History
The Wayne State University School of Medicine has a rich history of diversity encompassing underrepresented in medicine populations that began with its first graduating class.
The school of medicine, founded by five doctors who had served on the bloody battlefields of the Civil War, opened in 1868, just three short years after the Union victory over the South and the eradication of slavery. Those victories, however, did little to wipe away existing prejudices against Black Americans, prejudices that persisted even in the North that had fought to end slavery. Blacks were now free and theoretically equal, but they continued to confront bigotry and segregation in all facets of life throughout the recently restored union.
Integration
Yet when the newly opened Detroit Medical College the forerunner of the Wayne State University School of Medicine graduated its first class of physicians in 1869, that group of newly-minted doctors included Joseph Ferguson, the first African American man in Detroit and most likely in Michigan to earn a medical degree.
Ferguson was already practicing medicine without a degree in Detroit when he was admitted into the first class, treating Blacks who would not be seen by white doctors or treated in white hospitals. After he received his degree, Dr. Ferguson served two terms as a city physician and continued to care for Detroit's African American population until his death in 1887.
Dr. Ferguson was the first in a long line of minority physicians educated and trained by the WSU School of Medicine and its forerunners. That genealogy boasts the physician who helped found Dunbar Hospital, the first African American non-profit hospital in Detroit; the first African American physician to obtain an internship at a white hospital in Detroit and the first African American faculty member of the school; the first African American female physician who later became the first Black female resident and chief resident of Detroit Receiving Hospital; and the first Black physicians to integrate the staff of the city's major hospitals.
That history continues today and has widened its focus to include other populations not extensively represented in medicine but not without its hiccups.
To ensure that African Americans continued to have the opportunity to enter medical school, in 1969 the School of Medicine established its Post Baccalaureate Program, the first program of its kind in the nation. Initially launched to address the dearth of Black students entering medical schools, the free program immersed students whose applications had been rejected into a year-long education in biochemistry, embryology, gross anatomy, histology and physiology to improve their odds of future acceptance. Many who graduated from the program were accepted in the WSU School of Medicine. The program also served as a major pipeline for Black students into medical schools across the nation.
Five African American students were admitted in the initial program, which was so successful that it expanded to accept 10 students in 1972. The first Post Baccalaureate Program student graduated from the Wayne State University School of Medicine in 1974. The program expanded again to increase underrepresented minorities (Hispanics/Latinx and Native Americans) in medicine. Following the U.S. Supreme Court's 1978 Bakke decision, the program no longer could target only minorities in medicine, so it cast a wider net yet again, accepting socio-economically disadvantaged students regardless of race or ethnicity.
Now 50 years old, the program accepts a maximum of 16 students each year. In the last 30 years, the School of Medicine has invested $35 million in the program, which has graduated 401 students who have gone on to become physicians.
In the 1970s and early 1980s, the program served as a major pipeline for the admission of African American students to medical schools across the country. During the 1980s and 1990s, the WSU School of Medicine earned the distinction of graduating more African American physicians than any other medical school in the nation, with the exception of Howard University in Washington, D.C., and Meharry Medical College in Nashville. Representatives of U.S. medical schools flocked to Detroit to learn how WSU accomplished the achievement.
From 1977 to 2005, incoming medical classes included 250 to 260 students. Those classes included an average of 35 African American students. To address a shortage of physicians nationally and in Michigan, the school began accepting 290 new medical students each year beginning in 2006.
The number of minority students, however, began to dwindle in the late 1990s and early 2000s, the unintended victim of financial restraints and budget cuts. The decrease bottomed out with the incoming class of 2015. That year's class of 290 first-year medical students contained five African American students and two Hispanic/Latinx students, the lowest number in those categories in the school's modern history.
Diversity and inclusion
Recognizing the issue, the School of Medicine administration realized it was time to reassess and take action. In early 2015, a Diversity and Inclusion Task Force was formed to investigate. The task force developed a number of recommendations and presented its findings in May 2015. Those recommendations included creating the position of vice dean of Diversity and Inclusion, as well as securing funding to establish the Office of Diversity and Inclusion, and to resurrect student recruitment efforts.
WSU President M. Roy Wilson, M.D., and the university's Board of Governors provided a budget to do just that. Other improvements included bringing the school's student pipeline programs, such as the Post Baccalaureate Program, Wayne Med-Direct and the C2 Pipeline, under a single office, where they complement additional outreach programs such as Reach Out to Youth and the Michigan Area Health Education Center.
