Since the civil rights era, the number of black physicians has been rising, with African-Americans now making up 4 percent of U.S. physicians overall.
But while this statistic keeps inching up, it conceals a troubling trend: The number of African-American men entering medical fields has been falling since it peaked in the early 1990s, and it continues to drop, both here in Pittsburgh and across the United States.
William Simmons, an anesthesiologist at UPMC Shadyside and associate professor at the University of Pittsburgh medical school, said the decline is obvious.
"In a typical class at the University of Pittsburgh, we usually have 16 or 20 African-American students entering medical school, in a class of 150," he said. "This year, four of them are male."
Dr. Simmons sits on the university's advisory committee on diversity, but as of Jan. 1, he is also president of the Gateway Medical Society, a southwestern Pennsylvania organization whose mission includes bolstering the numbers of area black men in medical fields.
Founded in the late 1950s, Gateway is affiliated with the National Medical Association, which was founded in 1895, a time when African-American doctors were not allowed to join the American Medical Society and were barred from most medical schools.
Gateway's mission is to "Close the Gap," a phrase that points to a host of problems regarding the black community and health-related fields, including the dwindling number of male doctors.
"African-Americans have the highest incidence of SIDS (sudden infant death syndrome), of AIDS, the highest death rate of heart disease, of diabetes, of almost any kind of cancer," Dr. Simmons pointed out.
Access to medical care for minorities is often a problem, he added, with financial barriers and fewer physicians willing to service poor areas. Additional problems include cultural barriers, from reluctance to seek medical help to difficulty in communicating to physicians who may not understand the needs of minority patients.
Gateway sponsors a number of programs that seek to connect minority and underserved communities with health care and provide health-care education, including a yearly community symposium in the spring, a scholarship gala in the fall and a provider symposium that addresses specific medical issues of African-Americans.
In 2010, Gateway started the "Journey to Medicine" academic mentorship program to specifically address the shortage of male African-American physicians.
Fifteen African-American 6th-grade boys are chosen from public schools to attend regular educational activities. These teach skills from PowerPoint presentation and public speaking to suturing a cow heart and performing CPR on a medical manikin. Each boy is mentored throughout the program by a Gateway physician member, and the 15 progress through the program together.
The program receives financial support from the Heinz Foundation, as well as Highmark, the Pace Foundation, and the Allegheny County Medical Society. Gateway also works with area colleges and hospitals, so boys in the program have access to the University of Pittsburgh medical library system, science camps at Carnegie Mellon University and the Simulation, Teaching, and Academic Research Center (STAR) at West Penn Allegheny Health System.
Now in its second year, the plan is for the program to continue all the way through high school, providing SAT preparation and college application support.
"And we don't want to lose them in college," said Anita Edwards, chair of Gateway's program committee and an internist at Century III Medical Associates in Pittsburgh. "As long as they stay with us, we'll stay with them."
"This is not a quick fix," conceded Jan Madison, Gateway's chair of fundraising and a specialist in pulmonary critical care with Pittsburgh Pulmonary Associates.
She acknowledged that the interrelated factors that influence the decline of black men in medicine are multiple and complex, but that all research seemed to indicate that an early start predicted better outcomes.
"We're hoping to catch them at a young age and fill that pipeline," she said.
On Dec. 17, the now 7th- and 8th-grade boys attended their final daylong program of the year at the Allegheny County Medical Society Building.
Each boy, in a shirt and tie, gave a presentation with a microphone, with subjects ranging from the dangers of steroids to pioneering African--American doctors to their favorite experiences in the program. Some had assembled PowerPoint presentations, others brought photos.
They then participated in a chemistry demonstration by graduate students from the chemistry department of Carnegie Mellon University. The level of the material was aimed at high school students, but the boys were rewarded for their attention by participating in experiments making rubber balls, soap and ice cream.
The rest of the afternoon was dedicated to medical presentations by Gateway physician members, advice on taking advantage of the Pittsburgh Promise, a program that gives college tuition help to students enrolled in city schools, information on academic internships, and an award ceremony.
Morris E. Turner Jr., the youth program coordinator, pointed out that despite the "graduation" ceremony, the boys in the program won't have much time off -- meetings begin again in January.
He also begins the recruitment process for new 6th-graders immediately.
"To get those 15, I interview more than 60 kids," he said, adding that they look for a 3.0 grade point average, but that strong math and science grades are more important. The initial candidates are recommended by school principals and science and math teachers. Each boy must have signed permission from a parent or guardian to participate.
Mr. Turner noted that he's seen dramatic improvements in the boys in the program.
"We've made so much progress in public speaking, and the excitement they show for the kinds of things we're teaching them is a welcome sight," he said.
All the boys' grade point averages have improved, with some even averaging 4.0, or straight As.
Jordan Rawls, an 8th-grader at Sterrett Middle School, has been with the program since the beginning and admits that at times it was difficult.
"At first, it was hard to present in front of people you didn't know, and it does involve more work," he said. "We do things two or three times a month."
But he's decided it's worth it, and said his future goals include becoming an anesthesiologist, like his mentor, Dr. Simmons.
Troy Thompson is in his first year with the program and is a 7th-grader at Sterrett. He finds presenting difficult too, especially since, as his mother, Khaleelah Glover, points out, he tends to be shy.
"As he's been given more responsibility, he's gotten more confident around his peers," she said.
She added that the Gateway program was important because it focused on a group of boys with different needs.
"A lot of programs out there are for 'at risk' young men, and those programs are needed," she said. "But these kids need to be rewarded too. They're doing well, and people recognize that."
Dr. Simmons said the Journey to Medicine program attempts to address some of the many reasons why so few African-American men become physicians.
"We need to tell these boys, 'It's OK to be smart, it's OK to do well in school,' " said Dr. Simmons, who pointed to stereotypes and a lack of exposure and role models as significant factors.
"Some of these boys haven't seen many African-Americans who are professionals or physicians," he said. "They can't imagine going to medical school, it's not part of their experience."
Dr. Edwards stressed the importance of quality education as another factor at work.
"A lot is just academics -- our young men are not prepared. A lot of avenues are closed to them, because of economics, because of attending public schools that may not be serving them," she said.
But she indicated that cultural factors may play a role, too.
"I don't think African-American boys get the financial and emotional support from families that females do," she said. "And I think a lot of parents still don't grasp the importance of education."
The problems were difficult, she said, but as physicians, the members of Gateway had little choice about getting involved.
"You either sit on the sidelines and say, 'I'll do nothing,' or you try to change it," said Dr. Edwards.
"Why do we need African-American doctors?" added Dr. Simmons. "Because they are more likely to serve minority and economically disadvantaged communities, they're more invested in improving the lives of African-American people. And if we keep losing boys the way we are, they'll all be left behind."
For more information on the Gateway Medical Society and its youth mentorship program, go to http://www.gatewaymedicalsociety.org/index.html
Kate Luce Angell is a Pittsburgh freelance writer. First Published January 9, 2012 5:00 AM