Health Sciences administrators charged with increasing diversity at Columbia welcomed two Supreme Court rulings this summer decisions that allow institutions of higher education to continue considering race and ethnicity in admissions. But a number of barriers still impede efforts to increase minority enrollment. "We're glad the court recognized the value of diversity in education," says Dr. Hilda Hutcherson, assistant professor of obstetrics and gynecology and associate dean of minority affairs and diversity at P&S. "But our major challenge the very small number of minority applicants remains."
One of the positive results of greater minority enrollment is believed to be an improved "cultural competency" among students. "A critical mass of minority students enriches the education of all students in the class," Dr. Hutcherson says. This is particularly important for nursing, medical and dental school students since these schools try to improve the ability of all providers to care for patients from many different cultures. "Cultural competence is very valuable, and the only way to understand how to care for people from other cultures is by learning from patients and colleagues who are different from you," says Dr. Judy Honig, associate dean of student services in the School of Nursing.
There is another reason why it is important to increase minority enrollment: Evidence shows that minority dentists and physicians treat more minority patients, so increasing the number of African-American and Hispanic doctors could lead to better healthcare for minorities. Last year, the Institute of Medicine reported that minorities receive poorer quality of care than whites, even when insurance coverage and disease severity are taken into account. Among its recommendations, the institute suggested increasing the numbers of minority physicians. A 2000 Surgeon General's report made the same recommendation to help eliminate disparities in oral health care.
Underrepresented minorities African-Americans, Hispanics, and Native Americans make up 26 percent of the U.S. population but only 5 percent of dentists, 6 percent of physicians, and 12 percent of registered nurses. Minority enrollment in Columbia medical and dental schools hovers around 10 percent; nursing school's enrollment is about 16 percent minority; and, public health's enrollment is 18 percent minority. Great effort is being expended to increase those numbers.
Much of the reason for low minority enrollment stems from inadequate early education. "Many minority individuals are discouraged from pursuing medicine as early as elementary school," Dr. Hutcherson says. "They're often steered toward careers in the trades rather than the professions."
Both the dental and medical schools run state-funded programs to encourage students in New York City to pursue careers in medicine and research. The office of minority affairs and diversity in P&S runs a State Pre-College Enrichment Program (S-PREP); the office of minority affairs in the School of Dental and Oral Surgery runs a similar Science & Technology Enrichment Program (STEP) for students interested in dentistry. Students in grades 9 through 12 take classes in math and science most Saturdays from October to May. Medical, dental, and Ph.D. students, who also serve as mentors, teach the classes.
Even minority college students can get poor advice, Dr. Hutcherson says, and this is a situation P&S is trying to address. With funding from the Robert Wood Johnson Foundation, P&S brings more than 100 students from across the country to the Minority Medical Education Program (MMEP) each summer. P&S is one of 11 schools and consortia that offer the program, which includes coursework in the sciences, clinical experiences, and MCAT (medical college entrance exam) preparation. The Robert Wood Johnson Foundation started MMEP 15 years ago to improve the medical school acceptance rate of students who already have good test scores and grades. The foundation's research in the 1980s showed that many minority student applications were rejected because they didn't understand the importance of essays, interviews, and health-related volunteer activities to the application process.This year, for the first time, the program also includes seven students with an interest in dentistry. These seven students take the same coursework, but break away from the main group to attend dentistry-oriented lectures and clinical experiences. "With the increasing influence of managed care in medicine, I think even more of the MMEP students are starting to consider dentistry," says Dr. Martin Davis, SDOS dean of students. "Hopefully, the program will impact their career selection and they'll come here."
Columbia's MMEP is only in its third year, so it is too early to know its full impact, but nationally 63 percent of MMEP students who have applied to medical school have been accepted.
If professional schools have trouble finding as many qualified minority students as they would like, the challenge is even greater for basic science departments that train Ph.D. level researchers. "It's fairly easy to get students interested in medical school, because they and their parents know what a doctor does. They often don't know what Ph.D.s do," says Dr. Richard Kessin, professor of anatomy & cell biology and associate dean for graduate affairs. Only about 4 percent of doctoral-level scientists and engineers are from minority communities.The graduate school believes increasing the number requires bringing budding researchers into the lab for the summer. This summer, the Graduate School of Arts and Sciences, which includes all Columbia graduate programs, sponsors four students in basic science labs and 16 are sponsored by a Hunter College program started last year by physiology chairman Dr. Andrew Marks. (See sidebar). Three of last year's Hunter students will enroll in graduate school this fall, including Sidonie Jones who says her summer experience helped her decide to enroll in Columbia's Integrated Program in Cellular, Molecular and Biophysical Studies.
Dr. Kessin and other faculty and administrators also go to student conferences to look for promising students. Christopher Ortiz, now a second-year M.D./Ph.D. student at P&S, met Columbia faculty at a student conference two years ago, although he was already interested in Columbia for its neuroscience reputation. "It was important for me to talk to students from the program as well as administrators, so now I go on these trips to help Columbia recruit," he says. "Columbia has a really good name and some students may be intimidated, so we have to reach out and encourage these students to apply to a top school like ours."
As a result of such efforts, seven of this year's 71 incoming Ph.D. students and several M.D./Ph.D. students are members of underrepresented minorities, a significant improvement over the sporadic enrollments during the 1990s. "Slowly, but surely, the numbers of minority students are increasing, but it takes work," Dr. Kessin says. "If we relax, the numbers fall."
The Mailman School of Public Health is also working to recruit and enroll minority applicants. The school is currently involved in analyzing its recruitment efforts to be more effective in attracting and enrolling minority students. "We are committed to making every effort to increase our minority student population," says Urbano Garza, director of admissions and financial aid at Mailman. "In addition to our continued participation in some of the programs already being led by other schools within Columbia, we are designing new recruiting programs aimed at this goal, which will be implemented beginning this fall."
Increasing the proportion of minorities in residency programs and on the faculty is the next step in diversity efforts, Dr. Hutcherson says. "Our plan is to increase the number of residents and encourage them to stay on as faculty," she says. "Minority enrollment here is probably the same as the national average, but some specialties have few students and we need to find out why."
SDOS has had great success boosting the number of minorities, particularly African-Americans, on its faculty by taking advantage of a unique collaboration with Harlem Hospital. Starting in the late 1980s, the school waived tuition for hospital residents in Columbia's specialty programs if the residents became hospital staff or SDOS faculty after graduating. The result: Harlem Hospital now has a full array of dental specialists in a generally underserved community and SDOS has the highest percentage of African-American faculty among large schools, excluding Howard University and Meharry Medical College.
"Columbia has always been a leader in research and clinical care and increasing diversity is just another way to continue moving ahead," Dr. Hutcherson says. "We've done a good job and we can continue to improve."