vironments where all have an equal opportunity to participate and be heard—the process of perspective taking, which stimulates development, is fostered. However, there is a strong correlation between the ethnic/racial composition of the student body and the educational benefits to be gained from such diversity-related initiatives. For example, Chang (1999) provided evidence about the diminished benefits of diversity-related pedagogy and approaches when they are adopted with little or no change in student body composition. Currently, the number and percentage of medical school matriculants in the United States remains predominantly white, with little change in underrepresented minorities over the past 10 years. Given this, efforts to engage medical students from diverse backgrounds in educational initiatives to achieve goals for cultural competence will have diminished impact if student diversity is not increased.

Although our manuscript does not focus on admissions practices in medical school or health professions programs, deans and admissions directors should consider the connections that we have shown exist between a diverse student body and educational initiatives that help students achieve cultural competence as they reflect on the criteria they use for admissions to their programs. This is an important consideration to make in pondering ways to achieve greater diversity in these programs.

Bowen and Bok (1998) wrote about society’s increasing dependence on the character of the individuals who serve society in professional roles. Levin (1996) said, “Academic excellence must remain the most important single criterion for admission … but we should continue to look for something more—for those elusive qualities of character that give young men and women the potential to have an impact on the world, to make contributions to the larger society through their scholarly, artistic, and professional achievements, and to work and to encourage others to work for the betterment of the human condition.”

Recent reports detailing health-care disparities (e.g., Institute of Medicine, 2003) underscore the need to address more directly “the betterment of the human condition” by ensuring access to health care to certain populations in the United States. By achieving greater nonwhite diversity among their students, medical schools can play a key role in the longer-term solutions to these disparities. Studies conducted by Komaromy and colleagues (1996, reported in Bowen and Bok, 1998) and Keith and colleagues (1985, reported in Bowen and Bok, 1998) provide important evidence that black and Hispanic physicians are much more likely to treat patients in minority communities that include poor people and that minority physicians are twice as likely to treat patients in locations where there are health-care shortages (as identified by the federal government). Medical schools may want to consider documented outcomes like this or evidence about the



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