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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Page R4
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Page R6
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Page R9
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Page R11
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Page R13
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25130.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

An American Crisis: The Growing Absence of Black Men in Medicine and Science PROCEEDINGS OF A JOINT WORKSHOP BETWEEN THE NATIONAL ACADEMIES OF SCIENCES, ENGINEERING, AND MEDICINE AND THE W. MONTAGUE COBB/NMA HEALTH INSTITUTE Cato T. Laurencin, M.D., Ph.D., Rapporteur Board on Population Health and Public Health Practice Health and Medicine Division PREPUBLICATION COPY: UNCORRECTED PROOFS

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by the Aetna Foundation (Contract 10003873), Burroughs Wellcome Fund (Contract 10003742), W. Montague Cobb Institute/NMA Health Institute (unnumbered), KAVLI Foundation (10003589), National Academy of Medicine (unnumbered), National Institutes of Health (unnumbered), and the Robert Wood Johnson Foundation (Contract 10003809). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/25130 Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2018 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. An American crisis: The growing absence of Black men in medicine and science: Proceedings of a joint workshop between the National Academies of Sciences, Engineering, and Medicine and the W. Montague Cobb/NMA Health Institute. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25130. PREPUBLICATION COPY: UNCORRECTED PROOFS

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY: UNCORRECTED PROOFS

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY: UNCORRECTED PROOFS

PLANNING COMMITTEE ON INCREASING AFRICAN AMERICAN MALES IN THE MEDICAL PROFESSION1 CATO T. LAURENCIN (Chair), University of Connecticut KENDALL CAMPBELL, East Carolina University Brody School of Medicine THEODORE J. CORBIN, Drexel University College of Medicine GEORGE C. HILL, Vanderbilt University RANDALL C. MORGAN, JR., W. Montague Cobb/NMA Health Institute ELIZABETH OFILI, Morehouse School of Medicine VIVIAN PINN, National Institutes of Health (retired) Health and Medicine Division Staff RENEE GETHERS, Responsible Staff Officer (from January 2018) LESLIE Y. KWAN, Associate Program Officer (from March 2018) HOPE HARE, Administrative Assistant ROSE MARIE MARTINEZ, Project Director (until January 2018), Senior Board Director, Board on Population Health and Public Health Practice 1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Joint Workshop rests with the workshop rapporteur and the institution. PREPUBLICATION COPY: UNCORRECTED PROOFS v

REVIEWERS This Proceedings of a Joint Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings: L.D. BRITT, Eastern Virginia Medical School EVE J. HIGGINBOTHAM, University of Pennsylvania FAITH MITCHELL, Grantmakers In Health VALERIE MONTGOMERY RICE, Morehouse School of Medicine ALVIN POUSSAINT, Harvard Medical School JOHN A. RICH, Drexel University School of Public Health DARLA THOMPSON, The George Washington University Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by CARMEN R. GREEN, University of Michigan. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies. PREPUBLICATION COPY: UNCORRECTED PROOFS vii

CONTENTS ACRONYMS AND ABBREVIATIONS xiii 1 INTRODUCTION 1-1 Opening Remarks, 1-3 Overview of the Proceedings, 1-4 2 KEYNOTE PRESENTATIONS 2-1 Opening Keynote, 2-1 The Perspective from Academic Medicine, 2-3 Discussion, 2-6 3 EXPLORING THE CHALLENGES AND BARRIERS FOR BLACK MEN ALONG THE LIFE TRAJECTORY 3-1 Racism, 3-2 Reflections on Barriers to Becoming a Physician, 3-4 Mental Health and Resiliency in the Lives of Black Men, 3-4 Discussion, 3-5 4 EXPLORING THE CHALLENGES AND BARRIERS FOR BLACK MEN ALONG THE EDUCATIONAL TRAJECTORY 4-1 Mentoring in Medicine, 4-2 Men of Color, 4-3 Challenges Along the Educational Pipeline, 4-4 Ideas to Potentially Address the Shortage of Black Men in Medicine, 4-5 Discussion, 4-5 References, 4-7 5 CURRENT INNOVATIVE AND EXPLORATORY STRATEGIES TO SUPPORT ENTRY INTO SCIENCE AND MEDICINE FOR BLACK MEN 5-1 Meyerhoff Scholars Program, 5-2 Vanderbilt University School of Medicine African American and Disadvantaged Student Pipeline Program, 5-3 The Ohio State University Bell National Resource Center on the African American Male, 5-4 Aetna Health Professions Partnership Initiative (HPPI) Scholars Doctor Pipeline, 5-6 Harvard Medical School Office for Diversity, Inclusion, and Community Partnership, 5-7 Discussion, 5-10 6 REFLECTIONS ON MEETING DAY 1 6-1 Reflections, 6-2 Discussion, 6-5 Poster Session: Innovative Approaches to Black Men in Medicine (Student Perspectives), 6-6 PREPUBLICATION COPY: UNCORRECTED PROOFS ix

