To produce more Black male doctors, start by acknowledging bias

A key step on the way forward to increasing the number of Black men in the physician workforce is the acknowledgement that there is not a level playing field when it comes to who goes to college, who gets into medical school and who becomes a doctor.

“The explicit bias I worry about are the people that adamantly insist that there's no problem and that it’s all a meritocracy and that everybody has the same equal chance,” said Clyde Yancy, MD, vice dean for diversity, equity and inclusion at Northwestern University Feinberg School of Medicine. “Beginning with childhood, many people start off with so many barriers to overcome—the idea of an equal chance is a non sequitur.”

Dr. Yancy, who also serves as deputy editor of JAMA Cardiology, participated in a recent AMA-convened panel discussion on increasing diversity in medicine. The discussion followed a screening of “Black Men in White Coats,” a documentary featuring Black men sharing stories about their lives as physicians.

Dale Okorodudu, MD, an internist at University of Texas Southwestern Medical Center, in Dallas, founded an organization—also called Black Men in White Coats—and hopes that the film inspires Black youths and encourages more of them to become physicians.

Dr. Yancy said such inspiration is needed.

“What chills me is—I think about the number of Black men that went to medical school when I did,” he said. “The same number of Black men that went to medical school with me in 1978 is the same number that enrolled in 2016.”

In 1978, Black men accounted for 3.1% of the medical student body in the U.S. Forty years later, that percentage has fallen, according to the Association of American Medical Colleges.

The panel was moderated by AMA Trustee Willie Underwood III, MD, MSc, MPH, a urologist and executive director of the Buffalo Center for Health Equity.

Other panelists included:

• Former AMA Trustee William McDade, MD, PhD, an anesthesiologist and chief diversity, equity and inclusion officer of the Accreditation Council for Graduate Medical Education.
• Frank Clark, MD, a psychiatrist and former chair of the AMA Minority Affairs Section (AMA-MAS) Governing Council.
• Michael Knight, MD, an internist and obesity medicine physician and current AMA-MAS chair.

After completing residency in 2000, Dr. Underwood was admitted to the Robert Wood Johnson Foundation Clinical Scholars Program. As a clinical scholar, he participated is the applicant admission process and told a story about an experience that changed his way of thinking toward a philosophy that could help open the door for more Black men to become doctors.

The program received applications from high-level scholars from top academic institutions such as Yale, Duke and Johns Hopkins, Dr. Underwood said. Most applicants already had several papers published in leading medical journals such as JAMA and The New England Journal of Medicine.

Dr. Underwood told of an applicant from a lesser-known institution who had had only one paper published and who would have been passed over if it weren’t for another committee member who insisted this individual’s application be considered.

The committee members were asked to consider what it took for this applicant to get that one paper published without the academic resources and scholarly support system that existed at the other, better- known academic institutions.

“This is what we’re looking for: people with that kind of desire for excellence,” Dr. Underwood recalled the committee member saying.

Dr. Yancy noted that the story served as an example of “holistic review,” an idea promoted by Valerie Montgomery Rice, MD, the president and dean of the Morehouse School of Medicine and discussed in a 2020 AMA Innovations in Medical Education webinar.

With holistic review, a person’s work output is evaluated qualitatively, not quantitatively, and weight is given to what it took to accomplish that output, Dr. Yancy explained.

Dr. Knight agreed and noted that the “excellence does not always equal the highest score in the book.”

“Service, commitment, empathy, understanding of cultural and ethnic diversity and the needs of our patients—those are also excellent,” Dr. Knight said.

Dr. Clark lamented the prevalence of negative stereotypes in the media, including the wrongheaded notion that young Black men are only interested in achieving excellence in entertainment or sports.

“I was an athlete. I ran track and cross country in high school and college, and I'm a doctor—you can be both,” he said. “There has to be a narrative change.”

Dr. McDade, who appears in the “Black Men in White Coats” documentary, agreed and recalled that, when he was on the University of Chicago faculty, he would look to recruit talented scholars attending the Annual Biomedical Research Conference for Minority Students where 2,000 Black, Hispanic and Native American students would gather to discuss science and share their research findings.

“There are people out there who need to see this, who need to know that it exists, who need to see that level of excellence on the part of people who look just like them,” he said.

Learn how the AMA can help you host a virtual screening of the “Black Men in White Coats” documentary at your institution this year.