By Denye Mickens, John B. Ervin Scholar and 2021 graduate of Washington University in St. Louis; 2020-21 member of the LEDA Policy Corps and a National College Attainment Network student advocacy fellow
Today, only 5% of doctors in the United States identify as Black and 5.8% as Hispanic, despite both of these groups accounting for much larger and growing components of the American population. This is alarming because studies have shown that when patients
and their providers do not share the same identities, patients are less likely to understand their risk for developing disease or to follow the recommendations of their physician.
To prepare our nation to better serve its diversifying population in a way that fosters cultural humility and equitable health outcomes, physicians are urgently calling for more diversity in the medical field. However, financial and structural barriers in higher education pose significant obstacles that can deter students from pursuing careers in medicine and healthcare.
The Sullivan Commission’s report on “Minorities in the Health Professions” estimates that “48 percent of academically qualified low-income students do not
attend four-year colleges because of the financial barriers.” Many of those who do attend college accumulate considerable financial debt, with 62% of
Black matriculants and 45% of Latino matriculants to U.S. medical schools reporting debt from undergraduate education expenses in comparison to only 35% of White matriculants.
Under-resourced college students are also at greater risk of having to work while enrolled in classes, limiting their ability to focus on their coursework, engage in extracurricular activities,
and participate in internships and clinical shadowing opportunities, which could hinder their competitiveness for admission to medical school.
In addition to the burden of paying for college, students interested in obtaining a medical degree must navigate several steps in a long and complicated process, such as enrolling in a multitude of rigorous prerequisite lecture and laboratory courses
and taking the Medical College Admissions Test (MCAT). Some students, however, experience unforeseen challenges or even lack substantial academic preparation, potentially leaving them no choice but to retake these costly courses and exams to fulfill
these requirements.
These additional steps add to the already existing financial burden of higher education for students who are from low socioeconomic backgrounds: an identity that disproportionately includes Black and Brown students.
I have dreamed of joining the healthcare workforce since I was a little girl. As I witnessed my loved ones succumb to devastating illnesses, I aspired to someday remove barriers to high-quality healthcare and to help patients receive the life-saving medical
treatment that my family members were unable to access.
After navigating the complicated undergraduate admission and financial aid processes, I took my first steps in making this dream come true as I began college with the intention to double major in biology and sociology. I was fortunate to receive a generous
merit scholarship that allowed me to attend college without accumulating debt or being forced to work, something that is uncommon for many first-generation, low-income students like me.
I was making strong progress to graduate on time with both majors until one semester when my mental health deteriorated. As a result, I struggled academically and had to withdraw from a required science course. I was devastated, but I never let this setback
deter me from pursuing my dreams of becoming a doctor.
I made plans to take the course the following summer at my university. After learning that this plan would have cost me thousands of dollars in loans because financial support is extremely limited during summer semesters, I looked into taking the course
at a different institution that might be more affordable. Unfortunately, my university warned that they would not accept the transfer credit. Since my scholarship only covered my tuition for eight semesters, taking another year was also not a feasible
option, so I dropped my biology major.
I was ultimately able to complete the courses required for application to medical programs by paying for them out of pocket. But the difficulties I experienced in navigating the prerequisites and requirements for a STEM major and medical programs highlight
that more support is needed in higher education to ultimately diversify the population of students entering and completing medical degrees.
As of now, students who lack abundant financial resources are left with little room for error in the navigation of their college journey. For this reason, I recommend that universities, federal agencies, and private stakeholders join forces and take these
three steps to enhance support for students and broaden the pathway to medical school.
1. Increase financial support.
To alleviate the disparity in resources that low-income and underrepresented students currently face during the academic year and summer semester, institutions should offer more need- and merit-based scholarships. Also, federal policymakers should authorize
more funding for resources such as the Pell Grant.
2. Level the MCAT prep playing field.
Additionally, students often sacrifice thousands of dollars to pay for the increasing costs of preparatory classes and administrative fees for the MCAT. If this exam must remain a pillar to medical school admission, then academic support and financial
assistance should be offered by institutions to students who need them.
3. Cultivate community and support for STEM-focused undergraduates.
Lastly, to increase students’ interest in pursuing medical careers, ensure that students make sufficient progress towards completing their undergraduate degrees, and cultivate competitive applicants to medical school, every institution should develop
robust, specialized STEM enrichment initiatives such as preparatory or advising programs and mentorship opportunities.
The pipeline to medical school has disproportionately leaked the students of color and under-resourced students that it desperately needs for far too long. We must act now to reinforce this pathway by increasing the resources and support available to
students like me, so that we can meet the public health needs of this nation and improve the healthcare system for generations to come.
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