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Minorities
in Medicine - Continued, 12th Report
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GROUP II RECOMMENDATIONS: Given the changing demographics of the U.S., physicians will care for increasingly diverse populations, but the diversity of the physician workforce is not keeping pace with the diversity of the nation. Physicians need to have competencies that promote high quality care of culturally, racially, and ethnically diverse populations. To address issues of cultural competency in medicine, COGME makes the following recommendations:
- Convene a panel to define and develop consensus on the definition of cultural competency in medicine. The Public Health Service of the U.S. Department of Health and Human Services, the Association of American Medical Colleges (AAMC), the Association of American Colleges of Osteopathic Medicine (AACOM), and others concerned with medical education should participate in selecting members for the consensus panel.
- Private and public organizations should offer funding for the development, implementation, and evaluation of curricula and programs that promote cultural competency in medical schools, residency training, and practice settings, including managed care.
- Medical schools, residency programs, medical specialty organizations, and continuing medical education programs should incorporate, as essential elements of their required curricula, teaching methods and experiences that assure cultural competency in medicine.
- The National Board of Medical Examiners, the National Board of Osteopathic Medical Examiners, and specialty board certification and accreditation bodies should review examinations for appropriate assessment of cultural competency and make appropriate changes to reflect assessment of cultural competency. Accreditation standards for medical schools should also include an assessment of cultural competency.
- Managed care plans should develop targets for minority physician representation and track their success in achieving these targets. Measures of quality should include the ability of managed care plans to deliver culturally competent care with adequate numbers of minority physicians and staff who demonstrate cultural competency.
GROUP III RECOMMENDATIONS: Minorities should have access to all specialties and career choices in medicine, including academic medicine. More research is necessary to understand the factors influencing minority specialty choice.
- The Bureau of Health Professions (BHPr), the AAMC, and the AACOM should sponsor research to identify and eliminate any barriers to underrepresented minority entry into medical and surgical specialties. Medical and surgical specialty -organizations and societies should support research to determine whether minorities have the same flexibility in selecting their specialties as do non-minorities.
- As COGME and others consider policies to decrease the number of federally supported positions in specialty graduate medical education programs, they should track the impact on underrepresented minority participation in medical and surgical specialties and devise and advocate remedies for any disproportionate impact.
- By 2010, underrepresented minorities should constitute at least 10 percent of medical school faculty. Every academic medical center should have in place specific programs and a dedicated budget for identifying and supporting under-represented minority students with an interest in academic medicine.
- Managed care organizations should develop training and mentoring programs to promote minority physician leadership in these organizations. These organizations should participate in partnerships between medicine and pre-professional educational institutions.
GROUP IV RECOMMENDATIONS: The health status of minority populations may be improved by increasing access to medical care, by decreasing health professional shortages in minority communities, and by increasing minority representation in medicine. COGME recommends that:
- Governmental and private funding sources should provide resources for research to document the impact of minority physicians on minority health status. They should also provide resources to study the impact of culturally appropriate medical education and training on access to care and on minority health status. The targeted minority communities should participate in the design and planning of this assessment.
- Community service and outreach should be an explicit mission of academic medical centers. These centers should develop criteria to recognize community service among faculty and staff and track the impact of such recognition on career choice and practice location.
GROUP V RECOMMENDATION: Educational institutions, academic medical centers, and others should continue all constitutional and legal efforts to increase minorities in medicine.
- The AAMC and AACOM, with representatives from the Public Health Service, Office for Civil Rights of the Department of Education, and Justice Department, should educate universities and academic medical centers about effective and legal affirmative action programs. These bodies should develop and issue guidelines for judging the constitutionality of affirmative action programs.
GROUP VI RECOMMENDATION: Given the changing demographics of the U.S. population and the past and current underrepresentation of minority groups in medicine, COGME recommends that:
- The AAMC and the AACOM track and report the participation in medicine of various racial and ethnic subgroups. Policies to promote minority entry into medicine should reflect need as portrayed by these data. subgroups.
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