Setting the Course for Future Physicians

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by Kenneth J. Cooper

Two historically Black schools lead the pack. Xavier University continues to dominate, with 60 of its alumni graduating from medical schools around the country last year. Howard University is next, with 43. Xavier has been number one for two decades or longer, and Howard consistently hangs close to the top.

The next school on the list is a bit of a surprise. The majority White university that produced the largest number of Black undergraduates who earned MDs in 2011, with 26, is the University of Florida, edging out Harvard, Yale, Duke and Stanford universities.

“I’m excited to hear that,” says Dr. Donna Parker, associate dean for diversity and health equity at Florida’s College of Medicine, who plays a role in advising minority undergraduates interested in becoming physicians.

Nationally, the state flagship in Gainesville is known for producing professional football players like Tim Tebow and Emmitt Smith. But the University of Florida is actually better at preparing Black students for careers in medicine. Last season, 35 former students of all races and ages played in the National Football League; more Black graduates, 41, finished medical school in the last two years alone.

“I think it reflects just a strong commitment of the undergraduate admissions process in actively recruiting academically highly-qualified individuals from various ethnic and racial groups, and that there’s a large population of both African-American and Hispanic individuals in the state of Florida,” says Dr. Joseph Fantone, senior associate dean for educational affairs at the University of Florida College of Medicine.

In the state of Florida, which is 16 percent Black, and in the Southeast, the university already has a reputation beyond football.

For a decade, about 40 percent of freshmen have declared an interest in medicine or another health profession, according to Dr. Albert Metheny, director of academic advising in the College of Liberal Arts and Sciences.

“You almost get the sense that we’ve been identified as the place you go to get into med school or one of the health professions,” Metheny says. “We’ve really gotten that kind of identity among the undergraduates, at least in the state of Florida certainly, and in the surrounding states as well.”

Secrets to success

A combination of factors appears behind Florida’s success in preparing Black students to make the intense slog through medical school.

Campus administrators confirmed the presence of the factors that Dr. Marc Nivet, chief diversity officer at the Association of American Medical Colleges, cites as common to schools that see many Black graduates become doctors: effective pre-health advising of undergraduates, a large enrollment, rigorous curriculum, a medical school, an active Student National Medical Association chapter and, as Metheny notes, a reputation for graduates entering health professions.

The Association of American Medical Colleges ranked the top 10 undergraduate schools of Black medical school applicants and graduates for the last 10 years for Diverse: Issues in Higher Education. On those measures, the University of Florida has done better than its rankings by U.S. News & World Report as 19th among public schools and 58th among national universities.

Since 2004, Florida has ranked in the top 10 in the number of Black graduates who apply to medical school, rising to third behind Xavier and Howard in 2007 and staying there since then. In Black alumni graduating from medical school, Florida broke into the top 10 as number nine in 2009, dipped to number 10 the next year and then leapt to third in 2011.

Nivet says the types of schools that comprise that list have been consistent over the years.

“You’ve got your HBCUs. Xavier has been leading the pack for a good 20 years, if not more,” Nivet says. “Then you’ve got your Ivy League schools. Once African-American students or any underrepresented minorities get into those institutions with aspirations for medicine or any health professional school, they tend to get in. They’ve dealt with the sort of competitive, academic, rigorous curriculum, and so they become competitive applicants for medical school.”

Besides HBCUs, Ivies and similar schools like Duke and Stanford, state flagship universities also tend to be top producers of Black undergraduates who become doctors. “It’s sort of a volume thing” because flagships have such large enrollments, Nivet says.

Florida has an undergraduate enrollment of about 33,000. Two other large state flagships—the University of Michigan and University of North Carolina—tied for ninth in 2011 in the number of Black alumni receiving MDs.

With so many other state flagships having big enrollments, more than size distinguishes Florida’s pre-med preparation of its African-American students.

“I think the pre-health adviser is a critical component to the kinds of numbers you see there,” Nivet says of the top 10 schools in general. “It’s co-equal with having a rigorous curriculum. You have to have someone who can help them navigate, especially our underrepresented minority students. The vast majority do not have parents or relatives who are physicians who can help guide them through the application process.”

Florida has three pre-health advisers for undergraduates, led since 2008 by Bobbi Knickerbocker, who was a nurse for nearly 40 years. The advising starts at freshman orientation and continues through a student’s application to medical or other professional school. If minority students want additional support, Knickerbocker refers them to Parker or other staff in the Office for Diversity and Health Equity at the medical school.

“She has really made a difference,” Parker, also an assistant professor of pediatrics, says of Knickerbocker. “I think that, in order to be a mentor or a good adviser, you have to believe in the abilities of the person, and I think that is what comes through. She does believe in the students.”

Knickerbocker and her colleagues tailor their advising to each pre-med student, including those who do not take the traditional major in biology. Those students include music, business and journalism majors.

“We do have very, very strong science departments and majors,” Knickerbocker says. “We’re trying to work with students as individuals based on their interests, what their goals are and what their academic interests are. We’re very highly individualized in that direction.”

Among the top 10 undergraduate producers of Black medical school graduates in 2011, all but Xavier and Spelman College, ranked eighth, have their own medical school. Nivet says having one helps provide important opportunities for pre-med students to shadow doctors.

At the University of Florida, Fantone says, “A large number of students do shadow physicians in the UF Shands Hospital system. That’s one of the strengths of having the medical school and health system on the same campus as the main university, that it is easy access for both doctor shadowing and also getting research experience.”

The medical school also has a chapter of the Student National Medical Association whose members mentor undergraduates in the Minority Association for Pre-Health Students.

“Our Student National Medical Association chapter has been strong over the years and has actually won national recognition for its work,” says Parker, the group’s adviser.

Most Black undergraduates attend medical school in Florida, Knickerbocker says, though some go out of state, including one to Johns Hopkins University. About nine enrolled in the University of Florida’s College of Medicine last year, according to Parker, and a dozen the year before.

The University of Florida is likely to maintain a place among leading producers of Black undergraduates who become doctors. The number of applicants to medical school points to a continuing trend for at least four years, if the admission rate for those applicants—42 percent, according to Knickerbocker—holds up or increases.

Last year, the school ranked third in Black medical school graduates, who were drawn from 59 applicants in 2007. Florida’s averaged about the same number of applicants over the next three years. Incomplete data for this year, Knickerbocker says, show more than a one-third increase in the number of Black students seeking to enter medical school in the fall. Those who get in would graduate in 2016.

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