Doctors in the United States need to build trust with an increasingly diverse patient population — and they can’t learn that in a lecture.

Changing demographics

America is getting more diverse, but its medical schools aren’t keeping up. In 1960, the U.S. population was 85 percent white; by 2060, it will be just 43 percent, according to the Pew Research Center. And almost 61 million Americans speak a non-English language at home. But our medical schools don’t reflect these demographics. For example, 542 African American men entered med school in 1978, but only 515 did in 2014 — total stagnation for this group.

Economic diversity is also an issue. Currently 60 percent of U.S. medical students are from families in the top 20 percent income bracket, while only 3 percent of med students are from the bottom 20 percent. “But that bottom 20 percent have more health problems, including access to care,” says Neal Simon, president of American University of Antigua College of Medicine.

“Students who attend ethnically and culturally diverse medical schools report being better prepared to care for patients from diverse backgrounds.”

Patient impacts

The language barrier and subtler cultural issues can negatively impact patient care. “In some cultures, it’s difficult for a woman to talk openly about pregnancy,” Simon observes. “Male patients might not want to expose weakness,” which makes them reluctant to discuss their symptoms — depriving doctors of essential diagnostic information.  

To overcome these challenges, doctors need to be proactive about asking the right questions and building trust with patients. “They can’t learn that through lectures,” says Simon. “They learn it by being involved in different cultural and socioeconomic groups.”

Indeed, a 2008 study by the UCLA Higher Education Research Institute found that students who attend ethnically and culturally diverse medical schools report being better prepared to care for patients from diverse backgrounds.

Improving access

To make healthcare better for everyone, the Association of American Medical Colleges encourages people from diverse backgrounds to apply to medical school. These applicants should do more than just check the box stating their ethnicity; they should describe their experience elsewhere on the application — especially if they plan to serve their community after graduating.

However, U.S.-based medical schools have not done enough to increase diversity. For example, 542 African American men entered med schools in 1978, but only 515 did in 2014 — a total stagnation for this group. At some Caribbean medical schools, classes average around 20 percent African American.

Simon believes that medical schools should also look beyond standardized test scores: “Look at the student as a whole. What have they done in the past? How dedicated are they?”

“[Being a good doctor] is about patient trust,” Simon adds. “There’s no test for that.”