I wanted to be a doctor for as long as I can remember. I used to pour over my friend’s health books at slumber parties as early as middle school, and when I got to college I planned to become an OB-GYN. Although I didn’t have any family involved in medicine, I didn't have any reason to believe I couldn’t do it. I went to a top North Carolina public school and took AP science and math. When I landed at my liberal arts college in Pennsylvania I dove right into college-level biology and physics, preparing to go the pre-med route.
But my second semester of chemistry—the dreaded organic chemistry—pretty much stopped me in my tracks. It was hard. Really hard. Along with a friend who was also Cuban and pre-med, I struggled through the class, barely staying afloat. My friend and I passed the class, but in sophomore year, when I got my first lab assignment for Organic Chemistry 2, I had a panic attack. I couldn’t do it again. I hastily dropped the class, taking art history instead. My dreams of becoming a doctor faded away.
Kameron Leigh Matthews, a Chicago family physician, says this is not an uncommon story, especially among black, Latino and Native American students. “[In] those early science and math classes if the students are not adequately prepared early on, [it can be discouraging]. It’s more than just whether or not you’ve seen that information before, but whether you have the [necessary] study and test taking skills.”
This is why Matthews and a medical school classmate, Alden M. Landry, M.D., co-founded the Tour for Diversity in Medicine. Two times a year they visit college campuses across the country and talk with black, Latino and Native American students who are considering becoming M.D.s, dentists, podiatrists, pharmacists and doctors of osteopathic medicine.*
Matthews and Landry focus on these three groups because they are vastly underrepresented in the medical field. According to 2013 statistics about the racial makeup of U.S. physicians from the Association of Medical Colleges, only 4.1 percent were black, 4.4 percent were Latino and 0.4 percent were Native. Asians made up 11.7. Compare these percentages to 2013 census data: blacks represented 13.2 percent of the population; Latinos made up 17.4 percent; and Natives comprised 1.4 percent. Asians, at 5.4 percent of the total population, were over represented in the medical field.
I spoke with Matthews about her project and her own experiences as a black woman physician as she prepared to launch the eighth Tour for Diversity in Medicine this month.
Tell me a little about yourself and how you decided on a career in medicine.
Medicine was always my career choice. I was lucky to grow up with a father who is also a family physician. He is in private practice; I’m treating a lot of uninsured and low-income patients at a Federally Qualified Health Center.
The reason why I never wavered [in my career choice] is because my parents never wavered. They were entirely supportive every decision that I made. A lot of our students [get] no support from their parents, and even academic advisors [aren’t always supportive].
Did your father face obstacles as a black medical student in the 1970s?
My father was the first college graduate in his family. As a black male, when he was in medical school [at Jefferson University in Philadelphia], he was one of five [black men] in his class of 200. He has stories of a lot of racially motivated incidents, such as people not even recognizing [him] as the doctor even though he [was wearing] the white coat. Now he has a pretty significant leadership position as the chair of Jefferson's family medicine department, and he’s on the board of trustees. He’s one of the few minorities in leadership in his health system.
What was your experience in medical school?
At Johns’ Hopkins I didn’t personally face any racism; I definitely felt more sexism. There [are] definitely expectations of what fields women go into, and women don’t necessarily take leadership positions. Hopkins, I’m proud to say, has always done quite well in maintaining a diverse student group and faculty.
How did you decide to start the Tour for Diversity in Medicine?
We came up with the idea in 2005, but the first tour was in 2012. We decided to get on a bus in kind of a reverse form. [Rather than] the students going to visit campuses, [we'd] go around and visit the students. These students need to see doctors [who look like them] so they can imagine themselves in that role as well. We take anywhere from 10 to 16 medical students, dentists and doctors on the tour. The medical students can share their fears and problems, and [Landry and I], as young practicing physicians, can do the same.
What do you do during the tour stops?
It’s a one-day curriculum with a set of workshops we’ve refined over the past few years. We review the medical-school application process and [share] how [a student can] make themselves a more successful candidate. The fact that we can share our own personal stories really does give them that additional push. We don’t choose that perfect straight A student who got into medical school on the wings of her father [like me]. We purposely choose [students] who have struggled.
What do you think is the biggest barrier preventing black, Latino and Native students from becoming doctors?
The biggest barrier is the lack of motivation. The comment that we get most frequently is that now that they’ve seen young black and Latino physicians like us, they feel like they can do it as well. The information we’re presenting to them they can find online, but the fact that they can talk to someone [makes a difference]. It’s the mentoring that’s lacking. Even if they are not able to stay in touch with us, they should seek out their own mentors. They should seek out a positive influence that’s going to help them stay motivated.
Do Native students face unique challenges?
Yes, definitely. A lot of our Native American students around the country don’t have the exposure to preparation at an early age. They are faced with social ills like poverty and medical conditions which are rampant on reservations.
Within these three groups, what is the gender breakdown like?
The ratio is roughly three or four females to each male.*
Are doctors being trained to address race-based health disparities?
It’s not something that is formally addressed, and if it is, not adequately. They might have one lecture on trust in medicine that mentions [the Tuskegee Experiment]. From there the conversation ends. I think a lot of that is due to the lack of comfort in discussing racism. There is, unfortunately, racism in the system, and [it’s] institutionalized. As much as we as individual physicians don’t want to admit that, it’s there. Even outside of the social determinants of health, there is disparity in the way that treatment is afforded us.
Are the social determinants of health covered?
Social determinants of health are much more addressed. [But] within in traditional medicine we are not trained to treat it. [For] physicians it’s not really our specialty to fix poverty. But we are more trained than past generations that social determinants are affecting outcomes.
Is cost of medical education a barrier?
Significantly. That’s one I never bring up right away because it’s the obvious one. It’s unbelievably daunting to even apply to medical school. You have to pay about $100 per application. If you’re low-income enough you can get those fees waived. [Then] you have to fly to that school and pay for a hotel room [to interview]. The average student can spend upwards of $1,000 dollars just to apply.
How do students pay for that?
It’s either support from parents, school loans, or you put it on a credit card, which is what I did. If you are low-income, you might qualify for fee waivers.
What would be your one piece of advice for a black, Latino or Native student considering a career in medicine?
I think the biggest benefit will come from speaking with physicians and other health care professionals so you can get a good understanding of what it is we do. Depending on TV alone is not going to be enough. Finding a mentor is a necessity.
*The statistic has been updated since publication to reflect the correct ratio. "Osteopathic doctors" has been replaced by "doctors of osteopathic medicine," the precise term for U.S.-trained osteopathic physicians.