In the 2003 landmark Supreme Court decision on affirmative action at the University of Michigan Justice Sandra Day O’Connor wrote, “We expect that 25 years from now, the use of racial preferences will no longer be necessary to further the interest approved today.” Since that 2003 decision, the United States has made little progress in the areas Justice O’Connor had hoped, says Jorge Girotti, director, The Hispanic Center of Excellence at the University of Illinois College of Medicine. In fact, it appears the country is moving backwards, he added.

Statistics suggest that most U.S. medical schools can just attract, enroll or graduate significant numbers of Latinos. In the 2018-19 school year Latinos comprised only 6.4% of students enrolled in U.S. medical schools. Some schools, however, are the exception.

The University of Illinois College of Medicine, for example, enrolled 219 Latino students in the same period. That’s 16% of its entire student body. All other medical schools in Illinois enrolled just 175 combined, or about 5%. The College of Medicine is educating half of the Latino medical students in the state. “We’ve developed a track record of admitting and graduating a diverse student (population),” Girotti said. “We educate a disproportionate number of Latino physicians.”

Support From Leadership And Admissions

The Hispanic Center of Excellence (HCOE) was established in 1991. It’s goal is to improve the medical care of Latinos in Illinois by providing programs that strengthen the pipeline and increase the number of Latino applicants pursuing health careers. By most accounts it’s achieving its goal. Since 1991, the University of Illinois College of Medicine has seen its Latino graduation numbers rise. Between 1982 and 1991—before the Center was in operation—the College of Medicine graduated about 84% of its Latino students. Between 2012 and 2018, that percentage rose to 99.1%.

“The total number of matriculands has gone up percentage wise. So we are doing better,” Girotti said. And when he compares Latino graduation numbers to graduation numbers of the rest of the student body, he sees even more progress for Latinos. “We are graduating (Latinos) now at the same percentage as everyone else in the medical school, which was not the case in the earlier decades,” said Girotti, who wrote the initial grant to fund the Center.

Girotti is too modest to take all the credit for the rise in Latino graduation numbers. Much of the increase, he says, is due to the support of the school’s leadership, which has adopted an admissions policy that evaluates the entire individual. Without that support, initiatives would fail to yield the desired results. “If you don’t have the support of your dean and admissions committee and campus support, you can have all the great programs you want, (but) it’s not going to make a difference. To me you need to have commitment and support from your leadership,” Girotti said.

Leadership supports a host of policies that align with the school’s mission: addressing the health care needs of the entire community. One policy is the school’s admissions guidelines. “If your mission includes accepting a diverse group of students, then you must work in a holistic manner (and) take into account the ‘road traveled’ by applicants and what you believe they would contribute to your class and to the profession,” Girotti said.

Medical schools, if left to their own means, says Girotti, tend to prefer academic metrics like GPA and MCAT scores. “We know from history that our students don’t do as well in those matrices. But given the opportunity they actually rise to the occasion,” Girotti said.

Supporting The Student

Eighty percent of all medical students in the U.S. have parents who’ve earned at least one college degree. “These are kids who are very sophisticated in their understanding of higher education,” Girotti said. In comparison about half of the Latinos at the College of Medicine are first-generation college students. “That’s a very different kind of student,” Girotti said.

Although academically talented, many first-generation medical students are unprepared for the medical school experience. That’s where the HCOE comes in. The Center offers Latino students social and academic support. “Support means that once you admit students, you continue to support them in every way you can. For many of them, going to medical school will be the first time someone in their family has gone that far,” Girotti said.

Socially, the Center links Latino students with mentors who help them navigate a rigorous medical school program. The Center teams with the Latino Medical Student Association. “They provide peer support, which is huge,” Girotti said.

Academically, the Center provides students with mock medical board exams. “They’ve told us that this support is crucial because it gives them a chance to gage how much progress they’re making towards doing well on the (real) test,” Girotti said. To provide students with a glimpse into the many specialties in medicine, the Center arranges lectures with residency program directors.

Beyond the college walls, HCOE’s mission is to develop culturally and linguistically competent practitioners, which is not always easy. Latino parents are almost preprogramed to discourage their children from speaking Spanish because of the stigma attached. If a doctor cannot communicate with his patient, says Girotti, the quality of the treatment can suffer. “We always try to put at least a basic competence in Spanish as one of the things we ask from participants,” Girotti said.

Patients who see doctors who speak their language are more comfortable and their clinical outcomes are more successful, according to research. “People follow directions better and are willing to ask questions that sometimes they wouldn’t ask if the doctor didn’t speak their language,” Girotti said.

Getting more Latinos into the medical profession is not a static situation. When a student enrolls in a medical program, he or she will not practice medicine for at least seven years. “In that timeframe, our community will go from 17% to maybe 22%. If you were aiming for 17% this fall, by the time (those doctors begin to practice) you’re going to be behind. We need to overshoot the mark. If we know right now Latinos are 17%, let’s shoot for 30%,” Girotti said. •