equi pt hem t osavet hepeopl e t heyl ove. ” Asf orSander s, anat i veofSanDi ego, Cal i f or ni a, shei saf i r st -gener at i oncol l egest udent . Asa Bl ackmedi calschoolst udentpur sui nga M. D. / Ph. D. pr ogr am, shei soneofaver ysmal l numberofmedi calschoolst udent si nt henat i on. Forst udent sofcol ort henumberi sevensmal l er . “ Mypassi onf orr esear chandt hi r stf orst udyi ng i mmunol ogyi ncancerl edmet ocompl et ea mast er ’ si ncel lbi ol ogybef or eappl yi ngt o medi calschoolanddevel opedmyi nt er esti n r aci aldi spar i t i esi ncancer , ”shesai d. Sander swi l lbet het hi r dBl ackgr aduat ef r om t he Uni ver si t yofKansasMedi calCent er . Oneofher goal si st oi mpactBl ackchi l dr enwi t hex posur e t osi mpl el essonsi nbi ol ogy, chemi st r y, and physi cs. Sander ssai dshe’ sseent oomanyofher Bl ackpeer sbeganassci encemaj or swi t ha passi onf ormedi ci nebutcoul dn’ tcont i nue becauset heydi dn’ thavegr adest ocont i nue. “ If eelt hatl ackofknowl edgeandsci ence f oundat i oni scr i t i calt opr edi ct i ngt hesuccessof cr eat i ngBl ackphysi ci ans, ”shesai d. Fr om t hel ensandl i vedex per i encesofbot h Uz enduandSander s, t hi sdat abr i efdi mst he st at sandhumani z est her easonswhyt he numberofBl ackphysi ci anshasseenver yl i t t l e gr owt hsi nce1 940.
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MANYRI VERSTOCROSS: WHYTHEBL ACKPHYSI CI ANPI PEL I NEI S SL OW TOI NCREASE Raci alandEt hni cBr eakdownofU. S.Medi calSt udent sCompar edt oTot al Popul at i oni n201 8-201 9 5. 9% 0. 2% 1 . 3%
1 8. 3% 1 3. 4%
Amer i canI ndi anor Al askanNat i ve
Popul at i on
49. 8%
6. 5%
7. 3%
Bl ackor Af r i canAmer i can
76. 5%
22. 5% Hi spani c, L at i noor ofSpani shor i gi n
Medi calSt udent s
ForBl ackandBr ownmedi calst udent s, of t enr ef er r edt oasunder r epr esent ed mi nor i t yst udent s( URM) , t hechal l engesof bot hget t i ngi nt omedi calschooland navi gat i ngt hebar r i er st ogr aduat i onar e par t i cul ar l ydi f f i cul t . JustaskHar mony Sander s, af i f t h-yearcombi nedM. D. -Ph. D st udentatt heUni ver si t yofKansasMedi cal Cent er . “ Manymedi calst udent sar e Caucasi anandcomef r om pr i vi l eged backgr ounds, ”shesai d. “ Thi si ncl udesa par ent , andmanyt i mesagr andpar ent , whoi saphysi ci an. Thi sal l owsmaj or i t y st udent st ohavet headvant ageofknowi ng how t oopt i mi z et hei rappl i cat i onst o r esi dency. Bl ackst udent st endt obe f i r st -gener at i onandar econst ant l yt r yi ng t ol ear nwhati scomi ngnex ti nt r ai ni ng– whi l egoi ngt hr ought r ai ni ng. ”Sander sadds t heset hr eebar r i er sar eof t ent hemost di f f i cul tt oover comef orBl ackandBr own st udent s: 1 )At t empt i ngt onotonl ypassexamsbut scor ehi ghwhi l eal sonavi gat i ngt he compl excul t ur eofmedi ci newi t hout gener at i onalknowl edge.“ Medi ci nei sver y hi er ar chi cal , ”Sander ssai d. “ Al otofcul t ur e i sl ear nedt hr oughex per i ence, whi ch f i r st -gener at i onst udent swi l lal waysbe behi ndi nunder st andi ng. ”
