CLEVELAND — The pandemic has put a spotlight on the gap in medical care and the people providing that care, but before COVID-19, there were concerns that not enough Black men are becoming doctors.
A commonly cited report from the Association of American Medical Colleges found that despite efforts to improve diversity, numbers remained stagnant for over 40 years. 1,410 Black men applied to medical school in 1978, while only 1,337 did in 2014.
The report also found that there hasn’t been progress in terms of Black male matriculation. In 1978, there were 542 Black male matriculants to MD-granting institutions. In 2014, that number was 515. Also, despite the number of Black male college graduates increasing overall, the proportion of male to female medical school applicants is lowest for African Americans.
Roy James II is a young, Black man hoping to help turn things around. He’s a first-year medical student at Northeast Ohio Medical University College of Medicine.
“I decided to go to medical school because I've always found health to be an important aspect of living a full and productive life,” said James. “I would love to be an orthopedic surgeon.”
James said getting to medical school has been the hardest part of his experience thus far.
“For me, grades and finding people who were able to tutor me and really teach me the content, the material, but also navigating the application process, like it can be a little daunting sometimes,” said James.
Dwayne Chapman, a physician assistant student at Case Western Reserve University, is hoping to make a difference too. He was inspired to pursue a career in the medical field after receiving care for a heart ailment.
“I saw that there was a lack of African American representation among health care professionals in that setting when I was a patient and I want to pay it forward by showing people that people can look like them and that they can be in the profession,” said Chapman.
Both said they have experienced challenges while pursuing their medical education.
“One of the things that I think is pretty big is the culture shock, like you get in there and you truly feel like a minority,” said James. “College was like my first experience in a predominantly white space. But you really feel it in medical school because I look around and may be part of a class of like 165. I think there are like five black males, so it can feel a little bit isolating at times if you let it be that way.”
“When I was a patient care associate at the hospital, oftentimes, patients would refuse care because they would deem me incompetent due to the color of my skin,” said Chapman.
Discrimination, isolation, and cost are just a few of the barriers they said Black people have to overcome in order to succeed in the medical field — a field that has seen little growth in the number of Black men enrolling in medical schools over the last 40 years.
"There are also times when there's institutional barriers as well, where we don't support our Black and brown students as they're coming up with the mentorship and with the resource groups that will actually say, 'Hey, you can-this is the road ahead of you. Let me help you navigate that'," said Dr. Laolu Fayanju, the Regional Medical Director at Oak Street Health Ohio.
Fayanju said while the pandemic has reinvigorated interest in the medical field for many people of color, work needs to be done by medical schools, universities, and colleges, like loan forgiveness programs and grants and prioritizing mentorship, which he is passionate about.
In addition to teaching, Fayanju keeps mentorship relationships through his work at Oak Street Health. The agency has a role called a Clinical Informatics Specialist. The role is generally staffed by young people who are planning to pursue careers in medicine. He said physicians and providers facilitate mentorship and career development for those folks.
He also said throughout his education and even into his career, he was able to meet with other Black and underrepresented minority students who supported him. He was also a member of the Student National Medical Association, which is the oldest and largest independent, student-run organization focused on the needs and concerns of Black medical students in the United States.
Fayanju said the first step to rectifying the problem of underrepresentation in the medical field–is to acknowledge that there is a problem.
“I think it starts with building an active recruitment structure to bring and show Black and brown students that hey, it's possible you can do this,” said Fayanju. “The student debt and the amount of time it takes to complete one's medical training is a really big barrier for many folks who are coming from family situations where they can't absorb that kind of debt and they're delaying earning an income that can support their family and support their extended family. So we have to put structures in place that say, ‘Hey, look, we can do more debt forgiveness, loan forgiveness, more grants, more financial funding,’ so we can lower those barriers and give people more opportunity.”
The result affects more than just those who eventually don the white coat. Fayanju said identifying the lack of representation in the medical field has systemic impacts.
“If we have folks who are of the communities that we that we serve, it goes a long way towards building trust, building the kinds of lasting relationships that ensure that people are adherent to their medications, that they're willing to try medical therapy and lifestyle changes that can really impact their health and improve their long term health,” said Fayanju.
Chapman has been able to find mentors through Physician Assistants of Color, a national non-profit. He said they helped him with school applications and test-taking among other things.
He believes one thing that could help other medical students of color is for institutions to pay closer attention to the personal statements submitted with their applications.
“Read those statements, read those thoroughly, speaking in terms of like institutions and things of that nature, because I feel a lot of times where it's kind of hard for minority students is that they don't feel that they can relate to anybody in that sense, because a lot of times our stories might be different than that of our classmates,” said Chapman.
Once he graduates, he hopes to make an impact in underserved communities.
“I want to build that trust where they could come to the office and know that we're going to care for them and their health and not just their physical health, but their mental health as well,” said Chapman.
James said he didn’t find a mentor until his senior year of college, and felt like he was falling behind in the process of getting to medical school.
“You don't really know how important it is to have somebody to guide you through those kinds of little things or the soft components, if you will, of an application,” said James.
Now, he believes mentorship is one of the most important components of successfully navigating medical school. He believes more resources should be set aside for mentorship programs for Black middle and high school students.
He is a member of the Student National Medical Association and serves as the co-chair of mentorship. He and his colleagues are working to create those kinds of opportunities for his peers and the next generation of Black medical students.
“I kind of want to continue what I'm already doing now, like I feel like you don't need to to wait until you've made it like trying to pull other people up alongside you,” said James. “I've already kind of started setting up mentorship programs with college students, and hopefully I want to start extending that into high school, middle school. Just to continue being an example and really guiding people and giving them the best advice that I can muster.”
Back in 2020, the Association of American Medical Colleges and the National Medical Association announced a joint effort to create an Action Collaborative that would address the lack of representation of Black men in medicine.
Jade Jarvis is a reporter at News 5 Cleveland. Follow her on Facebook, Twitter, and Instagram.
