By the year 2060, the U.S. is likely to have a more diverse population, according to recent U.S. Census Bureau projections. Specifically, minorities — defined as all but the single-race, non-Hispanic, white population, currently 37% of the U.S. population — are projected to become 57% of the population by 2060. Looking at the projections a bit more carefully, we see that the total minority population is expected to increase to 241.3 million, which is more than double the current number of 116.2 million.
Notwithstanding this expected population shift, current increases in medical school enrollment for Black or African American, Hispanic/Latino/a and Native American students do not accurately reflect their respective population growth. That is, although African Americans, Hispanics/Latinos/as and Native Americans currently comprise 31.5 percent of the U.S. population, they comprise, in the aggregate, only 12.3 percent of the current physician workforce.
As we engage on many fronts to meet increased demand for physicians, let us consider the track record of Xavier University (XU) in New Orleans. What can we learn from XU, considered the only historically Black, Catholic institution of higher education in the United States, and which manages to prepare and place underrepresented students into medical schools across the country (including Harvard, Northwestern, Baylor, Emory, Meharry and Tulane)? What’s more, 93% of students graduate and become practicing physicians and dentists.
This question reveals the deeply integral nature and active implementation of several principles of learning in XU’s premedical program. That is, the program:
- Structures knowledge around the major concepts and organizing principles of several disciplines, including biology, chemistry, mathematics and physics, making it a knowledge-centered environment
- Structures and shapes student learning around particular tasks and activities, making it a learner-centered environment
- Academically and socially supports students’ capacity to learn with understanding vis-à-vis learning communities at many levels, making it a community-centered environment
Taken together, this approach supports the faculty’s focus on exit criteria rather than entrance requirements. It also informs the premedical faculty and staff members’ perspective that “course content, teaching methodology, and the rate of presentation should be determined by the relevant department as a whole, not by individual lecturers or textbooks.”* Toward this end, faculty members in the departments of biology, chemistry, mathematics and physics, jointly adapted and standardized several foundational courses, including general biology, general chemistry, organic chemistry, general physics and pre-calculus/calculus I. Faculty emphasized that, in planning meetings with members from each department, they “decide the material covered, the rate at which it is presented, and even the algorithms students will use in solving problems. This material is integrated in the workbooks students receive, which contain learning goals and sample problems, for example.”* As a result, “all faculty are aware of the content in basic courses and where to begin upper-level courses.” This ensures that “the responsibility for providing support is shared by all faculty, including new and adjunct faculty.”*
This integrated curriculum not only removes redundancies, but also reinforces difficult concepts and promotes conceptual mastery vis-à-vis interdisciplinary course work. As an indication of faculty commitment and dedication, this effort, which began in the early 1970s, continues today. Interviews with Dr. J.W. Carmichael, director of XU’s premed program, and premedical faculty indicate that this considerable curriculum modification stemmed from students’ struggles to conceptually link their mathematical knowledge with scientific concepts in general chemistry. Faculty also found that students tended to view getting additional tutoring in this area as embarrassing, and consequently did not actively avail themselves of it and other supports. Faculty moved thus to deliberately integrate academic supports as part of the course. This strategy ensured that “students are neither pre-judged because of their background nor punished for poor performance.”*
Thus, the standardization of biology and chemistry courses “provides structure. It helps tremendously, because we have students with a wide variety of backgrounds, and it helps to get everyone up to speed in one year. We believe we need to be very explicit about what students have to do. We are correcting for years and years of poor education. Everyone goes to tutoring. There is no stigma attached to tutoring. Standardized courses really make a difference” (personal communication, J.W. Carmichael, July 2005 and January 2010).
* Quotes from interviews with premedical faculty and staff conducted July 2005 to January 2010
Parts of this article are excerpted with permission from “Teaching and Learning in Higher Education: Studies of three undergraduate programs in the US.” Bridglall, B.L. (2013) Lexington Books: Rowman and Littlefield Publishers.
Dr. Beatrice Bridglall is Faculty Affiliate at the Institute for Social Development at NYU Shanghai and Fulbright Specialist, Council for International Exchange of Scholars (CIES).