How Undergraduate Programs Can Boost Minority Success in Medical School

Editor’s note: The opinions expressed by the authors do not necessarily reflect the opinions of the AAMC or its members.

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Freeman A. Hrabowski III, PhD

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Peter H. Henderson, PhD

Thirty years ago, African American students were failing in science at the University of Maryland, Baltimore County (UMBC). As we looked for ways to improve student success, we were fortunate that Baltimore philanthropist Robert Meyerhoff, who had a special concern about the plight of black males in America, took an interest in our work.  

With support from the Robert and Jane Meyerhoff Foundation, UMBC launched the Meyerhoff Scholars Program in 1989. Based on a holistic approach to educating black men, the program provides academic, social, and financial support to ensure these students succeed in college and continue on to doctoral programs. Our goal has been that they engage in research careers in the natural sciences, engineering, and medicine, where they are desperately needed. 

Bob Meyerhoff insisted that the program focus on black males in its first year, and we began with 19 black male college freshmen. The program has since bloomed and is now open to all students. During the 2015–2016 academic year, the program’s 270 students were 57 percent African American, 15 percent Caucasian, 15 percent Asian, 12 percent Hispanic, and 1 percent Native American.  

Today, UMBC is among the top 10 baccalaureate institutions for graduating African American students who go on to earn PhDs in the natural sciences and engineering, the only predominantly white institution in this category. Meyerhoff alumni are more than five times more likely to graduate from or be enrolled in a STEM PhD or MD-PhD program as students who were accepted to the Meyerhoff program but did not attend. And UMBC is one of three predominantly white institutions in the top 10 for graduating black students who eventually earn PhDs in life sciences.

Table 1. Top 10 U.S. baccalaureate-origin institutions of 2005-2014 black doctorate recipients in the natural sciences and engineering, by institutional control, 2010 Carnegie Classification, and HBCU status
 Rank    Baccaclaureate Institution  Institutional  Control  2010 Carnegie  Classification  HBCU    2005-2014 black NS&E  doctorate recipients
1 Howard University Private Research-High Yes 128
2 Florida Agricultural and Mechanical University Public Doctoral/research Yes 118
3 Xavier University of Louisiana Private Baccalaureate Yes 107
4 North Carolina A&T State University   Public    Doctoral/research Yes 104
5 Spelman College          Private Baccalaureate   Yes   100
6 University of Maryland, Baltimore County Public Resarch-High No 93
7 Morgan State University Public Doctoral/research Yes 82
8 Hampton University Private Masters granting Yes 82
9 Southern University and A&M College Public Masters granting  Yes 78
10 Morehouse College     Private Baccalaureate Yes 72

Source: National Science Foundation, National Center for Science and Engineering Statistics, 2014 Survey of Earned Doctorates, Special Tabulation (May 2016).

Table 2. Top 10 U.S. baccalaureate-origin institutions of 2005-2014 black doctorate recipients in the life sciences, by institutional control, 2010 Carnegie Classification, and HBCU status
 Rank 

 Baccalaureate
Institution
 

Institutional Control 2010 Carnegie Classification  HBCU  2005-2014 black NS&E doctorate recipients
1       Howard University  Private  Research-High Yes 45
2       Xavier University of Louisiana Private Baccaclaureate Yes 41
3 Florida Agricultural and Mechanical University Public Doctoral/research Yes 40
4 Spelman College Private Baccalaureate Yes 39
5 University of Maryland, Baltimore County Public Research-High No 35
6 Jackson State University Public Research-High Yes 29
7 Hampton University Private Masters granting Yes 28
8 Tuskegee University Private Baccalaureate Yes 26
9 University of Illinois at Urbana-Champaign Public Resarch-Very High No 24
10 University of Florida Public Research-Very High No 23

Source: National Science Foundation, National Center for Science and Engineering Statistics, 2014 Survey of Earned Doctorates, Special Tabulation (May 2016).

Behind Meyerhoff’s success

Expanding Underrepresented Minority Participation: America’s Science and Technology Talent at the Crossroads identified significant underrepresentation of African Americans, Hispanics, and Native Americans in the sciences and engineering. Published by the National Academies of Sciences, Engineering, and Medicine in 2011, the report found that most underrepresented minority students left STEM majors before completing a college degree and recommended comprehensive support for minority undergraduates in these fields—even as we also support K–12 academic preparation. 

But the report drove home another key point when it found that most whites and Asians were also not succeeding. All undergraduate students pursuing medical school or graduate programs in STEM fields begin with introductory courses in biology or chemistry, known universally as “weed out courses.” Two-thirds of students of all races, including those who are high achievers, leave STEM within their first two years, largely because the “weed out courses” are not structured to support student success.  

