Marisa Peryer

For the 2020 fiscal year, the U.S. Senate has approved $96 million less for programs intended to help minority and disadvantaged populations interested in health professions — a move that could decrease the diversity of Yale School of Medicine’s applicant pool.

Similar to many federally funded programs, Health and Human Services is always at the risk of losing funding. But for years, funding for Title VII and Title VIII programs connecting underrepresented populations to health care professions has been substantially reduced. Though the Health Profession and Nursing Education Coalition — or HPNEC — recommended Congress allocate $690 million in funding, the Senate only approved $633.5 million for the 2020 fiscal year. The decrease affects efforts to prepare medical professionals from underrepresented communities to practice medicine.

Recently, both the House and the Senate Appropriations Committees have reduced the Title VII and VIII funding and have also called for the complete elimination of Health Career Opportunity Programs, or HCOP.

“This program is critical to help students get exposure to what is possible,” said Darin Latimore, deputy dean and chief diversity officer of Yale School of Medicine. “Without these programs, vulnerable parts of communities will be less likely to access these jobs in the long run.”

Authorized in 1972, HCOP is the only federally funded pipeline program geared toward providing minority and disadvantaged students with skills needed to successfully compete for, enter and graduate from health and allied health professions schools. The pipeline follows students from K-12, college and graduate school focusing on acceptance, completion and retention at each educational level. As of 2019, more than 3,000 students nationwide participate in HCOP funded programs.

Initiatives to increase underrepresented minorities in medicine are not just limited to pipeline programs similar to HCOP.  In the early 1990s, the American Association of Medical Colleges, or AAMC,  initiated the “3000 by 2000” program focused on education-pipeline intervention implemented by medical schools, with the goal to enroll 3,000 underrepresented minority students into medical school by the year 2000.

Though not successful in achieving the 3,000 enrollees by 2000, the program did increase medical school enrollment and also highlighted the importance of pipeline programs starting in elementary school and extending to the graduate level. Still, a 2003 study in the Journal of Dental Education highlighted a systematic problem preventing underrepresented groups from entering the health care field. The study found that “profound disparities in the quality of primary schools, especially the difference between urban and suburban public schools are extreme.” And Latimore agrees. In an interview with the News, he stated that many low-income students lack access to the educational opportunities others may have.

Some Yale School of Medicine students know all too well the importance of these programs, having participated in them throughout their education. For Chinye Ijeli MED ’23, “Being put in touch with people from similar backgrounds made it not crazy to apply to an Ivy League for medical school.”

“As the child of immigrants  from Guyana and Nigeria, I am first generation in the family to pursue medicine, and I did not have those resources of people and networks growing up to pursue this,” said Brianna Olamju MED ’21. “I was fortunate to benefit from pipeline programs as it was my first significant exposure to seeing other doctors who look like myself. I was able to envision myself as a physician for the first time.”

Given evidence for the need for pipeline programs in addressing resource disparities, educational inequalities and representation exposure to increase diversity efforts in health care, some question why Congress would call for the elimination of HCOP.

One theory is the belief that workforce development programs and their funding should take place at the state or local level, instead of involving federal government — a view Latimore disagrees with.

“Though we would have foundation money and local money to continue with pipeline programs, it is important to have a national program in multiple areas with the same goal as that will have a significant impact,” he said. “In order to have an impact at the local level, we need to increase diversity in health care. We need a national program.”

Despite Congress’s calls to cut funding for these programs, more work remains to increase diversity in medical schools. In 2014, the AAMC released a report referring to the lack of black men in medicine as a “crisis.” And this year, the AAMC reported that out of 21,000 first-year medical students, only 730 are black men.

“With fewer and fewer African American men going into medicine — the same levels as in the 1970s —we have not made much progress,” Latimore said. “HCOP programs are where you can catch these students in high school and college where you can provide mentorship.”

Other students such as Autumn Nobels MED ’23 have also benefited from these programs. Nobels, who participated in a HCOP program at the University of Connecticut School of Medicine as an undergraduate, said it allowed her to better understand health disparities in Connecticut. Through shadowing opportunities offered by the program, Nobels became interested in emergency medicine.

“What will be put in its place if we eliminate a program geared to increase underrepresented in medicine across the nation?” Nobels asked, responding to the possible elimination of these programs.

The AAMC estimates a shortage of up to 120,000 physicians by 2023.

Faith Crittenden | faith.crittenden@yale.edu