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2 Factors that Define the Pipeline
Pages 21-45

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From page 21...
... No one can point to the sole reason for the persistent underrepresentation in minority enrollment and its subsequent impact on the number of minority health professionals in the United States. Some of the stalled progress in the late 1970s and through the 1980s has been attributed to a slower economy, a diminished domestic agenda, declining interest in- providing educational opportunities to minorities, and the publication of the 1980 Medical Education National Advisory Committee report, which predicted a significant oversupply of physicians in most specialties by the year 2000.
From page 22...
... A number of other institutions, particularly some medical schools, and organizations such as the National Medical Fellowships, Inc., the National Urban Coalition, the Association of American Medical Colleges (AAMC) , the National Medical Association, and a number of private foundations have put significant resources into efforts to increase the number of underrepresented minorities in the health care professions and other science-intensive disciplines.
From page 23...
... O Y ~ am, O ~Cd 0 0 ,N ~ z Figu~e 2-2. Leading college producers of underrepresented minority medical school matriculants, 1992.
From page 24...
... This chapter focuses on the pipeline beginning with the early school years when students first turn away, or are directed away, from careers in the health professions. It then presents information about the enrollment and fate of minority students entering medical and health professions schools and discusses the factors associated with minority underrepresentation.
From page 25...
... African Americans, Hispanics, and Native Americans comprise about 20 percent of the U.S. population and 19 percent of its workforce, yet underrepresented minorities make up only 5 percent of the science and engineering workforce (IJ.S.
From page 26...
... Difficult and impersonal introductory science courses are often cited as the specific reason many high school and beginning college students leak out of the medical school pipeline (Petersdorf, 1991~. Even as the number of students attending college increased in the 1980s, African Americans, Hispanics, and Native Americans continued to be underrepresented (NRC, 1989; Carter and Wilson, 1993~.
From page 27...
... degrees in science and engineering (NSF, 1992~. It is from this small group that the health professions schools draw, and compete, for their applicants.
From page 28...
... Degrees Ph.D.s Figure 2-4. Natural sciences and engineering pipeline (thousands of students)
From page 29...
... By 1972, according to one survey, most medical schools had initiated programs to increase minority enrollment: two-thirds of the surveyed schools had altered admissions procedures and three-fourths had altered their admissions criteria (Epps et al., 1993~. These factors pushed the first-year enrollment of underrepresented minorities from 4 percent in 1970 to 10 percent in 1974 (Petersdorf, 1991~.
From page 30...
... Paper prepared for the Institute of Medicine's Study to Increase Minority Participation in the Health Professions, 1993. In its report, the AAMC describes the average 1992 underrepresented minority medical school matriculant as female; from a family in which the parents are either professionals or in sales, with some post-high school education, and earning a combined income of $56,661 (AAMC, 1993a)
From page 31...
... Medical school admissions committees, under a mandate to increase the percentage of minority students, admit underrepresented minorities with lower MCAT scores and GPAs than their white counterparts. These scores have improved in recent years, particularly among African Americans, but African Americans are still being accepted at much lower rates than whites (Ready and Nickens, 1993~.
From page 32...
... Data from the most recent edition, published in 1990, and additional data from the 1991-1992 academic year provided by the Bureau show some modest upward trends in the proportional representation in first-year and total enrollment across the other professions, but these increases remain well below population parity (Tables 2-1 and 2-2~. In 1991-1992, the latest year for which the Bureau of Health Professions has comprehensive data, the racial and ethnic minority representation in firstyear classes of health professions schools ranges from lows of 5.8 percent for veterinary medicine and 7.1 percent for osteopathic medicine, to highs of 17.8 percent for podiatry, 13.5 percent for all types of registered nursing programs, and 12.5 percent for dentistry QIRSA tHealth Resources and Services Administrationi, personal communication, 1993~.
From page 35...
... These data include 26 allied health occupations. SOURCE: Bureau of the Health Professions, DHHS, 1993; AAMC, 1993.
From page 36...
... Nearly, threequarters of African-American first-year students who withdraw say they do so for academic reasons; 57 percent of Hispanics and 47 percent of whites who withdraw also cite academic reasons (American Dental Association, 1992~. Dentistry consistently has one of the highest proportions of underrepresented minorities among all health professions.
From page 37...
... Some nursing schools have now begun more innovative and concerted programs to increase minority participation and retention in the health professions. Early evaluations of this strategy in nursing have been favorable, but there are as yet few published studies of their impact (Epps et al., 19931.
From page 38...
... Like other health professions schools, allied health schools have received federal funds under the Health Careers Opportunity Program, and these schools have often succeeded in recruiting enough minorities to double their minority enrollment (Epps et al., 1993~. Belatedly, the schools have discovered that many of the new students are ill-prepared because of inadequate high school and college training in biology, chemistry, and physics (Epps et al., 1993~.
From page 39...
... But they may tolerate racism and racial insensitivity at their own institutions (Jennings, 1989~. Others concede that a less-than-hospitable climate for minorities on many college campuses has played a role in diverting minority students from careers in the health professions (Petersdorf, 1991; Richardson and Skinner, 1991~.
From page 40...
... Despite the daunting costs, however, many minority students are willing to shoulder the debt necessary to obtain an education in the health professions. However, medical students in particular too often make uninformed decisions about the medical schools they choose to attend and the manner in which they will pay for medical education (Johnson, 1990~.
From page 41...
... Average debt for indebted medical school graduates, 1981-1992. SOURCE: Minority Students in Medical Education: Facts and Figures VII, AAMC, 1993.
From page 42...
... For example, medical schools that have no minority staff worldling on minority affairs issues tend to have low minority enrollment (Ready and Nickens, 1993~. Furthermore, medical schools often show a lack of commitment to increasing minority enrollment by failing to include on admissions committees women and underrepresented minorities who might be sensitive to cultural differences (Edwards et al., 1990; Cregler et al., 1993~.
From page 43...
... , underrepresented minorities on average had weaker academic credentials than other students accepted to college and health professions schools as they began their studies in what had been nearly all-white institutions (Johnson et al., 1975~. This factor, combined with the psychological barriers noted below, contributed to the relatively high attrition rates among minority students (Ready and Nickens, 1993~.
From page 44...
... Had these programs been carefully evaluated, later initiatives could have anticipated and overcome previous failings more readily. In the early days of federal funding under HCOP, evidence of success appeared because the numbers of minority students were increasing in the health professions schools funded under the program.
From page 45...
... This decision, taken against the backdrop of declining societal interest and commitment to opening up opportunities for minorities, is thought to have contributed to the stagnation in minority enrollment in health professions schools (Cregler et al., 1993~. Individual and Community Responsibilities Minority families, communities, and institutions must share the responsibility for changing the system, working with nonminority policymakers and educators (Action Council on Minority Education, 1990~.


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