Acosta David, Olsen Polly
University of Washington School of Medicine, Seattle, Washington 98195-7430, USA.
Acad Med. 2006 Oct;81(10):863-70. doi: 10.1097/01.ACM.0000238047.48977.05.
Minority populations in the United States are growing rapidly, but physician workforce diversity has not kept pace with the needs of underserved communities. Minorities comprised 26.4% of the population in 1995; by 2050, these groups will comprise nearly half. Medical schools must enlist greater numbers of minority physicians and train all physicians to provide culturally responsive care. The University of Washington School of Medicine (UWSOM) is the nation's only medical school that serves a five-state region (Washington, Wyoming, Alaska, Montana, and Idaho). Its mission addresses the need to serve the region, rectify primary care shortages, and meet increasing regional demands for underserved populations. The UWSOM Native American Center of Excellence (NACOE) was established as one important way to respond to this charge. The authors describe pipeline and minority recruitment programs at UWSOM, focusing on the NACOE and other activities to recruit American Indian/Alaskan Native (AI/AN) applicants to medical schools. These programs have increased the numbers of AI/AN medical students; developed the Indian Health Pathway; worked to prepare students to provide culturally responsive care for AI/AN communities; researched health disparities specific to AI/AN populations; provided retention programs and services to ensure successful completion of medical training; developed mentorship networks; and provided faculty-development programs to increase entry of AI/AN physicians into academia. Challenges lie ahead. Barriers to the pipeline will continue to plague students, and inadequate federal funding will have a significant and negative impact on achieving needed physician-workforce diversity. Medical schools must play a larger role in resolving these, and continue to provide pipeline programs, retention programs, and minority faculty development that can make a difference.
美国的少数族裔人口正在迅速增长，但医生队伍的多样性却未能跟上服务不足社区的需求。1995年，少数族裔占美国人口的26.4%；到2050年，这些群体将占近一半。医学院必须招募更多的少数族裔医生，并培训所有医生提供具有文化适应性的医疗服务。华盛顿大学医学院（UWSOM）是美国唯一一所服务于五个州（华盛顿州、怀俄明州、阿拉斯加州、蒙大拿州和爱达荷州）的医学院。其使命是满足该地区的需求，纠正初级医疗服务短缺的问题，并满足该地区对服务不足人群日益增长的需求。UWSOM美国原住民卓越中心（NACOE）的设立就是应对这一使命的重要举措之一。作者描述了UWSOM的人才输送和少数族裔招募计划，重点介绍了NACOE以及其他吸引美国印第安人/阿拉斯加原住民（AI/AN）申请医学院的活动。这些计划增加了AI/AN医学生的数量；开发了印第安健康路径；努力让学生为AI/AN社区提供具有文化适应性的医疗服务；研究AI/AN人群特有的健康差距；提供留校计划和服务以确保成功完成医学培训；建立指导网络；并提供教师发展计划以增加AI/AN医生进入学术界的人数。未来仍面临挑战。人才输送的障碍将继续困扰学生，联邦资金不足将对实现所需的医生队伍多样性产生重大负面影响。医学院必须在解决这些问题上发挥更大作用，并继续提供能够产生影响的人才输送计划、留校计划和少数族裔教师发展计划。
