Diversity in the Department of Medicine
It’s a
dilemma that has plagued the U.S. healthcare system for decades: While the
nation’s population is growing more diverse, its healthcare workforce is not.

Nearly one
third of the population is now Latino, African American or Native American,
according to U.S. census data. Yet only 8.5 percent of doctors share those
ethnic backgrounds, according to the American Medical Association (AMA). The
number of under-represented minorities entering medical schools nationwide
hovers around 13.2 percent, up only slightly from 11.3 percent in 1980.
Meanwhile, just 7.5 percent of medical school faculty are from minority background,
based on data from the American Association of Medical Colleges (AAMC).
The good
news: Thanks to a host of sweeping new initiatives at the School of Medicine
and within the Department of Medicine (DOM), the University of Colorado is fast
improving those numbers.
“We are
taking a bold new approach and it is working,” says Rob Winn, M.D., former Associate Dean of Admissions for the School of Medicine (SOM). In his two years on the job (2010-12), the school’s minority enrollment soared to an
unprecedented 39 percent of incoming students.
Under the direction
of DOM Chair David Schwartz, M.D. who identified diversity as a top priority
for the department, members of the DOM are working to spread
that success throughout the academic pipeline.
“I think the opportunity to improve diversity
in medicine at the University of Colorado is probably greater now than at any
time since I have been here,” says Suzanne Brandenburg, M.D., who came to CU in
1986 and now directs the DOM’s Internal Medicine Residency Training Program.
Why diversity matters
Just as women
often prefer being treated by women, patients from diverse ethnic backgrounds
often find comfort in seeing a physician who shares, or is at least sympathetic
to his or her cultural background, says Karen Villalon, M.D., who completed her
residency in the DOM in 2007 and stayed on as a clinician researcher in
geriatric medicine.
“I see a lot
of older Hispanic women who are Spanish speaking, and they immediately make a
connection with me because we have similar upbringing,” she says.
Noelle Northcutt,
M.D., Chief Resident in the DOM, notes that just understanding certain cultural
dynamics, like the fact that sons and husbands often play a strong role in a
Hispanic woman’s care decisions, can go a long way in improving the
patient/doctor relationship.
The more
diversity that exists among faculty and housestaff, with each member sharing
such subtle nuances with fellow residents and attending medical students, the
more culturally competent everyone becomes. “It adds another layer to what
everyone is able to learn,” says Northcutt.
Big picture, studies
suggest that physicians from minority backgrounds are more likely to conduct
research impacting those populations, practice medicine in underserved areas,
and serve underinsured and uninsured patients. As the AAMC puts it: “A more diverse health profession workforce
is key to eliminating health care disparities.”
And in the
long run, a more diverse population of physicians begets a more diverse
population of physicians. “The truth of the matter is, you are not going to
inspire the next generation of African American or Latino physicians if young
people don’t see them,” says Winn.
Real Progress at the School of Medicine
In the fall
of 2012, the CU SOM welcomed its most diverse class in history, with 61 of its 160
incoming medical students coming from underrepresented minorities.
Winn stressed that as
the numbers of diverse students have risen, average GPAs and MCAT test scores
have remained the same, or risen slightly. “Diversity does not trump
excellence,” he says. “These people are not here because of their skin color.
They are here because based on their academic record and their experience; they
are wonderful people that every medical school would want.”
The school
recently earmarked $10 million over the course of five years to support
scholarships for incoming students from under-represented communities, including
rural and ethnically diverse communities (of the 61 incoming students of
diverse backgrounds, 16 are on scholarship).
Winn noted that
the school has also gotten more aggressive about recruiting, traveling to prestigious
universities and elsewhere with a message that University of Colorado not only
has top-notch facilities and divisions, and a diverse population of patients, but
also a more “holistic” approach to medicine that goes beyond academics. “We
believe in a humanistic approach to taking care of patients,” he says. “You
don’t find that everywhere.”
Bold initiatives for Department of Medicine

Within the
Department of Medicine, the numbers are also improving – albeit more slowly,
with nearly 11 percent of internal medicine residents now coming from
underrepresented minority backgrounds.
Several
initiatives are underway to try to boost that number to closer to 20 percent
within a few years.
The DOM developed
a five-year diversity plan and amassed a group of faculty members and residents
(including Brandenburg, Villalon, and Northcutt) to tackle the issue.
In hopes of
boosting its pool of diverse residency applicants, the DOM is broadening its local
and national recruitment efforts this year. To better welcome those applicants,
diversity ambassadors now personally reach out to everyone to answer questions
or offer advice.
Through its
new DREAM Program, the DOM will provide stipends to connect medical students
already on campus with DOM faculty and researchers. The hope is that they will
form a relationship and stay on for their residency training and beyond.
To make
incoming housestaff feel more comfortable once they get here, efforts are
underway to create more social support for them on and off campus. “If we are
going to say, ‘We understand you are coming from a diverse background and we
want you here’ we need to provide a support net so when they need it, it
exists,” says Northcutt.
Ultimately,
Brandenburg would also like to see the DOM reach out to underrepresented middle
and high school students, to show them what the path there might look like. “It’s
all about the pipeline,” she says. “As diversity increases at the school of
medicine, we are trying to attract more diverse students into the residency
program, and then encourage some of them to stay on as faculty.” “At the end of
the day,” she says, “the patients win.”