Most are familiar with the college less likely than prison for various low
income populations. At the other end of the spectrum is admission to
medical school. The same groups falling out to prison, unemployment, and
welfare are also increasingly denied admission to college and medical
school, although most would rather look at higher education and not look at
age -1 year before birth to 2 years to 5 years after birth.
The following are admissions ratios for medical school for the 1994 - 2000
graduates of all US Allopathic Medical Schools.
The results are a good fit for socioeconomics with the exception of the
Vietnamese displaced peoples who are lower in parent education and income,
but rising fast in American society with higher than expected medical
school admissions. They maintain higher choice of family medicine
consistent with lower parent income and education levels and greater
numbers of first and second generation to college (rural populations and
Mexican American also in this group). This first generation impact appears
to be critical for any service oriented profession. Asian Indian students
are the fastest rising in recent years and Asians next. Foreign born is now
over 16% and Asian students are 22% of medical students. About half of
Asian students are foreign born. About 38% of the medical students will be
Asian or foreign born nationwide in a few years. Already East and West
Coast Schools are 40 - 50% foreign born. Asian, foreign born, out of state
born are all markers of most urban birth, highest income and education
level, most college prep, and parents who are most likely to be
professionals. Whites and other groups with similar markers all have the
high admissions levels and poor physician distribution.
My questions have to do with documentation of first and second generation
to college and societal mobility and service oriented professions. How
would I link up to understand more about these areas?
Rural males are having more and more trouble with college and medical
school. Are there studies showing increasing crime and prison rates with
rural males?
Also medical associations have not show any interest in publishing these
areas or in accepting the work for presentation at national physician
workforce conferences. one suggestion is public health venues. Other
suggestions?
The medical profession also has a history of becoming defensive and
entrenching. Still hold hope to work from the inside, but increasing
concerns for the nation.
% of Medical Students
1994 - 2000 Allopathic Graduates (AAMC data)
Ratio of
Population age 18 – 24 to Medical Students
6.5% Asian Indian 22.6
1 out of every 22.6 citizens and residents of medical school age is an
allopathic medical student
3.9% Chinese 59.7
6.0% All Foreign Born* 279.8 Attending US allopathic school
16.2% All Asian Students 63.2
1.1% Vietnamese 83.6
87.0% All Urban Born* 138.6
100.0% US All Student Total 201.7
65.3% White 214.1
0.7% Any Native American 501.3
0.7% Only Native American 314.7
13.0% All Rural Born* 356.9
7.1% Black 422.4
2.3% Mexican American 915.1
4.8% All Hispanic 756.3
2.9% Low Income Rural* 677.6
The problem of physician distribution can be seen by income level. More
higher income origin students mean poorer distribution. Those of lower
income are much more likely to choose primary care, rural practice,
underserved or low income primary care, or family medicine, the specialty
that distributes to all of these areas providing 38% of primary care, 38%
of primary care in underserved, 25% of rural practice, 56 - 60% of isolated
rural or whole county shortage physicians (birth origins data) and 43% of
Community Health Center physicians (Hart, WWAMI national CHC study)
AAMC Student Debt Data
60.0% Top Quintile Income 67.2 7 - 9%
in FP or rural practice
20.0% 2nd Quintile Income 201.7 10.5 - 11.5%
FP or rural practice
12.0% 3rd Quintile Income 373.6 10 - 11.3%
FP or rural practice
8.0% 4th Quintile Income 616.4 12.7-13.6%
FP or rural practice
2.0% Bottom Quintile* 1500 - 2689.8 16.2-18.2% FP
or rural practice
ranges given due to small and variable
denominators or data estimates from proxies
* data from my birth origins database based on AMA Masterfile
As difficult as it is to turn urban or higher income students into family
physicians as noted above, this task was accomplished with the managed care
and health policy reforms of the 1990s, with 50% increases in FP choice and
the greatest increase in the urban born types.
Robert C. Bowman, M.D.
U of Nebraska
[log in to unmask]
|
