Even at a young age Lawrence Cresswell knew he wanted to be a doctor. As a high schooler in New York, he participated in a program at the University of Rochester and remembers asking students there about potential pre-med programs.
He was pointed to Xavier University in New Orleans.
Over the years this small private university has built a reputation in successfully graduating some of the highest numbers of black pre-med students in the country. In 2017, the Association of American Medical College’s reported that with 103 pre-med graduates, Xavier was second only to Howard University in Washington D.C. in graduating the highest numbers of pre-med students who identify as either black or African American.
Those efforts are significant considering the chronic underrepresentation of African American, as well as Hispanic, medical students in the U.S.
Students who identify as white (58.8 percent) and Asian (19.8 percent) represented the largest proportion of medical school graduates in 2015, according to the Association of American College’s “Current Trends in Medical Education” report. By comparison, students who identified as black or African American made up 5.7 percent of all graduates. Those who identified as Hispanic or Latino made up 4.6 percent of all medical school graduates in 2015, according to the report.
“Specifically, when it comes to African Americans, we have historically been very underrepresented in medical education,” Cresswell said. “I see programs like Xavier helping bridge that gap.”
Cresswell now practices emergency medicine at East Jefferson Hospital and works with residents at the VA Hospital in New Orleans. He returns to his alma mater every August to speak to a new cohort of incoming pre-med students. About 10 to 15 students annually shadow him at work to gain clinical experience.
Cresswell remembers his days as a Xavier undergraduate and how he was put to work starting in freshman year to prepare for medical school.
“The pre-med program has grown since I was student,” Creswell said. “They really help you every step of the way, preparing what you have to do after freshman year, helping you with summer programs, with their tutoring center. They provide every single opportunity to succeed.”
Quo Vadis Webster, the director of premedical program at Xavier University, credits the university’s multi-layered approach for its graduates’ high acceptance rates into medical programs. The approach identifies, supports and coaches students who want to go to medical school from day one of freshman year, she said.
“Not everyone comes to college prepared to understand the demands,” Webster said.
She said the school not only emphasizes courses in the STEM fields but non-sciences as well.
“It’s crucial that they have that foundation to get into med school,” she said.
Xavier University has been trying to combat the diversity problem by reaching out to high school students early and letting them know what resources are available to put them on track for medical school, Webster added.
“There are repeated challenges that these students face in the pre-K through 12th-grade education system alone,” she said. “We hope that by reaching out early, there is a possibility that they will be able to persevere through those challenges.”
Xavier University President C. Reynold Verret said that the school has to acknowledge the educational disadvantages many students face growing up, and address students’ weaknesses and strengths early by steering them to courses that work for their education level.
He estimates that about 50 percent of Xavier’s student population comes from Louisiana, while the other half comes from out of state.
“We set high expectations for them, but try not to discourage them,” he said. “We want to show them it’s possible and there is a pathway to medical school.”
The approach could be a model as schools and others work to address diversity in medicine.
The number of black or African American women applying to, being accepted to and graduating from U.S. medical programs has increased in recent decades. An AAMC report found the share of black female med school graduates increased by 53 percent from 1986 to 2017.
The reverse is true for black men. There was a 39 percent drop in the number of black men graduating from med school during the same period, according to the report.
Local medical schools say they too are trying to tackle the diversity problem. Bennetta Horne, a Xavier University graduate, was hired to run the office of multicultural affairs at the Tulane University School of Medicine three years ago, specifically to help increase student diversity.
When Horne was hired, the school reported an average of about five African American students per class. Classes at Tulane’s med school are typically between 190 and 200 students.
“They recognized there were opportunities to do better,” Horne said.
The office focuses on engaging with local high school students who are interested in pursuing careers in medicine, particularly in African American, Vietnamese and Hispanic communities.
The primary barrier for many students is the MCAT, the entrance exam used to apply for medical schools. Horne said Tulane has started considering factors other than test scores when reviewing applications, including whether or not the applicant has any clinical experience.
“We start outreach early and I let students know early what they can do to strengthen their applications,” she said.
There has been an average of five African American students enrolled in the incoming class of medical students for the past ten years including when Horne started at Tulane in 2015. This year, there are 17.
The total enrollment of African American medical students at LSU Health New Orleans during the 2017/18 school year was 41. There were 2 students who identified as American Indian or Alaska Native, and 13 students who identified as Hispanic or Latino. This is by comparison to the 614 students who identified as white, according to AAMC data.
Dr. Robert Maupin, the associate dean for diversity and community engagement at LSU Health New Orleans, explained although this is a national problem, it is a particular challenge in Louisiana where the African Americans make up about 6.7 percent of the physician workforce according to AAMC data from 2014.
His office has developed several programs including a Summer Science program and a Summer Research program that brings in high school students and college undergrads interested in pursuing medical and research career in public health or clinical sciences.
Maupin explained these programs give students access and exposure not only to the profession but to professionals who look like them and share a cultural background.
“A lot of that is who they see. In cases where they don’t have a family member or anyone they know in medicine, they are seeing real individuals who have been successful at making it into medical school,” said Maupin.
In April, the office helped sponsor the LSU School of Medicine’s Student National Medical Association’s Pre-Med Day with an emphasis on getting underrepresented pre-medical students ready to apply for medical school. About 65 students attended the event, according to Shonte Joseph, a third-year medical student at LSU Health Sciences Center in New Orleans and co-president of the organization.
Joseph said in an interview in April that a lack of information on how to apply, as well as sparse financial resources, are barriers for students of color who are interested in applying to medical schools.
“Louisiana’s population is not represented in our student body. New Orleans’ population is not represented in our student body,” Joseph said. “If you are not getting exposure to a huge subset of your population, how are you going to be able to offer compassionate care?”
Studies show that a diverse population of doctors can result in better health outcomes for patients. Cultural competence can play an important role in successfully communicating with a patient.
Minority physicians are also much more likely than their counterparts to work in underserved communities and care for minority and underinsured patients, according to one study from the National Institutes of Health.
Reflecting on his own experience, Cresswell said patients “can clam up if they feel they are not being heard.” A doctor who shares a similar cultural background can help ease that tension, he said.
Patients, particularly children, need to see “doctors who look like them and are able to communicate with them, in a way that will reach them, to have a positive impact on their health and well-being,” Creswell said.
Originally produced by Maria Clark, and Published on www.nola.com The Times-Picayune