7 ACCOUNTABILITY IN MEDICINE: WHAT CAN MEDICAL SCHOOLS DO TO ADDRESS THE CRISIS? 7-1 Opening Remarks, 7-2 Accountability in Medicine, 7-3 Discussion, 7-10 8 FINANCIAL BARRIERS TO MEDICAL EDUCATION 8-1 National Medical Fellowships, 8-2 The Jackson/Minton Scholarship Fund, 8-3 Financial Barriers to Medical Education from the Student Perspective, 8-5 Discussion, 8-6 9 APPROACHES FROM PHILANTHROPY 9-1 Burroughs Wellcome Fund, 9-2 The Commonwealth Fund, 9-3 Robert Wood Johnson Foundation, 9-4 Discussion, 9-6 10 APPROACHES FROM GOVERNMENT 10-1 National Institutes of Health and Engaging New Partners, 10-2 Health Resources and Services Administration Health Workforce Priorities and Programs, 10-3 Discussion, 10-4 11 REFLECTIONS ON THE WORKSHOP AND FINAL THOUGHTS 11-1 Reflections on the Workshop, 11-2 General Discussion on Innovative Solutions and Final Thoughts, 11-7 APPENDIXES A Workshop Agenda A-1 B Speaker Biographies B-1 PREPUBLICATION COPY: UNCORRECTED PROOFS x

BOXES AND FIGURES BOXES 1-1 Statement of Task, 1-4 7-1 Liaison Committee on Medical Education Standard 3 on Academic and Learning Environments and Element 3.3 on Diversity/Pipeline Programs and Partnerships, 7-16 7-2 Liaison Committee on Medical Education Consensus Statement Related to Satisfaction with Element 3.3, Diversity/Pipeline Programs and Partnerships, 7-17 FIGURES 2-1 Matriculants to U.S. medical schools by race/ethnicity (alone or in combination), 1978– 1979 through 2017–2018, as of November 1, 2017, 2-4 2-2 Matriculants to U.S. medical schools by race/ethnicity (alone or in combination) and sex, 2016–2017 and 2017–2018, as of November 1, 2017, 2017, 2-5 5-1 The Marshall Plan for American education, 5-7 5-2 UConn Health Aetna Health Professions Partnership Initiative (HPPI) Scholars Doctors Pipeline, 5-12 PREPUBLICATION COPY: UNCORRECTED PROOFS xi

ACRONYMS AND ABBREVIATIONS AAMC Association of American Medical Colleges AHEC Area Health Education Centers AOA American Osteopathic Association APA American Psychological Association BHW Bureau of Health Workforce BUILD Building Infrastructure Leading to Diversity program CHC community health center DO doctor of osteopathic medicine FDA Food and Drug Administration GRE Graduate Record Examinations HBCU historically Black colleges and universities HCOP Health Careers Opportunity Program HHS Department of Health and Human Services HPPI Health Professions Partnership Initiative HRSA Health Resources and Services Administration LCME Liaison Committee on Medical Education MATC Milwaukee Area Technical College MCAT Medical College Admissions Test MD doctor of medicine NAM National Academy of Medicine NCAA National Collegiate Athletic Association NHSC National Health Service Corps NIH National Institutes of Health NMA National Medical Association NMF National Medical Fellowships NSF National Science Foundation SES socioeconomic status STEM science, technology, engineering, and mathematics UConn University of Connecticut UMBC University of Maryland, Baltimore County UNC University of North Carolina UT University of Texas VUSM Vanderbilt University School of Medicine PREPUBLICATION COPY: UNCORRECTED PROOFS xiii

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Black men are increasingly underrepresented in medical schools and in the medical profession. A diverse workforce is a key attribute of quality healthcare and research suggests that a diverse workforce may help to advance cultural competency and increase access to high-quality health care, especially for underserved populations. Conversely, lack of diversity in the health workforce threatens health care quality and access and contributes to health disparities. In this way, the growing absence of Black men in medicine is especially troubling, because their absence in medicine may have adverse consequences for health care access, quality, and outcomes among Black Americans and Americans overall.

To better understand the factors that contribute to the low participation of Black men in the medical profession, facilitate discussion of current strategies used to increase their participation in medical education, and explore new strategies along the educational and professional pipeline that may have potential to increase participation in medicine, the National Academies of Sciences, Engineering, and Medicine and the Cobb Institute jointly convened a 2-day workshop in November 2017, in Washington, DC. This publication summarizes the presentations and discussions from the workshop.

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