Med Schools’ Equity Efforts Thwarted by Pandemic

Aug. 26, 2021 — Efforts to improve diversity and equity in academic medicine have been “moved to the back burner” in the face of the coronavirus pandemic, despite a growing need to address racial disparities, said the top diversity expert at the Association of American Medical Colleges.

“It’s the notion of ‘here we go again.’ [Diversity] issues are moved to the back burner, they’re no longer on the front burner because of the pandemic everyone is concentrating on,” said David Acosta, MD. “Our academic health centers were certainly impacted by the guidelines like social distancing. Our CEOs, our CFOs found themselves not being able to operate in a normal manner. It wasn’t business as usual.”

Acosta spoke during a webinar organized by Herbert Smitherman Jr., MD, vice dean of diversity and community affairs at Michigan’s Wayne State University School of Medicine.

Acosta focused on the longstanding lack of diversity in medicine, which he said has only been amplified by the racial reckoning following the murder of George Floyd by a Minneapolis police officer. But the simultaneous pandemic has left little bandwidth to address these problems.

Things like long-term disruption in elective surgeries were costly for academic medical institutions, Acosta said, resulting in budget cuts and furloughing in diversity and inclusion departments.

At the same time, clinical faculty who had previously been vocal in these efforts and served as mentors for medical students and residents of color were called out because of the rising patient caseload, Acosta said.

“When you talked to the physicians and faculty, they felt overwhelmed. Not just overwhelmed, but exhausted,” he said. “It’s not just physicians and faculty that are burning out, it’s our medical students and residents.”

But the racial disparity in medicine is a crisis that also needs attention, Acosta said. There are still holes in the pipeline that keep people of color — particularly Black men — from attending medical school. And those who do enter academic medicine suffer daily microaggressions, imposter syndrome, lack of exposure to mentors of color, and other stressors that make an already demanding career more difficult, Acosta said.

“We have a critical crisis going with black men in medicine,” he said. They’re disappearing from the landscape. There’s a growing absence.”

Acosta cited data from the Association of American Medical Colleges — which represents roughly 400 major teaching hospitals across the country — showing that of the 52,757 total medical school applicants in 2018-2019, only 4,430 were Black. Of the Black applicants, only 1,558 were men. Of the 21,622 people enrolled from that time, only 604 were Black men.

He added that not only are there inequities in the education system, societal barriers, and stereotypes to overcome, but once people of color enter medical school, they’re expected to assimilate to the largely white environment regardless of cultural background.

Acosta encouraged institutions to revisit inclusion efforts and prioritize equity, despite the necessary and ongoing focus on the pandemic.

“It’s really a time to expand those efforts,” he said. “It does require investment in many shapes, and not just financial.”