Abstract
The professional healthcare admissions process is rife with inequalities, and it is imperative that advisors do not amplify the unequal system. Health professions advisors can use their work with historically marginalized students to overcome systemic racism in pre-health advising and the professional school application process. Health professions advisors must support students who have not historically been supported in pursuing admission to professional healthcare programs. In this chapter, advisors will learn how to engage with those who do not fit the traditional image of a “perfect” candidate for professional healthcare programs. Advisors will learn how historically marginalized students, with non-traditional activities, are in fact strong candidates for their respective professional programs. This chapter also recommends specific language that advisors can use to engage with students who have varied experiences in order to support them on their journey to a professional healthcare career.
TopBackground
In 1926, William J. Gies, Ph.D. released Dental Education in the United States and Canada, (Gies, 1926) commonly referred to as the Gies Report, wherein Dr. Gies detailed the importance of, and urgent need for, more practitioners of color in the dental profession, recognizing that populations needing the most care receive the least (Booker et al., 2021). Fast forward to 2004, the issue is still front and center in the Sullivan Commission’s report Missing Persons: Minorities in the Health Professions where it is noted that the United States is rapidly diversifying and healthcare professions must become more diverse to reflect the population that they serve (The Sullivan Commission, 2004). The 2015 report from the Association of American Medical Colleges (AAMC) report Altering the Course: Black Males in Medicine (AAMC, 2015) points out that there are fewer black males applying and matriculating to medical school in 2014 than in 1978. Most recently, in April 2021, systemic racism was officially declared a public health crisis in a media statement released by Rochelle P. Walensky, MD, MPH, Director of Centers for Disease Control and Prevention (CDC). The CDC officially defines racism as “a system consisting of structures, policies, practices, and norms that assigns value and determines opportunity based on the way people look or the color of their skin. This results in conditions that unfairly advantage some and disadvantage others throughout society” (CDC, 2021, p.1). While systemic racism has recently been at the forefront of a national conversation about race and ethnicity in America, clearly it is not a new issue (Cruz, 2020).
The 2020 Census confirmed that the U.S. population has grown much more racially diverse (Frey, 2020), and this shifting demographic requires a change in who pursues healthcare careers and provides care to an increasingly diverse population. Since 2010, the multiracial population, defined as two or more races, increased 276%, growing to nearly 33.8 million people in 2020 (Jones et al., 2021; see Figure 1). While this could be due to the additional choices on the 2020 census form (Denby & Wang, 2021), it could also be related to the fact that Latinx/Hispanic individuals were not comfortable checking just one box for their race identity, identifying more with their ethnicity than the racial categories offered by the form (Wang, 2021). Regardless, two things are clear. First that the new boxes on the 2020 census allowed for individuals to more accurately self-identify, and second that the America of the future will continue to be a more richly diverse, multiracial, and multiethnic population.
Figure 1. Percentage change in race groups: 2010 and 2020
Key Terms in this Chapter
Gatekeeping: The act of limiting access and controlling the outcome of an individual or group of people based on internal bias.
Bias: Tendency to be for or against something or someone based on preconceived notions.
Predominantly White Institution: Higher education institution where the majority of students in attendance self-identify as white.
White Supremacy: Power structure that seeks to normalize the placement of individuals of European ancestry being above all others.
Racial Wealth Gap: Income disparity between people of different races because of systemic racism.
Oppression: Holding someone back by insisting they are not worthy of their goals.
Student Empowerment: Encouraging a student to take ownership in achieving their goals.
Microaggressions: Subtle or indirect comments or actions that devalue and dehumanize an individual based on one or more facets of their identity.
Core Competency: Career knowledge derived from a skill directly related to an activity.
Equity: Ensuring that all individuals have the resources they need to fully contribute to American society.
Implicit Bias: Unconsciously discriminating against someone because of preconceived stereotypes.
Historically Marginalized Student: A student who has not been given access to the full opportunities of American life due to one or more facets of their identity.
Inclusion: Ensuring that students feel welcome, seen, and heard in a community.
Health Professions Advisor: A primary contact for students interested in working in health professions, typically this person works at an institution of higher education.
Systemic Racism: The manner in which racism permeates the structures of a society.
Safe Space: Environment where students are allowed to embrace all facets of their identity without judgment or penalty.