A Check-Up of Black Enrollments at American Medical Schools

There is a severe shortage of medical practitioners in many predominantly inner-city black neighborhoods as well as in rural areas of the South. Over the past decade there also has been a decline in blacks enrolling and graduating from medical school. In recent years there has been only a slight increase in the number of blacks pursuing medical training.

Most commentators in the field of medicine in the United States are of the view that the small number of black and other minority physicians and other health service professionals is a fundamental cause of the persistent racial disparities in the health of Americans. Other income and cultural differences may be factors, yet the shortfall in medical care remains an important explanation for the present situation. Since black doctors are far more likely than white physicians to set up practice in the inner city and in other predominantly black communities, there is an urgent need in our country to train blacks for careers in medicine.

Despite the demand for more black doctors, the number of African-American students at U.S. medical schools has increased at a snail’s pace in recent years. Over the past decade black medical school enrollments have actually decreased.

In 1996 there were 3,527 blacks who applied for admission for medical training, the highest level in history. From 1996 to 2003 black applicants to medical school dropped by more than 20 percent to 2,808. Since that time, there has been a slight increase in black applications to medical school of 5.4 percent. Yet black applications to medical school remain far below the level that prevailed a decade ago.

In 1994 there were 1,519 first-year black students in medical school. By 2003 the number of new black students in medical school dropped to 1,100. In 2006 there was a slight improvement to 1,176 black students entering training for careers in medicine. But once again, this total is far below the level that prevailed in the mid-1990s.

The number of blacks who earned their medical degrees reached an all-time high of 1,192 in 1998. By 2004 the number of blacks who were awarded a medical degree dropped by 13 percent, to 1,034. In 2006 there were 1,122 black medical school graduates, an improvement over 2004 but still below the all-time high.

In 2006 there were 46 U.S. medical schools that graduated at least 10 black doctors. There were 65 black graduates at the Howard University School of Medicine in 2006, the most black graduates of any U.S. school of medicine. Meharry Medical College was second with 51 black graduates. Morehouse College of Medicine ranked sixth with 25 black medical graduates.

Among the predominantly white medical schools, Temple University led the way with 29 black graduates in 2006. The medical schools at Wayne State University, the University of Michigan, Louisiana State University, the University of Medicine and Dentistry of New Jersey, Indiana University, Ohio State University, and the University of Illinois all had at least 20 black graduates.

Among the 10 highest-ranked medical schools Johns Hopkins University, the University of California at San Francisco, Washington University, Stanford University, and the University of Washington all had fewer than 10 black graduates.

Serious Implications of the Decline in the Number of Blacks Enrolling in Medical School

In view of the historical underrepresentation of blacks in the field of medicine, any significant decrease in the number of blacks applying to, enrolling in, and graduating from medical school is profoundly troublesome. Given the pressing need for more black practitioners, the recent trends in medical school participation by blacks must be seen as a major crisis.

Why has there been such a sharp decline in black applicants, enrollments, and graduates at U.S. medical schools? There are a number of reasons. Many college students — black as well as white — appear to have chosen to leave school after college in order to explore employment opportunities in law, business, and the high-tech sector. Since the introduction of the burdens of managed care in the United States, medicine is no longer viewed as a high-paying profession. Medicine is perceived as a heavily regulated and often frustrating career. The huge rise in malpractice insurance costs is undoubtedly prompting many black as well as white students to forgo careers in medicine.
Also, medical school enrollments may be down because college graduates — particularly those from low-income families of which blacks make up a disproportionate number — may be unwilling to commit to the many years outside the job market required to complete medical school training. The huge gap between black and white family incomes is always a factor. The very high cost of medical school combined with the fact that the medical student will not be earning money for many years in the future may disproportionately persuade prospective black medical school students to pursue careers in business or law for which formal training will take less time.

An important reason for the decline in black medical school enrollments is the prohibition of race-sensitive admissions at state-operated medical schools in states such as California, Florida, Michigan, and Washington. The threat of litigation or the prospect of public referendum prohibiting race-sensitive admissions at other state-operated medical schools is probably having a dampening effect on black admissions at other medical schools across the country.