The administration's vision for health care reform calls for the "creation of a new health workforce," and enhanced investment in "recruiting and supporting the education of health professionals from population groups underrepresented in the field" (American Health Security Act, 1993).

The current call for systemic change is compelling academic health centers and other institutions involved in education for the health professions to reassess future health workforce needs within a context of universal access and the health care needs of a more diverse society. The problem of dwindling access and declining coverage has brought into sharper relief the special health needs of underserved Americans, of whom a disproportionate number are minorities. Further, there is every indication that any reform strategy will provide incentives for enlarging the ranks of primary caregivers, nurses, and allied health professionals who enter community practice, a focus that represents promising career opportunities for minorities.

To meet the needs for health care, education, and research in an increasingly diverse society, the committee tried to formulate a strategy that would ensure a significant increase and a continuous supply of minority health professionals. The committee believed it critical to recommend greater emphasis on the "throughput"* of the educational process and on programs that will significantly increase the number of minorities prepared academically to pursue careers in medicine and science. Past reliance on stand-alone, rather than integrated, programs has nourished only a few institutions that compete for a small number of talented minority students and faculty. A greater presence of minorities in the health professions in clinical practice and research cannot, however, be reached by the field of medicine alone. Energized, sustained, and concerted strategies must involve the other health professions as well, including dentistry, optometry, pharmacy, podiatric medicine, veterinary medicine, nursing, and the growing field of allied health.

The committee calls for a more systematic, strategic, and sustained effort to ensure the continuous flow of minority students qualified to choose careers in the health professions. Any substantial improvement in minority enrollment in health profession's schools can occur only if the pipeline expands and more minority students gain the opportunity for solid academic preparation in a supportive environment, beginning well before high school. The fundamental cause of underrepresentation of minorities in health professions schools is an inadequate number of academically qualified and near-qualified students interested in health

*  

The concept of "throughput" is derived from The Goal: A Process of Ongoing Improvement, written by Eliyahu Goldratt and Jeff Cox (1986). This widely revered treatise/novel on modem industry and new global principles of manufacturing describes a process for ongoing growth and improvement in industry, education, and science.



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