Medical Schools for the Underserved

Underserved Medical Schools

Howard and Meharry

Era (1867-77) two premier schools for black medical education opened÷Howard Medical School in Washington,DC, and Meharry Medical School in Nashville, Tennessee

Links to Howard and Meharry

Facts&Figures2002 on minority faculty (NEW)

Meharry Medical College looks back on history of service http://umns.umc.org/01/nov/518.htm

Welcome to the Meharry Medical College Home Page

More about Howard University and Underserved and Problems with Graduate Programs there

Controversy in Medical Education

The Pfizer Minority Medical School Scholarship Program

The following is a Reflection by Robert C. Bowman, M.D. on an article from Harvard Courant By ANDREW JULIEN And JACK DOLAN Courant Staff Writers on June 30 2003

I really enjoyed reading this article. It did an excellent job of discussing some of the challenges facing the schools and some of the benefits of the schools. However it did not repair the damage done by previous articles such as "Four that Flunk" which included Howard and Meharry. Rather than attempt to defend, it was interesting to reflect on what else could have been written such as

Why other medical schools fail to meet the needs of underserved communities and peoples? see Thoughts On Medical Schools and Physician Discipline
Why resources are distributed so poorly in education and health
Why those who attempt to serve the poor also are rewarded so poorly in health, education, and other areas
Historical comparisons of the past issues facing Women's College of Pennsylvania (and other women's professional schools)
Reflections on the difficulty that Florida State had in gaining accreditation from the LCME to establish a medical school to serve minority, rural populations, and the elderly.

Rather than look at what Howard and Meharry do not have, let us look at what we have because of them.

Thousands of graduates who have served in underserved areas giving access to care, saving lives, and generating millions of dollars for underserved communities and peoples.
Role models in critical areas throughout the nation giving hope and direction for future generations of professionals and leaders.

I particularly enjoyed the following excerpts from the article that answered:

Why have special medical schools? "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."
And the major challenges that Howard and Meharry face regarding students and resources: 1. Resources - Ruth Hanft, a retired George Washington University professor who has done extensive research on minority medical education and attributes many of the problems at historically black colleges to a chronic lack of money, said the subject is a difficult one to discuss. "It's so sensitive because of the long history of racism," said Hanft. "You have very great sensitivity. If the white institutions criticize the black institutions, it could be seen as racist. But the fact is, the black institutions are under-funded - and substantially under-funded." 2. Students "We take kids knowing they bring baggage," Dr. Henry Foster, former dean of Meharry's medical school, said in a 1991 interview with USA Today. "We know they can catch up. It's not how they enter that counts, it's how they exit. We'll put our graduates up against anybody."

Commentary continues: Seems that any school that attempts to get involved with underserved, minority, or poverty problems faces challenges. God help any school that fully embraces native or border peoples. We may also need special schools for graduating rural professionals of all types, given current trends in education.

If K-12 and college education were different, then the student situation would be better for blacks, minorities, rurals, and others. Sadly those schools desiring better resources have had to resort to lawsuits challenging states. Seems that giving education to those who are poor, have language and culture barriers, and have larger numbers of at risk kids is actually a harder job, especially with less experienced teachers and greater security and administrative needs. Education Centralization and Regionalization

Those hoping to serve the underserved and restore balance and opportunity across the nation will always struggle between meeting immediate needs and future needs.

If Howard and Meharry need to spend more time on meeting graduate medical education and medical school problems, then that is important. However, it is entirely possible that doing so may compromise their ability to meet the needs of their current patients and those who work with them.

The key issue is whether schools such as Harvard and Meharry can balance the changing accreditation, resource, and student obstacles vs the need to continue to serve the underserved. Such schools could move farther away from those in need, but this is unlikely because this very need is why they exist. Such schools could move even closer to the underserved, but this proximity and the lack of funding that goes with caring for poor and Medicaid and needy folks is what is giving them so much difficulty, especially in a time when clinical revenues are so much a critical part of medical school resources. Howard and Meharry and others could also attempt to wall themselves off from accreditation and government and other sources of criticism, but this can also bring disaster in terms of educational value and funding. For reasons why working with the Underserved might make a physician more likely to be disciplined, see Physician Discipline and Caring for the Underserved

Fighting through such problems might actually develop leadership and abilities greatly needed in this nation, in the students who graduate as well as the leaders of the schools. Perhaps it is no accident that graduates and leaders of the schools are serving well in the highest positions in government, and in the neighborhoods most in need.

In some ways I am envious from my perspective as a rural advocate. At least minority issues get some recognition. The decline in rural school funding and quality is largely ignored. Rural background students admitted to medical school have dropped from 27% to 16% in recent decades at a time when there has been no changes in the rural-urban distribution of MCAT applications. Medical School Admissions Package. During roughly the same period Australia has moved from 10% rural background students to over 25%.

For fun ask yourself why it is that schools in Minnesota and Pennsylvania have had the best success with graduating doctors that go and stay in small towns. A most successful outcome that is published but not well known which I call Superselection. Could it be the quality of the K-12 in these states in rural areas that allows admissions committees the luxury of picking not only rural background students, but RB students that want to return? In other states and probably in recent events in Australia, every rural background candidate who can possibly make the grade is selected, including those who have no plans for a return to rural practice. For a review of state education, see State By State Education Status

Admissions Package