Black Medical Schools Struggle To Compete
By ANDREW JULIEN And JACK DOLAN
Courant Staff Writers
June 30 2003
Black Medical Schools Struggle To Compete -
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Forty years ago, that lineup would have been all but out of reach for a black woman in the United States. But the tide of integration at American medical schools, while moving too slowly for some, has meant profound changes for young African Americans such as Ahonkhai.
It has also meant changes for historically black medical schools such as Howard University in Washington and Meharry Medical College in Nashville, once among the only options for black students. Now, Howard and Meharry must compete for African American pre-meds with powerhouses such as Johns Hopkins and Cornell, schools with greater prestige and more money to offer.
A Courant analysis of disciplinary actions against doctors nationwide found, however, that both Howard and Meharry produce troubled doctors more frequently than most other schools - at rates about 10 times greater than the schools with the lowest numbers. The actions ranged from a simple citation to permanent license revocation for a range of misdeeds including medical incompetence, ethical lapses and criminal behavior.
The findings - controversial and politically sensitive as they are - defy simple explanation.
Howard and Meharry are not offshore schools with little accountability to U.S. regulators. Their programs are regularly reviewed and are subject to the same accreditation standards as all other American medical schools. They graduate many fine doctors.
So what accounts for the higher rates of disciplinary actions?
Are graduates of these schools, who are predominantly black, subjected to harsher discipline because of racism among their peers on state disciplinary boards?
Has the recruitment of African American and other minority students by predominantly white medical schools forced historically black universities such as Howard and Meharry to lower their admissions standards?
Have financial and other problems at these schools affected the quality of education they are able to provide, or the caliber of candidate they can attract?
It doesn't take more than 10 minutes walking around campus to figure out that Howard University's medical school in Washington, a pair of nondescript buildings on "W" Street next to the university hospital, occupies a unique place in the annals of American medical education.
A school where most of the students are black, next door to a hospital where many of the doctors are black, is a powerful reminder that decades of segregation and prejudice created a demand for such an institution. In an earlier era, many hospitals and doctors in the United States refused African American patients, and medical schools wouldn't train African American physicians.
In fact, for most of the 20th century, about 85 percent of all black physicians were educated at Howard and Meharry, according to Charles Epps Jr., former dean of the medical school at Howard. Doctors trained at these schools have gone on to provide care for many patients with few options.
It is a mission that many of the schools' graduates take seriously.
In the small, impoverished towns outside of Selma, Ala., a network of health clinics run by Meharry graduate Dr. Edgar Brown is one of the few medical options available to many people. Brown's patients are farm laborers, fish-factory workers and the unemployed - people who often lack insurance or the cash to pay the bills.
Brown, a 1977 graduate, first started working in the poor towns of Alabama more than 20 years ago to satisfy the community service requirement of a public health service scholarship. He never left.
"It was my initial intent to do my three years and move on to greener pastures, but after doing my three years, the need was there," he said. "I had the desire, and I decided to remain in the communities where I served."
Today, the call to serve still resonates with a newer generation of students.
"Howard is the only place I applied to," said Mia Thompson, a first-year medical student at Howard. "Their mission is basically to give back to the community. To me, it's very important to give back to the community."
With the introduction of affirmative action policies in the 1960s, minority applicants increasingly found that doors to the prestigious medical schools, once barred, were opening, and the number of African Americans attending medical school climbed from 783 in 1969 to 5,384 in 1997. Howard and Meharry found themselves in the unusual position of having to compete for top talent with previously all-white schools.
According to "The Complete Medical School Preparation and Admissions Guide," the average Medical College Admission Test scores of successful applicants at Howard and Meharry are 7.0 and 7.5, respectively, out of a possible 15. Those numbers are on the lower end of the spectrum. At Johns Hopkins, the average score is 11.3; Harvard, 11.5.
Another, possibly more vexing, problem has hobbled these schools and others like them since their inception: money.
As far back as 1910, a scathing critique of U.S. medical education, known as the Flexner Report, cataloged academic and clinical deficiencies at dozens of schools, many of them under-funded. Medical schools that catered to black students were hit especially hard, and fallout from the report effectively shut down all but two: Howard and Meharry.
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Copyright 2003, Hartford Courant