Building a Pipeline.

Abstract

HomeCirculationVol. 139, No. 20Building a Pipeline Free AccessNewsPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessNewsPDF/EPUBBuilding a PipelinePrograms Aim to Boost the Ranks of Black Cardiologists, Researchers Bridget M. Kuehn Bridget M. KuehnBridget M. Kuehn Search for more papers by this author Originally published13 May 2019https://doi.org/10.1161/CIRCULATIONAHA.119.040999Circulation. 2019;139:2372–2373As an undergraduate, Mark Crowder, a fourth-year PhD student at Vanderbilt University in Nashville, TN, turned down the opportunity to do undergraduate research 3 times, thinking he didn’t want to be stuck in a laboratory.But Crowder eventually landed in the laboratory of Vanderbilt’s Joey Barnett, PhD, a professor of pharmacology doing American Heart Association (AHA)–funded research. There, Crowder became an AHA Historically Black Colleges and Universities (HBCU) Scholar studying the development of heart valves and coronary vessels. The experience laid the groundwork for his career, said Crowder.“To be at the bench working out these problems yourself, that’s really what’s exciting for me,” said Crowder, who’s currently studying the mechanisms that regulate metabolism in fat cells in Vanderbilt’s Division of Cardiology.The HBCU scholars program is one of a growing number of efforts to boost the ranks of blacks and other minorities in medicine overall and cardiology specifically. The programs seek to help black students overcome obstacles at every step in their education. For many black students, a lack of role models, concerns about the length or costs of medical school, discrimination, or misconceptions about potential paths to medical or health careers stand in their way, noted Kameron Matthews, MD, JD, who cofounded the Tour for Diversity in Medicine. The tour brings young physicians and other health professionals of color to colleges around the country each summer to talk with students who may not have considered health careers.“There’s lack of exposure to even knowing a physician or dentist sometimes,” said Matthews, who is a family physician and deputy undersecretary for health for community care at the Veterans Health Administration in Washington, DC.UnderrepresentedBlacks make up about 13% of the US population, according to the Pew Research Center, but they remain underrepresented in medicine. In 2018, blacks accounted for 9.8% of US medical school applicants and just 8.6% of medical school matriculants. In 2018, the ranks of blacks applying to US medical schools grew 4% to 5164, and the numbers matriculating grew 4.6% to 1856, according to the Association of American Medical Colleges.But more progress is needed, particularly among black men, who are outnumbered by black women as medical school applicants almost 2 to 1. In fact, a 2018 National Academy of Sciences (NAS) report classified the dearth of black male physicians as a crisis that undermines the ability of the field to address health disparities.“Racism continues to be a challenge and a barrier to black men all along the process of becoming a physician,” noted Cato T. Laurencin, MD, PhD, the lead author of the NAS report and Albert and Wilda Van Dusen Distinguished Professor of Orthopedic Surgery at the University of Connecticut. For example, he noted that fewer black men who apply to medical school are accepted.The problem is particularly acute in cardiology, where a 2015 American College of Cardiology survey found that only 4% of cardiologists are black women and only 2% are black men. Such a dearth of black cardiologists is a substantial barrier to reducing disparities in heart disease, which disproportionately affects blacks. For example, studies have found better communication about cardiovascular prevention between black male physicians and black male patients, and that having greater diversity in medical school boosts the cultural competency of white students.To better understand what is driving underrepresentation of blacks and other minorities in medicine, the AHA commissioned a RAND study, said AHA President Ivor Benjamin, MD, at the 2018 AHA Scientific Sessions. The report discovered that black and Latino students pursue STEM majors (science, technology, engineering, and mathematics) in undergraduate school at rates comparable with their white counterparts, but fewer minority students complete STEM degrees. In response, the AHA is increasing its commitment to undergraduate pipeline programs. These programs include the Supporting Undergraduate Research Experiences (SURE), which will offer summer research experiences at Stanford University, Vanderbilt University, Northwestern University, the Medical College of Wisconsin, and Boston University, said Monique Wilson, MPH, the AHA’s vice president of community impact, diversity, and inclusion for the Greater Southeast Affiliate. It will also expand its Ongoing Scholars Program, which provides mentoring support throughout the school year to students at historically black colleges and universities throughout the Southeast.The NAS report identified numerous steps that can be taken to improve representation of black men in medicine, including mentoring for black students throughout their educations, increasing