Academic medicine : journal of the Association of American Medical Colleges
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Admissions officers assemble classes of medical students with different backgrounds and experiences who can contribute to their institutions' service, leadership, and research goals. While schools' local interests vary, they share a common goal: meeting the health needs of an increasingly diverse population. Despite the well-known benefits of diversity, the physician workforce does not yet reflect the nation's diversity by socioeconomic status, race/ethnicity, or other background characteristics. ⋯ The authors argue that reexamining the use of MCAT scores in admissions provides an opportunity to diversify the physician workforce. Despite evidence that most students with midrange MCAT scores succeed in medical school, there is a tendency to overlook these applicants in favor of those with higher scores. To improve the health of all, the authors call for admitting more students with midrange MCAT scores and studying the learning environments that enable students with a wide range of MCAT scores to thrive.
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Microaggressions are subtle verbal or nonverbal everyday behaviors that arise from unconscious bias, covert prejudice, or hostility. They may contribute to the persistent disparities faced by women in medicine. In this study, the authors sought to identify common microaggressions experienced by women faculty in medicine and to determine if specific demographic characteristics affect the reported frequencies of these microaggressions. ⋯ Privilege is often invisible to those who have it, whereas bias and discrimination are readily apparent to those who experience it. Knowledge of common microaggressions will allow for targeted individual, interpersonal, and institutional solutions to mitigate disparities in medicine.
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Diversity initiatives in U. S. medical education, following the passage of the Civil Rights Act of 1964, were geared toward increasing the representation of African Americans-blacks born in the United States whose ancestors suffered under slavery and Jim Crow laws. Over time, blacks and, subsequently, underrepresented minorities in medicine (URMs), became a proxy for African Americans, Puerto Ricans, Mexican Americans, and Native Americans, thus obscuring efforts to identify and recruit specifically African Americans. ⋯ S.-based, systematic, multigenerational discrimination shared by African Americans. In the high-stakes effort to increase URM representation in medical school classes, admissions committees may fail to look beyond the surface of phenotype, thus missing the original intent of diversity initiatives while simultaneously conflating all people of color, disregarding their divergent historical and social experiences. In this Perspective, the authors contend that medical school admissions committees must show greater discernment in their holistic reviews of black applicants if historical wrongs and continued underrepresentation of African Americans in medicine are to be redressed.
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Those in medical education have a responsibility to prepare a physician workforce that can serve increasingly diverse communities, encourage healthy changes in patients, and advocate for the social changes needed to advance the health of all. The authors of this Perspective discuss many of the likely causes of the observed differences in mean Medical College Admission Test (MCAT) scores between students from groups well represented in medicine and those from groups underrepresented in medicine. The lower mean MCAT scores of underrepresented groups can present challenges to diversifying the physician workforce if medical schools only admit those applicants with the highest MCAT scores. ⋯ The authors describe the widespread consequences of structural racism on economic success, educational opportunity, and bias in the educational environment. They close with 3 recommendations for medical schools that may mitigate the consequences of structural racism while maintaining academic standards and admitting students likely to succeed. Adopting these recommendations may help the medical profession build the diverse physician workforce needed to serve communities today.