By Joseph Neighbor
Among the many first-year medical students who started class this week are six who are returning to campus, one of whom just donned his white coat for the second time. Michael Hernandez (P&S ’17) put on his first white coat here two summers ago as a rising college junior, when he studied in CUMC’s Summer Medical and Dental Education Program (SMDEP). That experience helped him prepare for applying to P&S in pursuit of a medical career.
“When I was in the program, the administrators were rooting for me, believing in me, encouraging me,” said Mr. Hernandez.
SMDEP is one of four major CUMC “pipeline programs,” developed to enhance opportunities in science and medicine for under-represented minority and socioeconomically disadvantaged students. All four schools are involved in pipeline programs, which draw approximately 170 students to CUMC to study and to get advice and support for applying to schools in the health professions. Approximately 80 participate in SMDEP, a six-week residential program with outstanding success rates. More than one in four students who graduated from SMDEP between 2006 and 2009 matriculated at CUMC.
“The most important thing we offer is encouragement and guidance,” said Hilda Hutcherson, MD, associate dean of the Office of Diversity Affairs at CUMC. “These are not students who would normally have expectations of attending medical school. Lots of these kids are the first in their family to graduate from high school. They are good students who need support.”
The Robert Wood Johnson Foundation launched the SMDEP—originally called the Minority Medical Education Program (MMEP)—in 1987. CUMC was among the first schools to host the first summer session, in 1989. Over the following two decades, the program expanded to 12 schools and added a pre-dental component. The program adopted its current name in 2005, to reflect the new dental track and the expansion of the project to include economic disadvantage, as well as race.
The statistics testify to the remarkable efficacy of SMDEP. To date, more than 21,000 students have participated in the program nationwide; of those, 66 percent were accepted to medical school, and 97 percent of that group subsequently matriculated.
“Your environment plays a huge role in who you become,” said Richard Ansong, DDS, MSD, a 2002 graduate of MMEP, now a postdoctoral student at the College of Dental Medicine. “A lot of kids know they want to be doctors, but how? SMDEP helps you understand what it’s like to be a doctor and how it feels to help patients.”
The program succeeds in part because it takes a holistic approach to instruction, pairing courses in basic sciences with those teaching study skills. Participants attend financial planning workshops and seminars; they also spend time in a real-world, clinical environment, shadowing physicians in a range of specialties. The 60 pre-medical and 20 pre-dental participants in SMDEP are coached not only in academics, but also in the practical aspects of getting into medical school and succeeding once there. For aspiring physicians and dentists who may not have met a doctor from their background, this mentor-based approach can make a world of difference.
“Many of them wonder, ‘Can I do this?’ because they’ve never seen a faculty member or a physicians who is a minority,” said Dr. Hutcherson. “On the first day, I ask how many of them have been told they can’t become a doctor or a dentist. Almost everyone’s hand goes up. It gives you goose bumps.”
A lack of diversity in medical school is of more than academic interest: It has an impact on patient access to care. Minority physicians and dentists practice in under-served communities at much higher rates than do whites. In a 2012 study by the Association of American Medical Colleges, 55 percent of African American medical school students and 36 percent of those of Hispanic or Latino descent planned to practice in an under-served area, compared with 21 percent of whites. And minority patients tend to choose minority health care providers, according to another study by the American Medical Association. Thus, reducing disparities in health care is inextricably bound to increasing the number of minority doctors.
National pipeline projects, in concert with scholarships and affirmative action, have leveled the field in some respects, but there is still much work to be done. Minorities represent only 6 percent of doctors in the US, though they represent 26 percent of the population. One of the best ways to address this disparity is to encourage more minorities to apply to medical school.
Before he began his formal medical studies this fall, Michael Hernandez spent the summer volunteering as a teaching assistant and residential adviser for the program that gave him so much. “SMDEP set me up for success,” he said. “Now I’m fortunate enough to come full circle. I want to give that back.”
After graduation, he wants to provide primary care for under-represented groups, particularly the LGBT community, to address “health disparities that affect minorities here and across the nation.” This is but one example of how opportunity begets opportunity. Pipeline projects like SMDEP have proved to be a valuable means of diversifying our medical schools and, by extension, the field of medicine. That many of these students will one day go on to improve the quality of health care in their communities is well worth celebrating and of benefit to all.