When Brian Hainline, MD, interviewed for a neurology residency at NewYork-Presbyterian/Weill Cornell Medical Center, the last hour focused on a topic that had little to do with medicine: tennis. As an undergraduate at the University of Notre Dame, Hainline was the team’s number one player in singles and doubles his senior year.
Fred Plum, MD, then-chair of the neurology department at NewYork-Presbyterian, asked Hainline how he could possibly have been a double major (in philosophy and premed) while also training four hours a day for his sport. “You’re going to be the person who teaches everyone the sense of discipline and persistence,” Plum told him. He got the residency.
Hainline is now the chief medical officer at the National Collegiate Athletic Association (NCAA), and he wants to formalize the pathway from student-athlete to a career in medicine. To that end, he has met with representatives from the AAMC and the National Institutes of Health (NIH) to discuss a pilot project that would do two things: encourage more student-athletes to consider professions in the medical field and attract a more diverse group of students to medicine.
Why student-athletes?
In 2012, researchers at the Washington University School of Medicine in St. Louis published the results of a retrospective study looking at which candidates admitted to their otolaryngology residency program turned into the most successful clinicians as ranked by faculty. At first, they were looking to see whether such objective measures as USMLE test scores, grades, and letters of recommendation correlated with higher faculty ratings. (Faculty ratings take into account practice-based learning, interpersonal and communication skills, good judgement, empathy, patient care, and medical knowledge.) What they found, instead, was that those who got the highest faculty ratings were those with an “established excellence in a team sport.”
While the researchers cautioned that not all residency program directors should rush to look for student-athletes, the study did isolate two traits of student-athletes that might translate into success in medicine: time management skills and teamwork.
Indeed, it’s not specific athletic skills that matter, says M. Roy Wilson, MD, president of Wayne State University and former chair of the AAMC Board of Directors, but the ability to juggle sport and academic responsibilities and excel at both. “Learning how to manage time efficiently is critical, and the main complaint that medical students have is just the volume of material they have to digest.”
“So much of medicine is really about personality, or the ability to deal with people effectively and the ability to lead people. Those are characteristics we see in student-athletes who have been successful in team or individual sports.”
Atul Grover, MD, PhD
AAMC Executive Vice President
Student-athletes also know how to function as a member of a team in ways other students may not. “Increasingly health care is a team sport. You have to be able to get along with and work with other health care professionals. You have to round on patients and people from other disciplines who come from other perspectives,” says Wilson. “It’s important to take their perspectives into account and to synthesize all of that in a way that benefits the patients.”
Athletes also prove to be leaders in the workforce, especially women, who last year made up the majority of both applicants and enrollees in medical school but currently represent just a fraction of department chairs and medical school deans, according to AAMC data.
A 2015 study conducted by espnW and EY found that 80% of female Fortune 500 executives played competitive sports at some time in their lives, and that 65% of those on the 2017 Fortune List of Most Powerful Women played sports competitively in either high school, college, or both.
“So much of medicine is really about personality, or the ability to deal with people effectively and the ability to lead people,” says Atul Grover, MD, PhD, executive vice president of the AAMC. “Those are characteristics we see in student-athletes who have been successful in team or individual sports.”
Making this connection also presents another option for student-athletes, who in general have higher graduation rates and GPAs than non–student-athletes, according to the NCAA. While many associate college athletics with sports like football and basketball, the reality is that just 1% of student-athletes go on to play professional sports. “We train people to be professionals for life but haven’t really looked at medicine per say until very recently,” says Hainline.
The student-athlete challenge
Team activities are already considered in some application processes. For example, faculty for the otolaryngology residency program at Washington University School of Medicine, who conducted that 2012 study, now look for experience in an activity that requires teamwork, like playing sports or being part of a musical group.
But there’s no formalized, nationwide effort to recruit student-athletes into medicine, at least not yet. A major goal of a pilot program between the NCAA, the AAMC, and the NIH would be visibility: to show students that it is possible to play sports and be a STEM major. “Some people believe that you can’t be premed or be a STEM major and be an athlete at the same time,” says Hainline. “I was at a Thanksgiving party and a junior high school student told me ‘I’m going to give up sports when I go to college because it’s too hard.’”
The NCAA also hopes to work with universities to give student-athletes the flexibility that would allow them to take more rigorous academic courses. “Premed students have certain requirements that take them away from athletics. Can we get athletic directors and coaches to buy into a more adaptive pathway?” Hainline asked.
Some institutions that boast strong athletic programs already have strong medical schools and health sciences programs, says Grover. So encouraging those students to consider a career in medicine might simply be a matter of connecting “the coaches and academic advisors who work with those student-athletes,” he says.
“Some people believe that you can’t be premed or be a STEM major and be an athlete at the same time.”
Brian Hainline, MD
National Collegiate Athletic Association
For student-athletes at universities without medical schools, the AAMC could provide students with resources to prepare for the MCAT, as well as let students in non-STEM majors know of post-baccalaureate programs where they could make a pivot. “It just feels like there are some bridges we could make there, even in our own institutions,” Grover says.
Diversity in medicine
Increasing diversity within medical school classes would be another aim of the pilot program. Many historically black colleges and universities have strong Division II sports teams, as well as well-established schools of medicine. “It’s a missed opportunity,” Grover says.
In 2014, 1,337 African American men enrolled in medical school. That number rose to 1,856 in 2018, but it’s still just a fraction of the total number of students (21,622) who entered medical school that year.
Such disparities have real implications for health and health care, Grover says. In a 2018 study, the National Bureau for Economic Research found that 62% of black men with a black doctor agreed to cholesterol tests as part of a health check, compared to 36% of black men with a white or Asian doctor.
“To get on the other side of trust is the single most important issue in medicine,” says Hainline. “You can be as smart as you want to be and make the great recommendations, but if trust isn’t there, the overall quality of life and health care declines.”
“In light of predicted physician workforce shortages, the academic medicine community needs to consider new strategies to engage a diverse talent pool,” adds Grover. “The AAMC sponsors a range of programs and initiatives to improve access to information about the pathway to medical school for all students. This pilot will be a unique opportunity to learn more about the needs of aspiring doctors, and to leverage multiple partnerships with the goal of increasing diversity in medicine.”