Why aren't there more African-American physicians? A qualitative study of African-American high-school students' perspectives

Background: African-Americans (AAs) comprise 13% of Americans but only 4% of US physicians. The reasons for this disparity are unclear.Objective: To identify AA high-school student perspectives on barriers to AAs pursuing careers in medicine. Methods: Focus group interviews (consisting of 13 questions) were conducted of AA high-school juniors attending a Milwaukee public high school in which 82% of students are AA. All interviews were transcribed, and analyzed using grounded theory. Results: The 12 students interviewed in 2 focus groups had a mean age=17 years; 41% of students' parents were high-school graduates. Major barriers to becoming a physician cited by students included financial constraints (college and medical school are too costly), lack of knowledge about medicine, little/no encouragement at home or in school (“It's not that [I'm not interested], but nobody else is really trying to encourage me to go to medical school”), negative peer views on excelling academically (“When there's one of you and sixty of them, everyone of them is kicking and having fun and you sitting there in the corner reading your book, that's gonna get to you”), lack of AA role models in the community and on TV, racism in medicine, and easier and more appealing alternatives for making money (“We think in order to make it out of the projects, you gotta be a rapper or have a jumpshot”). Students stated that increasing the number of AA physicians would enhance patient-physician communication and relationships (“We can relate more, they tell you what to do but they still understand where you coming from”), and more AAs would become physicians if there were greater exposure to medicine in schools, more guidance at a younger age, and more role models (“If you're surrounded by people that are going to college and becoming doctors, maybe it'll change the outcomes”). 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 contribute to racial disparities in the physician workforce. Exposure at a young age to role models and to medicine as a profession might increase the number of AA physicians.