Why Your Physician Is Most Likely to Be White or Asian

Racial disparities in medical schools and professions persist. But a storefront medical school in Harlem is working toward a solution.

Sitting in front of a computer inside Montclair State University's career services office, Jemima Akinsanya was facing an incredibly modern, deeply American dilemma.

In 2011, Akinsanya was on the verge of graduating from Montclair State, a college about a half hour's drive outside New York City. She had a more than decent GPA, a nearly lifelong dream of becoming a doctor, and a score on the standardized medical-school entrance exam that Akinsanya delicately describes as "not competitive." Akinsanya knew she wasn't on the verge of joining the truly disadvantaged. But the hard work and academic focus her Nigerian immigrant parents had insisted upon weren't going be enough to make Akinsanya a doctor.

A Montclair State career services counselor parked Akinsanya in front of a search engine with some specific advice: Find a program for would-be medical students that grants an independently valuable credential, a scientific master's degree, and a chance to boost second-round medical school applications. When Akinsanya combined that advice with her own search terms, the system spit out one name: Touro College of Osteopathic Medicine.

"Once I read the description, I was pretty sure I had found my answer," says Akinsanya, 25, now a third-year Touro student who just began her clinical rotation at a New Jersey Hospital.

That Akinsanya's route to medical school led to Touro Medical College—a seven-year-old, private nonprofit college situated above a history-steeped Harlem storefront rather than some part of the nation's traditional educational establishment—affirms what many of the country's academic upstarts have been arguing for years: They can play a key role in helping the nation develop a truly diverse, highly educated workforce.

In 2007, Touro Medical College opened its doors above the former Blumstein's, a department store just feet from the famed Apollo Theater. The building had been largely vacant for years, but had a rich, if not ironic, history. Blumstein's had once been the subject of a boycott partially organized by racial-justice firebrand and future congressman Adam Clayton Powell, after Blumstein's refused to fully integrate its staff. Decades later, after the store had become one of the first to feature black mannequins and pressured manufacturers to make cosmetics for black women, Martin Luther King Jr. was stabbed during a book signing at Blumstein's. His life was saved by two police officers, one white and one black.

Founded in the 1990s, Touro has college and university campuses in several states and countries, and offers both undergraduate and graduate education. The school saw the Harlem building as an ideal place to plant a medical school. After transforming the building with lockers, beaker-filled labs, and microscope-equipped classrooms designed to serve a diverse array of students, Touro College of Osteopathic Medicine was open for business.

At the time, John Palmer was the chief administrator at Harlem Hospital, a nearby major medical center serving a large volume of critically ill and often low-income patients. Palmer heard longtime Harlem business and community activists express concern about the limited diversity in Touro's faculty and staff and question how long the school would last. There was also quieter grumbling inside nearby medical schools, says Palmer, who has served as Touro's director of community affairs since 2012.

It didn't help Touro's case that Harlem and many other communities with large minority and military veteran populations were already awash in students who had enrolled in newer, for-profit schools, Palmer says. Some of these institutions have consistently enrolled lots of lower-income, minority, and older students, according to federal data. But, as a group, they have not delivered graduating classes that match, according to two U.S. Senate investigations. 

The Touro school network itself had also gained some noteriety. In 2007, 10 individuals—at least two of them officials at Touro's medical sciences campus in a different part of Manhattan—were implicated, and some later jailed, in connection with a cash-for-grades or fake-degrees scandal.

When the first class of 135 medical students who enrolled at Touro Medical College graduated in 2011, 47 percent were white, 6 percent were black, 7 percent were Latino, and most of the remainder reported Middle Eastern, Asian, or Southeast Asian heritage, according to the school's data.

Altogether, about 14 percent of the students that Touro dispatched for additional training in hospitals around the country were members of racial or ethnic groups that the Health and Human Services Department has long described as underrepresented among U.S. medical students and practicing physicians. As recently as a few years ago, just over 6 percent of all medical students were black, 8 percent were Latino, 20 percent were Asian, and nearly 58 percent were white, a 2012 Association of American Medical Colleges report found.

Those figures weren't simply a measure of opportunity in the medical profession, the study's authors found. "Current evidence supports the notion that greater workforce diversity may lead to improved public health, primarily through greater access to care for underserved populations and better interactions between patients and health professionals," the AAMC report found.

Brittney Phillips, 26, is a dual MBA and medical student at Howard University in Washington. She is also the chair of the Student National Medical Association, the student arm of the similarly named black doctors' professional association created during the 100-year period when black doctors were not admitted to the American Medical Association.

It's in that role that Phillips hears from undergraduates interested in medical school. Many minority students do not have a family member or close acquaintence who has been to medical school to steer them through the process or write a letter of recommendation that might bolster an application, Phillips says. In some cases, that disadvantage may be layered on top of a lifetime of poverty, access to lower quality schools, or even the tempered expectations of guidance counselors who steer minority students away from challening science and math courses, Phillips says.

"There's a lot going on," says Phillips. "But the bottom line is that we have to be very serious about changing who goes to medical school if we want to provide the best care possible to our changing population. We can't escape that."

At Touro College of Osteopathic Medicine, early figures describe classes that were more diverse than many others around the country but less heterogeneous than Touro had expected, Palmer says. "I think Touro sort of naïvely thought, 'We're here on 125th Street—recruiting a diverse student body won't be a challenge,' " says Palmer.

When Palmer took on his current role at Touro in 2012, the school's admissions team continued all the normal activities associated with student recruitment. But Palmer also brought a second layer of recruiting activity to historically black colleges and universities around the country and those that serve large black and Latino student populations. Other administrators at the school set up new programs that bring junior-high and high-school students to the medical school's 125th Street campus for one-time events and even regularly scheduled, credit-granting science courses.

A group of minority students at the medical school helped to set up a mentoring and skill-building program for minority undergraduates that is run by the National Medical Association, a professional association of black physicians created when the AMA would not grant black doctors membership. An unpaid community advisory board also meets four times a year and tracks student and faculty diversity, as well as the number of graduates who sign up for federal and state student-loan forgiveness programs that send new doctors to work in communities where health care is hard to come by.

By 2011, Touro students were also posting competitive scores on the same nationally administered tests all medical school students must clear, Palmer says. Others were proving their skills in clinical rotations at hospitals in and around New York, he says. And the school's students often set up community health screenings and other events in Harlem. People started to see the school differently, Palmer says. So did potential students. Of the 135 first-year students who entered Touro College of Osteopathic Medicine this month, 60 are white, 13 Latino, 15 black, and 44 are Asian, according to the school. If all of these students graduate, 21 percent of the class of 2017 will be made up of students from groups underrepresented in the medical profession.

Touro officials attribute at least some of that growth to the decision to create its now-six-year-old master's program in Interdisciplinary Biological and Physical Sciences. Students in the program gain automatic admission to Touro's medical school if they meet certain GPA and test-score standards. This year, 74 students completed the program. Of these, 38 have enrolled in medical school at Touro.

"All students do not have the same opportunities, the same exposure to their career options and interests, the tools, and even the courses you need long before it's time to apply for medical school," Palmer says. "We really have tried to build bridges so more students—students who, mind you, are capable and qualified—can get to the other side."

Note: This story has been updated to reflect the proper and complete spelling of Akinsanya's surname.