Asi an
Whi t e
Sour ce:AAMCPhysi ci anShor t ages
2)I dent i f yi ngcul t ur al l ycongr uentment or swho canr el at e.“ Havi ngament orwhol ooksl i keyou hel pst r emendousl y, ”shesai d. “ Butf i ndi ngt hem i sachal l engebecauset her ear esof ew. ” 3)L ear ni ngt omanagement alheal t hand copi ngski l l st hatmani f estasi mpost er syndr omewhi l ei nmedi calschool .Sander ssai d t hi sf eathast obemanagedwhi l ebal anci ngt he needsoff ami l y, home, andcommuni t y. “ Wear e of t ent i edt oourf ami l yandser veasapi l l art o t hei rwel l -bei ngandt hatdoesn’ tst opj ust ei nmedi calschool . ” becausewear
ThePi pel i neNeedst oSt ar t Ear l y
Anez iUz endu, M. D. , acar di acr esear chf el l ow at Sai ntL uke’ sMi dAmer i caHear tI nst i t ut ei nKansas Ci t y, andMVPKC al umnus, sai dt hepat hwayt o medi ci nemustst ar tear l y. Ear l yex posur et o car eer si nmedi ci nei sal soi nt egr alt oi ncr easi ng t heBl ackandBr ownpi pel i ne. “ Ir emember gr owi ngupbef or eObamaandt hi nki ngt hat t her ewoul dneverbeaBl ackpr esi dent , ”Uz endu sai d. “ Ther ear esomanyt hi ngst hatunt i lyousee orar eex posedt osomeonewhol ooksl i keyou, youdon' tknow t hati t ’ savai l abl et oyou. So st ar t i ngt hepi pel i neear l ymeansr eachi ngback t ogr adeschoolandmi ddl eschoolandl et t i ng t hem know [ t hi s]i savai l abl et oyou, t oo. ” 3
FROM FI NANCI ALRESOURCESTO SOCI ALCAPI TALTOSTEM –BL ACK ANDBROWNSTUDENTSREQUI RE MOREACCESS Sour ce:Amer i canMedi calCol l egeAppl i cat i onSer vi ce
Medi calSchool s
Cost s
MCATPr epar at or yCour ses
$500-$2, 000
MCATRegi st r at i on
$31 5
Medi calSchoolAdmi ssi on Requi r ement sDat abase
$28
Pr i mar yAppl i cat i onFee
$1 60f orf i r st , $39 f oreachf ol l owi ng pr ogr am
Secondar yAppl i cat i oni fr equest edbymedi cal school
$40-$1 00
Tr anscr i ptFee
$1 0perschool
I nt er vi ews
$500-$3, 000 perschool
I nt er vi ew At t i r e
$1 00-$500
Admi t t anceVi si t
$500-$3, 000
Nonr ef undabl eAccept ance Deposi t
$500-$3, 000
Sander sconsi der sher sel fl uckybecause shewasabl et obenef i tf r om f i nanci alai d, l oans, andaf eewai verf r om t heAssoci at i on ofAmer i canMedi calCol l eges( AAMC)t o suppl ementt hecostofmedi calschool appl i cat i ons. Evenwi t ht heseai ds, shest i l l wor kedaf ul l -t i mej obt ocovert he r emai ni ngcost s, coupl edwi t ht r avelcost st o f l yar oundt hecount r yf orr esi dency i nt er vi ews. “ Fi nancesar eaconsi st enthur dl e f r om pr emedandbeyond, ”Sander ssai d. “ Admi ssi ons, r esi dency, andf el l owshi p appl i cat i onsal lcostasmal lf or t une. Boar d ex am r egi st r at i ons, i ncl udi ngSt ep1t hr ough St ep3ar eal soex pensi ve. ” However , bef or eanyoft hatcanhappen, appl yi ngt omedi calschoolr equi r eshi gh academi cper f or mance, shadowi ng ex per i ence, andmoney.“ Hi ghacademi c per f or mancei sdi f f i cul ti ncol l egei fst udent s ar eal sowor ki ng, pr ovi di ngf orf ami l y member s, andf eel i ngi sol at edasami nor i t y st udent , ”Sander ssai d.
