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Foundation Promotes Medical Careers For Minority, Low-Income Students

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With a sizable boost from the Josiah Macy Jr. Foundation, about 1,000 high-school students--most from minority groups, all from low-income families--will be able to move a step closer to careers in biomedicine, a field in which such groups have, historically, been underrepresented.

Over the next four years, the foundation's $4-million grant will go to seven high schools--two in New York City and five in rural Alabama--to allow them to provide the students with the concentrated mathematics and science curriculum necessary for them to pursue biomedical careers, if they choose to do so, in college and beyond. The grant is believed to be the first provided by a foundation for this specific purpose.

Recipient Schools

The recipient schools include the A. Philip Randolph High School in Manhattan, the Clara Barton High School for Health Professions in Brooklyn, and five high schools in rural Alabama. Officials at the University of Alabama at Tuscaloosa will coordinate the Alabama program.

Although one of the project areas is urban and one is rural, they share similar educational and medical problems and have few resources for remedying them, according to project directors.

The funds will be used to hire and train more teachers, equip science laboratories, provide more and better career counseling, and develop strong and competitive curricula. The New York and Alabama sites will be similar in most respects, but not identical.

The foundation chose the target population--unusually young to be planning for medical school--because education statistics suggested that high school, not college, is the point at which medical careers are ruled out for many minority and rural low-income students.

Until they reach college, students from the different racial groups are proportionally represented in mathematics and science enrollment, according to John Bruer, program officer for the Macy Foundation. In college, however, the number of minority students taking what could be a premedical curriculum drops off sharply.

This is reflected in the number of minority students who enter medical school, according to the American Association of Medical Colleges (aamc). In the late 1960's, when minority groups were represented in the medical professions in very small numbers, the medical-college organization set a goal of 12 percent for minority enrollment.

By 1973, nearly 9 percent of all entering medical-school freshmen were black, American Indian, or Hispanic. By 1979, however, fewer blacks were entering medical school, and currently, the percentage has leveled off at between 6 and 7 percent.

Although the causal links are hard to document, some observers believe that the Bakke case, a reverse-discrimination question decided by the Supreme Court in 1978, has significantly and negatively affected the rates at which minority students are accepted by medical schools.

In its decision, the Court ruled that educational institutions could not establish quotas for minority-group enrollments.

Charles Fentress, director of public relations for the aamc, pointed out that although the number of qualified white applicants to medical schools has grown over the past decade, the pool of qualified minority applicants has held steady at about 3,000.

One reason for this, organization officials believe, may be that black students are choosing other careers that require less commitment of time and money.

Inadequate Backgrounds

But another, Mr. Fentress said, may be that a disproportionate number of minority students do not have adequate scientific backgrounds. "That's been a problem, too," he said. "They're really not coming out of college prepared to be competitive."

Students from rural areas, regardless of whether they are members of a minority population, are also less likely to pursue careers in medicine, according to Harry J. Knopke, associate dean for academic affairs at the University of Alabama's College of Community Health Science at Tuscaloosa, who will direct the project with Robert S. Northrup, chairman of the department of community medicine there.

Over the last 15 years, fewer than 10 percent of the applicants to Alabama medical schools have been from rural areas, Dr. Knopke said. Of these, only a small percentage have been accepted.

The situation has implications for health care in rural areas, many of which suffer from shortages of physicians; physicians who are from rural areas are much more likely to return to them to practice medicine.

But those involved with the Macy foundation program and officials of the aamc agree that the problem begins long before the students reach college. Low-income minority students, many of whom attend inner-city or rural schools, frequently do not take the science and mathematics courses that would qualify them for further study, Mr. Bruer said. The problem, although not confined to this group, is more acute for such students.

"In terms of what you need to study medicine, the deck is pretty much stacked by the time you finish high school," said Morton Slater, director of admissions for the City College of New York's seven-year B.S./M.D. biomedicine program and project director for the Macy-sponsored program at Randolph High School.

For example, in Alabama, Mr. Bruer said, students are required to take one year of mathematics and one year of science to graduate from high school. Both courses, typically, are general and do not provide students with a strong base for continuing with either subject in college. "People with that sort of minimal exposure to science and other quantitative subjects just cannot compete," Mr. Bruer said.

Dr. Knopke agreed, noting, "There are not enough [rural] students who can compete with their urban counterparts. Students don't have the same educational opportunities. A student who is bright and interested doesn't have the chance to go to college, much less medical school."

And although some districts offer "enriched" or accelerated programs in science, the population of students targeted by the foundation is less likely to participate in these programs. In New York City, Mr. Slater said, almost no students from the low-income districts in which they recruited for the Randolph pro-gram were accepted into the Bronx High School of Science and Stuyvesant High School, the city's two highly respected science high schools. One month of recruiting yielded 1,000 applicants to the Macy program, 300 of whom met the minimum standards for acceptance.

Ability and Achievement

The schools involved in the project will use the Macy grants in slightly different ways. At each site, about 100 students--most about to enter the 9th grade--have been chosen to participate. Students were selected on the basis of ability and achievement, as well as other factors, such as determination.

For the Randolph project, Mr. Slater said, admissions officials interviewed 300 students and their parents. "Parent involvement will be important," he said, since much will be demanded of the students, and it is important that parents be aware of this. At that project, about 40 percent of the students are male, 60 percent female.

The school will receive $2.6 million for the project, and will use the funds to set up a "minischool." Class size will be limited to about 20 students, which will necessitate hiring more teachers. In addition, the school will provide more guidance counselors and will provide medical students from City College as tutors.

The curriculum will emphasize science, but not to the exclusion of other subjects. There will be considerable emphasis on social studies, especially as it relates to the problems of the city, Mr. Slater said. The school will also emphasize oral and written communication, both of which are essential skills for physicians.

The Clara Barton High School for Health Professions, established as a "magnet" school in 1972, will have a different approach to using its $340,000 grant. The students are already preparing for careers in the health professions, so the funds will be used to strengthen a special honors program, according to Sylvia Ballatt, principal of the school.

Through this program, the school will enhance an already strong curriculum--currently, 95 percent of the students go on to college. "We get two or three students a year into biomedical programs [special seven-year programs from which the student receives both a B.S. and an M.D. degree], Ms. Ballatt said. "With this, we can get eight or nine in.''

'Science-Projects' Course

During the 9th and 10th grades, students will take a special "science-projects" course designed to expand their critical-thinking ability. The program will stress scientific research, so that by the time students reach the 12th grade, they should be able to conduct relatively sophisticated experiments on their own.

In Alabama, where the project will receive a $985,000 grant, the relatively large geographic distances involved require a different approach. Students will attend their regular county high school, but those selected for the program will take special courses, taught by teachers who have been chosen and trained for the program. The students will spend Saturdays working at the university, and will, beginning in 1983, spend six weeks on campus during the summer, according to Dr. Knopke.

The courses will emphasize science, mathematics, and writing. The students will work with university premedical students, partly to help their academic performance, but also to make them more comfortable with the thought of going to college. Many of the students--officials have no exact figures--will be the first member of their family to attend college.

Foundation officials and the directors at the various sites all emphasize that the project's goal is to provide the students with a broader range of choices when they finish high school than many of them otherwise would have had. They note that the overall goal is one of enrichment; project directors will not be distressed if the students pursue other careers. "That's fine, as long as they make the choice," Mr. Slater said.

"If they decide to be poets or journalists or educators, that's okay with us, too," Mr. Bruer said.

"If they want to be doctors, we don't want them to settle for anything lower,"said Ms. Ballatt of the Clara Barton School. "If they want to be registered nurses, we don't want them to have to be practical nurses."

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