Medical schools willing to invest in qualified students from disadvantaged backgrounds can impact the nation’s physician workforce by increasing the number of doctors serving in regions designated as health professional shortage areas and medically underserved populations, according to a Wayne State University School of Medicine study published in Academic Medicine, the Journal of the Association of American Medical Colleges.

“Impact of a 50-Year Premedical Postbaccalaureate Program in Graduating Physicians for Practice in Primary Care and Underserved Areas,” (https://journals.lww.com/academicmedicine/Abstract/9000/Impact_of_a_50_Year_Premedical_Postbaccalaureate.96936.aspx) a review of the impact of the School of Medicine’s Post Baccalaureate Program over its 50-year life, found that the program has been successful in graduating a large proportion of physicians from disadvantaged and diverse backgrounds. Many of these physicians went on to practice in regions with a shortage of doctors and in areas with underserved populations, accomplishing the goals of addressing the broad primary health care needs of all Americans, said lead author Herbert Smitherman Jr., M.D., M.P.H., professor of Internal Medicine and vice dean of Diversity and Community Affairs.

The study set out to evaluate the effectiveness of the School of Medicine’s premedical Post Baccalaureate Program in achieving its goals, measured by medical school, medical school graduation, primary care specialization and current practice.

The program’s foundational goals are to provide academically-qualified students from lower socioeconomic, disadvantaged and underrepresented backgrounds the opportunity to become physicians; to identify and select students likely to return to their underserved communities to practice; to increase access to health care in underserved communities and therefore improve health outcomes; to increase the number of primary care physicians both locally and nationally; and to increase diversity in the physician workforce in an effort to address health inequities, disparities and social determinants of health.

To ensure that qualified minorities continued to have the opportunity to enter medical school, in 1969 the WSU School of Medicine established the Post Baccalaureate Program, the first of its kind in the nation. Initially launched to address the dearth of African American students entering medical schools, the free program immerses students into a year-long education in biochemistry, embryology, gross anatomy, histology and physiology. Many who graduated from the program were accepted into the WSU School of Medicine, but the program also served as a major pipeline for Black students into medical schools across the nation.

Five African-American students were admitted into the initial program, which was so successful that in 1972 it expanded to accept 10 students. The first Post Baccalaureate Program student graduated from the Wayne State University School of Medicine in 1974. The program expanded its efforts to increase underrepresented minorities in medicine. Following the U.S. Supreme Court’s 1978 Bakke decision, the program cast a wider net yet again, accepting socio-economically disadvantaged students regardless of race or ethnicity.

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.

Today, as many as 200 Michigan undergraduates apply for the program each year. A maximum of 16 students are accepted annually.

The study found that of 539 students who graduated from the program between 1979 and 2017:

• 463 (85.9%) successfully completed, then matriculated to the School of Medicine. Of those, 401 (86.6%) obtained a medical degree.
• Of the 401 who obtained a medical degree, 233 were female.
• The average investment per Post Baccalaureate Program student was approximately $52,000; for a M.D. graduate approximately $77,000.
• The majority of doctors who graduated the program (72.1%) lived in areas identified as medically underserved or having a shortage of physicians when they were admitted to the program. Today, 82% practice in such areas. Most practice primary care medicine.
• The program’s total cost for 50 years was $32 million, an average investment of approximately $52,000 per student, and approximately $77,000 per graduated physician.

Today there are 250 similar programs in the United States, but a study by the AAMC found only 63 focused on underrepresented in medicine students and only 18 of those had explicit diversity-based missions. Because the WSU program cost structure is flexible, the study team reported, universities with existing medical education resources can readily adapt the program to meet their needs.

Other members of the study team include Anil Aranha, Ph.D., associate director of Diversity and Inclusion; De’Andrea Matthews, D.R.E., director of the Office of Diversity and Inclusion; Andrew Dignan, chief information officer and chief administrative officer for Health Centers Detroit Foundation Inc.; Mitchell Morrison, M.P.H., former intern in the Office of Diversity and Inclusion and now a clinical research associate for IQVIA/Roche & Genentech; Eric Ayers, M.D., associate professor of Medicine and Pediatrics; Leah Robinson, Ph.D., director of Academic Support for the Office of Diversity and Inclusion; Lynn Smitherman, M.D., associate professor of Pediatrics; Kevin Sprague, M.D., associate dean of Admissions; and Richard Baker, M.D., vice dean of Medical Education.