UNI TEDSTATESMEDI CALL I CENSI NG EXAM ( USML E)
St ep1
$645
St ep2
$645
St ep3
$1 300
St ep4
$895
REGI STRATI ON FEES Sheaddst hatt ooof t enBl ackst udent sdon’ t havet henecessar ypr epar at i ondur i nggr ades K-1 2, andneedaddi t i onalt ut or i ngandgui dance t oper f or m wel lasanunder gr aduat e. Andt hose whol acksoci alcapi t al , oraccesst of ami l y member sorf ami l yf r i endswhoar eal so physi ci ans, mayal sof i ndi thar dt oshadow ot hermedi calpr of essi onal s. “ Shadowi ngi s t ypi cal l ygai nedbasedonwhoyouknow. Whi t e st udent sgai nt hi sex per i encef r om af ami l y connect i onl i keapar entphysi ci anora l ong-st andi ngr el at i onshi pwi t hapedi at r i ci anor f ami l yphysi ci an. However , Bl ackpr emed st udent sneedar esour cet ogai nadequat e shadowi ngt i meandsoci alconnect i ons. ” Uz endusai dt hatget t i ngi nt omedi calschooli s becomi ngi ncr easi ngl ycompet i t i vewi t h r equi r ement sf orvol unt eerwor kandshadowi ng. “ Youal mosthavet ohavear egi ment edgame pl ani nhi ghschoolt hr oughyourf r eshmanyear ofcol l ege, ”hesai d. Asf orex cept i onal l yt al ent edBl ackst udent swho pl ant ogot ocol l ege, getgoodgr ades, t aket he MCAT®, andt hengetaccept edi nt omedi cal school , Uz endusai dt heyar ehavi ngr ude awakeni ngs. “ That ’ snotenough. Ther e’ syear sof wor kt heyshoul dhavehad. Thevol unt eerand r esear choppor t uni t i est hatar enecessar yof t en comet hr oughconnect i ons. Youhavet oknow someonei nt hatar eat obeof f er edt hose oppor t uni t i es, ”hesai d. 4
Per cent ageofenr ol l edst udent si nU. S.medi calschool sby r ace/et hni ci t y( al one) , academi cyear201 8-201 9. 0. 2% 22. 1 %
49. 9% 7. 1 %
0. 1 % 6. 2% Whi t e Bl ackorAf r i canAmer i can Asi an Hi spani c, L at i no, orofSpani shOr i gi n Amer i canI ndi anorAl askaNat i ve Nat i veHawai i anorot herPaci f i cI sl ander Sour ce:AAMCAppl i cantMat r i cul antDat aFi l easofMar ch20, 201 9
Uz endudescr i best hef i r stpar tofmedi cal schoolascl assr oom i nst r uct i on. I t i ncl udesst andar dt est s,andl ear ni ng anat omyandphysi ol ogyamongot her t hi ngs. Formanyst udent sofcol or , access t oSTEM cl assest opr ovi decont ex tand ex posur et oanat omyandphysi ol ogy cour sesi nmedi calschoolcomesl at eor notatal l . Sander saddst hatl at eSTEM cour sewor ki nhi ghschoolmeanst hat under gr aduat ecol l egecl assesr equi r e st udent st of i l li nt hegaps. “ Col l ege st udent shavet ot eacht hemsel ves. ”She sai dt heal t er nat i veshoul dbeear l y i nt r oduct i ont oSTEM concept swi t hhi gh r epet i t i ont hr oughoutmi ddl eandhi gh school .
