the number of individuals who are members of the population involved” (42 U.S.C. 295). Adoption of this definition would acknowledge the substantial demographic changes that have occurred and the lack of significant progress in the integration of these groups in medical education. If approved, the AAMC could then establish targeted enrichment programs and promote affirmative action admissions programs designed to fully integrate these groups in the medical profession.
Although the Civil Rights movement of the 1960s and 1970s outlawed overt barriers to admission, it did not rectify the legacy of discrimination that persists. Major obstacles remain for students living in homes and communities with high rates of poverty. These students lack access not only to quality educational programs but also to advanced placement programs, college-level courses, quality advising, role models, and mentors. Students whose parents have lower levels of educational achievement, who live in low-income households, or who are exposed to violence and racism in the community face increased challenges in reaching their full potential. Exclusion from educational and professional opportunities experienced over several generations persists because there are fewer well-trained teachers in rural and inner city public schools than in middle- and upper class communities. The stereotype of lower expectations for minority students by teachers and other adults also has negative self-fulfilling effects for those who do not believe in their own potential. This widespread lack of support for disadvantaged students who wish to excel makes peer pressure to join gangs, use drugs, and drop out of school a frequent choice for many students living in America’s inner cities and poorest communities.
While inequities in educational opportunities for many URM students contribute to the small size of the health professions applicant pool, inadequate advising creates other less obvious dilemmas even for those students who go on to college with an interest in the health sciences. Students who experience academic difficulty in science and nonscience courses during their first year of college often seek help from premedical advisors at a critical stage in their education. While some receive the advice they need to pursue their goals, others are discouraged from a career in medicine or science on the basis of grades received in one or two courses. Turnover among health sciences advisors creates further challenges in ensuring that all students have access to reliable information about admissions and the full range of resources that are available to help them (UCOP, 2000).