Students who are part of a more ethnically and racially mixed student body feel better prepared to provide health care for diverse patient populations, a new study finds.
The first-of-its-kind research will be published in the online edition of the Journal of the American Medical Association Tuesday, Sept. 9, and will appear in the print edition Wednesday, Sept. 10.
“Our study indicates that diversity in medical schools matters,” said Somnath Saha, M.D., M.P.H., staff physician, Portland Veterans Affairs Medical Center and associate professor of medicine (general internal medicine; public health & preventive medicine and medical informatics and clinical epidemiology), Oregon Health & Science University School of Medicine. “If we want to produce physicians who are prepared to care for a diverse patient population, we need to make sure that medical schools have the tools they need to create diverse student bodies. That includes policies and programs that allow schools to recruit, admit and retain students from diverse racial and ethnic backgrounds,” said Saha.
“Improving the care of minority patients is particularly important right now because access to health care and the quality of care for minorities are grossly unequal compared to that of white patients. As a nation, we need to do whatever we can to reduce these inequalities in health care,” he said.
Previous studies have shown that medical students value diversity and believe it enhances the educational environment, but, until now, there was no direct evidence that diversity improved student outcomes. This study found that white students who attended more diverse medical schools reported they were better prepared to treat minority patients. Saha said the effects of diversity began to become apparent when the proportion of underrepresented minority students -- African Americans, Latinos and Native Americans -- exceeded about 10 percent.
A surprising finding, according to Saha, was that fewer than half of medical students nationwide strongly agreed that everyone is entitled to adequate medical care regardless of their ability to pay. But the researchers found that students in more diverse schools were more likely to consider health care as a right. Another interesting finding is that even in the schools with higher percentages of minorities, white students were not more likely to say that they intended to practice in underserved areas. It was mostly the underrepresented minority students who opted to serve in these areas.
“We couldn’t determine why we didn’t see any effect on the white students’ practice plans following graduation, even though they came from a diverse student body. My speculation is that it is more difficult to change students’ practice plans, which may be shaped by other factors as well as by plans they had before they entered medical school,” Saha said.
This research is especially timely because in the last decade, affirmative action policies at universities have come under attack, making special consideration for minority students illegal in three states. In November, several more states are expected to vote on whether to abolish policies that allow schools to consider race and ethnicity in their admissions decisions. The U.S. Supreme Court, however, has upheld these programs on the argument that diverse student bodies enhance education. This is the first study to show that this rationale applies to medical schools.
To conduct this study, Saha analyzed data from 20,112 students from 118 medical schools using the 2003 and 2004 Medical School Graduation Questionnaires administered by the Association of American Medical Colleges. Data from those years were used because the questionnaire included specific questions that allowed the researchers to test the diversity hypothesis, said Saha. Although the results were self-reported by the medical students, it has been found in other studies that doctors’ self-appraisals predict the quality of care they provide for minority patients, Saha explained.
Other researchers involved in this study include: Gretchen Guiton, Ph.D., University of Colorado School of Medicine; Paul Wimmers, Ph.D., and LuAnn Wilkerson, Ed.D., both from the David Geffen School of Medicine at UCLA.
Oregon Health & Science University is the state’s only health and research university, and Oregon’s only academic health center. OHSU is Portland's largest employer and the fourth largest in Oregon (excluding government), with 12,400 employees. OHSU's size contributes to its ability to provide many services and community support activities not found anywhere else in the state. It serves patients from every corner of the state, and is a conduit for learning for more than 3,400 students and trainees. OHSU is the source of more than 200 community outreach programs that bring health and education services to every county in the state.