Why aren't there more African-American physicians? A qualitative study and exploratory inquiry of African-American students' perspectives on careers in medicine

Purpose: African Americans comprise 13% of Americans but only 4% of U.S. physicians. The reasons for this disparity are unclear. The purpose of this study was to identify African-American high-school student perspectives on barriers to African Americans pursuing careers in medicine. Method: Focus group interviews (consisting of 15 questions) were conducted of African-American high-school juniors attending a Milwaukee public high school in which 89% of students are African Americans. The two focus groups were conducted in 2006, transcribed and analyzed using grounded theory. Results: The 12 students interviewed in two focus groups had a mean age of 17 years; 41% of students' parents were high-school graduates. Major barriers to becoming a physician cited by students included financial constraints, lack of knowledge about medicine, little/no encouragement at home or in school, negative peer views on excelling academically, lack of African-American role models in the community and on TV, racism in medicine, and easier and more appealing alternatives for making money. Students stated that increasing the number of African-American physicians would enhance patient-physician communication and relationships, and more African Americans would become physicians if there were greater exposure to medicine in schools, more guidance at a younger age and more role models. Conclusion: Financial constraints, insufficient exposure to medicine as a career, little encouragement at home and in schools, lack of role models, and negative peer pressure may contribute to racial disparities in the physician workforce for African Americans. Exposure at a young age to role models and to medicine as a profession might increase the number of African American physicians.