The only program of its kind in Michigan, Wayne Med-Direct is designed to attract top-tier students with an interest in battling health disparities. Launched in 2015 in line with the university's mission to develop a pipeline of high-quality students from disadvantaged socioeconomic backgrounds, the program guarantees 10 eligible high school students each year advanced admission to WSU's School of Medicine, four years of paid undergraduate tuition, room and board, and four years of paid medical school tuition.
Created by President Wilson, Wayne Med-Direct's eligibility requirements include a minimum 3.5 grade-point average and a 1340 SAT or 30 ACT score. Preference is given to students from disadvantaged socioeconomic backgrounds who are also interested in studying health disparities. Incoming freshmen in the program arrive on campus in the summer for enrichment courses in chemistry, biology, physics and writing. They participate in seminars, workshops and hands-on research and clinical training while undergraduates. Other benefits include free MCAT and GRE preparation, travel to conferences and symposia, and access to cutting-edge research facilities on campus.
"Attracting top-tier students with an interest in health disparities is important to the future of our School of Medicine," President Wilson said. "As we advance toward becoming a national hub for health disparities research, it is crucial for us to get future medical practitioners and clinical scientists committed to Wayne State University as soon as possible."
The C2, or College to Careers, Pipeline is sponsored by Wayne State University's College of Nursing and operates in 15 Detroit area high schools. The program focuses on increasing graduation rates, improving academics and ensuring ninth- through 12th-graders are college and career ready. After-school programming operates for 32 weeks during the academic school year. C2 Pipeline also offers six weeks of summer programming that includes a number of labs on the WSU campus. The program's emphasis is on science, technology, engineering and math, and health care professions.
Community
Additionally, the Michigan Area Health Education Center was established by WSU's School of Medicine and College of Nursing in 2010 to improve access to primary care for Michigan residents, especially those residing in areas with too few health professionals. Federal and state government statistics indicate 79 of Michigan's 83 counties have at least a partial designation as primary care health professional shortage areas. In addition, 76 have a shortage of dental professionals and 45 have a shortage of mental health professionals. MI-AHEC aims to address these shortages by working with schools, community organizations, government agencies and health providers to prepare underrepresented and disadvantaged youth for health care careers, promoting clinical training opportunities for health professions students in shortage areas and providing professional development programs for health professionals.
Through recruitment and retention initiatives, as well as special clinical education programs, MI-AHEC exposes disadvantaged students to health care career opportunities. One of its main goals is to increase the pipeline of underrepresented minority students to health professions via awareness, outreach and enrichment efforts across the state. Since its launch, more than 7,017 students have participated in MI-AHEC activities and 1,847 students gained hours in clinical rotations. More than 80 percent of health career pipeline program participants were either underrepresented minority or disadvantaged students.
The Reach Out to Youth annual event, presented by the School of Medicine's Black Medical Association and developed by two Black alumni physicians, also gives thousands of children from disadvantaged backgrounds the opportunity to explore the world of medicine and science, and to see that they, too, have a role in the future of medicine.
Energized by the new vision provided by President Wilson and additional staff and resources, in 2015 the administration set out to actively recruit qualified students from segments of the population the Association of American Medical Colleges defines as underrepresented minorities in medicine: African American students, Hispanic/Latinx students, Native American students and students from socio-economically disadvantaged backgrounds. Under the renewed emphasis and new holistic admissions interview process, the number of enrolled underrepresented in medicine students increased. The 2016 class included 11 African American, four Hispanic/Latinx and 53 socio-economically disadvantaged students. In 2017, the uptick continued, with 31 African American, 26 Hispanic/Latins, four Native American and 61 socio-economically disadvantaged students.
The numbers continue to climb. The graduating Class of 2021 includes 33 African American students, 25 Hispanic/Latinx students, five Native American students and 65 students from socio-economically disadvantaged backgrounds. This turnaround was accomplished without lowering expectations in grade-point average or MCAT scores.
The AAMC so swiftly recognized the turnaround that it invited the administration to give a presentation during the organization's 2016 annual meeting in Seattle on the school's experience and success.
The school's leadership continues its emphasis on diversification efforts, including establishing an ongoing Diversity Advisory Committee that reports directly to the dean.
"Shifting demographics requires deeper understanding of all cultures in our nation," Dean Schweitzer said. "We must train medical students how to provide care in our culturally diverse society. This knowledge and skills set is essential to serving the health needs of America, improving health outcomes and in addressing health disparities. This is our mission, and it is a righteous one."