“ Thi si scr i t i calbecause manyBl ackpr emed st udent sdonothavet he gr adest ogot omedi cal schoolanddonotgr aduat e, or , accountf ort hemaj or i t y ofUni t edSt at esMedi cal L i censi ngExami nat i on® ( USML E)St ep1f i r st -t i me f ai l ur er at es. ”
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Per cent ageoff ul l -t i meU. S.medi calschool f acul t ybyr ace/et hni ci t y, 201 8.
2% 3. 6% 0.
1 9. 2%
3. 2% Whi t e Bl ackorAf r i canAmer i can Asi an Hi spani c, L at i no, orofSpani shOr i gi n Nat i veHawai i anorot herPaci f i cI sl ander
63. 9%
Sour ce:AAMCAppl i cantMat r i cul antDat aFi l easofMar ch20, 201 9
REPRESENTATI ONMATTERS Uz endusai ddur i ngt hesecondhal fof medi calschoolst udent sr ot at et hr ough hospi t alwar ds, andar eof t enassessed subj ect i vel y. “ I t ’ snotaboutABC-mul t i pl e choi ce, buti nst ead, i t ’ ssomet i mest he physi ci an’ sopi ni onofyouandyour per f or mance, ”hesai d. “ Somet i mest hei r owni mpl i ci tbi asmaypl ayar ol ei nsome eval uat i onst hatBl ackst udent sr ecei ve. ” Uz enduaddst hati t ’ snotenought ol ookat gr aduat i onr at es, butt hesum ofbar r i er s Bl ackst udent smustover come, bef or et hey everwal ki nt oacl assr oom, t oex celi n medi calschool . Theef f ect sofi mpl i ci tbi as andr aci sm ar epal pabl ef orst udent sof col or . “ How youi nt er nal i z et hoset hi ngscan suppr essyourabi l i t yt oachi eve, ”Uz endu sai d. “ Whenyoudon’ tf eell i keyour pr of essor s, ort hepeopl ewhoar e supposedt obeadvocat i ngf oryoubel i eve i nyou, i tcanaf f ectyourper f or mance. ”
“ Idon’ tt hi nki t ’ s al waysmal i ci ous, ” “ Butt her ear e subconsci ous bi asest hatmake peopl esetdi f f er ent ex pect at i onsf or di f f er entpeopl e. ”
Thepar adi gm shi f tcomesdownt ohavi ng mor eBl ackphysi ci ansandpr of essor si n t her oom. Whent her ei sl i t t l eornopeopl e ofcol orr epr esent ed, r aci albi asest endt o per si st .
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MVPKCWORKSTOFUELTHEPATHWAY
MVPKC i samemberof t heKansasCi t yHeal t h Equi t yL ear ni ngand Act i onNet wor k( t he L AN) , undert he l eader shi poft he Heal t hFor war d Foundat i onandi n par t ner shi pwi t ht he I nst i t ut ef orHeal t hcar e I mpr ovement( I HI ) , andt heKC Heal t h Col l abor at i ve( KCHC) .
TheL ANact i vel ydevel ops compr ehensi vest r at egi es andact i onpl anst hat pr omot ecul t ur al l y r esponsi ve, ant i r aci stheal t h car e. ThePhysi ci anPat hwayPr oj ectwas devel opedasapar tofMVPKC' swor kwi t ht he L ANt oi ncr easet heBl ack, L at i n, and I ndi genouspi pel i neofheal t hpr of essi onal s.
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Wi t hmor et han50 or gani z at i ons par t i ci pat i ng, t heL AN pr ovi desaf or um f or engagement , gi r ded byashar edagenda, wi t heducat i on, t r ai ni ng, t ool s, and ex per t i set omar kedl y changesyst ems, pol i ci es, and st r uct ur es. Thegoali st o el i mi nat edi spar i t i esi n heal t hcar edel i ver y, whi l er eal i z i ng measur abl e i mpr ovement s st eepedi n equi t y-cent er ed, cul t ur al l yr esponsi ve heal t hout comesf or al lheal t hcar e consumer s.
Vi si tMVPKCt ol ear nmor e, orsuppor tt he or gani z at i onbydonat i ngonl i ne.