Our program is successful in part because of its core principle: the university is responsible for supporting student success, not weeding students out. Two of the program’s key components are recruiting top students and setting high expectations. We have a summer bridge program to help high school students transition to college, and once there, we provide them with academic support, including advising, study groups, and tutoring. The program’s focus on research—including summer lab internships and community service opportunities—contributes to our students’ success. 

“As a society, we face a particular challenge in the shortage of black males in medicine ... We must create more programs that emphasize the importance of mentorship, student research, and a sense of community in educating African American undergraduates.”

Many faculty are involved in the program. One of them, Michael Summers, PhD, an HHMI investigator and member of the National Academy of Sciences, speaks annually to high school students considering the program. He relates how significant racial/ethnic health disparities persist and that African American research scientists are the ones most likely to tackle diseases that disproportionately affect the black community. 

The rigorous evaluation of the Meyerhoff program has demonstrated the importance of mentorship, student research, and a sense of community to student success. These components help students develop a vision of themselves based on high expectations. Evaluating the program has been important since its inception, both for making continuous improvement and for supporting proof of concept. The latter has led to funding from Howard Hughes Medical Institute (HHMI) to adapt the program for Pennsylvania State University and the University of North Carolina at Chapel Hill.  

Meeting the diversity challenge

We focus on producing students who will continue their education and earn PhDs and MD-PhDs. There is an urgent need for diversity among doctorate holders in these fields, and our program underwriters—donors, foundations, and federal agencies such as the National Science Foundation and National Institutes of Health—have required an emphasis on PhDs. We have not identified similar financial support to educate and train MDs.

Nevertheless, some Meyerhoff scholars decide to go on only to medical school. UMBC currently ranks 25th on the list of undergraduate schools for African Americans who earn MD or MD-PhD degrees. About 10 African American graduates of UMBC earn an MD or MD-PhD annually, and approximately one-third of them are male. We would only need to produce five more per year to be in the top 10.  A concerted effort and deliberate approach could double or triple these numbers.

Table 3. Top 14 U.S. baccalaureate-origin institutions of 2011-2015 black or African American graduates in MD-PhD program, by institutional control, 2010 Carnegie Classification, and HBCU status
 Rank   Baccalaureate Institution  Institutional Control 2010 Carnegie Classification  HBCU  2011-2015 black MD-PhD recipients
1 University of Maryland, Baltimore County Public Research-High No 15
2 Yale University Private Research-Very High No 7
Xavier University of Louisiana Private Baccalaureate Yes 5
4 CUNY Hunter College Public Masters granting No 4
5 Harvard University Private Research-Very High No 4
6 New York University Private Research-Very High No 4
7 Morehouse College Private Baccalaureate Yes 4
8 Oakwood University Private Baccalaureate Yes 4
9 Cornell University Private Research-Very High No 3
10 Massachusetts Institute of Technology Private Research-Very High No 3
11  Princeton University Private Research-Very High No 3
12 University of California San Diego Public Research-Very High No  3
13 University of Illinois at Urbana-Champaign Public Research-Very High No 3
14  University of Virginia Public Research-Very High No      3

Source: AAMC Data Warehouse, Special Tabulation (May 2016).


UMBC has excelled in producing MD-PhDs by encouraging students interested in medicine to also consider research careers. Meyerhoff alumni have graduated from the country’s leading MD-PhD programs. Some have moved to faculty positions at medical schools—for example, four black males are now on the faculty at Duke University School of Medicine, three with MD-PhDs and one with an MD-JD.

As a society, we face a particular challenge in the shortage of black males in medicine. To address this, we must identify institutions, such as UMBC, that have been successful in educating African American undergraduates. We must create a broad partnership of undergraduate institutions, medical schools, professional societies, federal agencies, and philanthropic organizations to support programs that can provide student financial assistance, program coordination, advising and mentoring, tutoring, test preparation, and internships. 

Meyerhoff alumni now number more than 1,000, 70 percent of whom are African American. Among our alumni, 350 are currently enrolled in graduate or professional schools, including 42 in MD and 41 in MD-PhD programs. Our graduates have earned 236 PhDs, including 45 MD-PhDs, 154 MDs, and 14 other professional degrees in health care. In addition, 271 of our alumni have earned master’s degrees, mainly in engineering and computer science. 

The ultimate goal is to help these students eventually improve the health of African American and other minority communities, as well as the nation as a whole.

Dr. Hrabowski is president of UMBC. Dr. Henderson is senior advisor to the president at UMBC. They served as study committee chair and study director, respectively, for the National Academies report, Expanding Underrepresented Minority Participation: America’s Science and Technology Talent at the Crossroads. UMBC is a predominantly white, yet historically diverse, research university in the Baltimore-Washington Corridor.