support systems, and helping them to build resilience in the face of discrimination, noted Laurencin. One promising pool of potential black physicians are those who aren’t accepted into medical school on their first try, said Laurencin. The report also lists several programs that work to interest and retain minority students in STEM starting as early as elementary school, such as Mentoring in Medicine.Another resource for both aspiring black cardiologists and others who wish to promote diversity and reduce health disparities is the Association of Black Cardiologists (ABC). The organization aims to boost collegiality in the field and promote health disparities research and interventions and has helped finance cardiology subspecialty training for 44 black cardiologists through its Richard Allen Williams scholarships, said ABC president John Fontaine, MD, MBA, professor of medicine at Drexel University College of Medicine and Director of Arrhythmia Services.Role ModelsDuring the Tour for Diversity’s 7-hour seminars, the mentors describe potential health career options, what the application process is like, and how students can make themselves strong candidates. The mentors also talk about the paths they took, which may have included pursuing other careers before applying for medical school. For example, Matthews noted, one mentor taught science before eventually returning to medical school and is now a practicing physician.“We’ve definitely gotten feedback that the students connect with us, that they actually see themselves in us and so therefore consider healthcare as a real possibility,” Matthews said.Tour mentors often have frank conversations with students about discrimination they’ve experienced, how they’ve managed their finances, or how they raised a family while pursuing a health career, Matthews noted. They also emphasize the importance of seeking out mentors and building a peer support network. For physicians who wish to mentor, Matthews advises them to avoid playing a gatekeeper role, and instead share information about their path, answer questions, and offer advice.“We are not here to tell a student whether or not we think that they’re appropriate for medicine,” she said. “We’re here to motivate them and help them see a pathway.”Being surrounded by a supportive network of peers and mentors who could help him cope with the stressors of laboratory life was the most important part of the HBCU scholar program for Crowder.“Sometimes minority students can feel isolated at major research institutions because there are not very many people that look like them,” said Crowder. “It is tremendously important having that community there.”Having minorities and women in visible leadership roles who can serve as mentors and role models is also critical for specialties like cardiology, noted Fontaine and Laurencin. Laurencin suggested institutions create a dean-level position focused on eliminating racism and bias from their institutions, in addition to a dean devoted to boosting diversity. Fontaine suggested that organizations like the AHA and the American College of Cardiology can help by selecting physicians from underrepresented groups for highly visible leadership and decision-making roles.“You can identify with people of color and women who are telling you that you can do it,” Fontaine said. “That’s encouraging to people.”Download figureDownload PowerPointAn undergraduate research experience helped set Mark Crowder, a fourth-year PhD student at Vanderbilt University in Nashville, on a path to a career in cardiovascular research. Photo by Linda Sealy, Vanderbilt University, Nashville, TN.Footnoteshttps://www.ahajournals.org/journal/circ Previous Back to top Next FiguresReferencesRelatedDetailsCited By Cansino C, Khanna K, Johnson Bhembe X, Overholser B, Burstin H and Spector N (2021) The Path Forward: Using Metrics to Promote Equitable Work Environments, Pediatrics, 10.1542/peds.2021-051440G, 148:Supplement 2, Online publication date: 1-Sep-2021. North M, Harris K, Garberich R, Traverse J, Hurrell D, Dick J, Hendel M, Sharkey S and Henry T (2021) Cardiology Research Internship for Undergraduate Students Provides Unique Opportunity for Next Generation of Health Care Professionals, JACC: Case Reports, 10.1016/j.jaccas.2021.05.001, 3:6, (985-988), Online publication date: 1-Jun-2021. Davenport D, Alvarez A, Natesan S, Caldwell M, Gallegos M, Landry A, Parsons M and Gottlieb M (2022) Faculty Recruitment, Retention, and Representation in Leadership: An Evidence-Based Guide to Best Practices for Diversity, Equity, and Inclusion from the Council of Residency Directors in Emergency Medicine, Western Journal of Emergency Medicine, 10.5811/westjem.2021.8.53754, 23:1, (62-71) Williams M, Myers A, Finuf K, Patel V, Marrast L, Pekmezaris R and Martinez J (2022) Black Physicians’ Experiences with Anti-Black Racism in Healthcare Systems Explored Through An Attraction-Selection-Attrition Lens, Journal of Business and Psychology, 10.1007/s10869-022-09825-z May 14, 2019Vol 139, Issue 20 Advertisement Article InformationMetrics © 2019 American Heart Association, Inc.https://doi.org/10.1161/CIRCULATIONAHA.119.040999PMID: 31082300 Originally publishedMay 13, 2019 PDF download Advertisement