For Your Health

News from the University of North Dakota School of Medicine & Health Sciences

From the Dean: Broadening our scope

As one of UND’s vice presidents, I had the pleasure to be part of the interview team that visited with the four outstanding final candidates who are under consideration for the deanship at the UND School of Law to follow Dean Mike McGinnis, who is stepping down in June. I enjoyed chatting with all of them; three are outside candidates and one (Brad Myers) is internal.

One comment by one of the outside candidates really got me thinking – when talking about his background, the candidate mentioned that not only was he the first person in his family to go to law school, he also was the first to go to college! As I reflected back on my own upbringing, the option of going to college wasn’t discussed with me or my brothers by our parents – it was assumed. Thus, to chat with someone who is a first-generation undergraduate/law student was instructive and educational for me. It got me thinking about the connectivity of the SMHS with similar potential matriculants but who come from backgrounds where they might not consider college (or the SMHS!) as a viable option. Consider, for example, kids who grow up in rural North Dakota and/or on a reservation. Is being a doctor, a physical therapist, or a nurse even in their mindset and dreams? Or are these professions not even considered as options?

These musings are especially relevant when we think about our efforts (both at UND and the School) to increase the diversity of our student classes, faculty, and staff. I would suggest that there are two critical components to those efforts – one internal and the other in conjunction with external factors. The internal part is that we have to continue to work to make the SMHS in this case attractive to, and supportive of, rural and American Indian potential applicants. We also need to make sure that our application and selection process is fair and equitable, and we need to address potential biases, both explicit and implicit, that might hinder our efforts. I would posit, though, that these important steps, while necessary, are not sufficient.

Additionally, we need to partner with external constituencies to ensure that there is an adequate flow of potential candidates for us to consider for admission. Here is a case in point: up until a few years ago, the number of male African American matriculants in U.S. medical schools actually was lower than it had been some three decades previously (fortunately, this trend subsequently has been reversed). But it also was true that the overall number of male African American applicants to medical schools was lower than it had been decades ago. The point here is that simply improving and optimizing the selection process isn’t likely to have a major impact on what really matters, which is the number of graduating male African American doctors.

Two factors clearly are vitally important if we wish to increase the size of the pool of minority applicants and thus the eventual production of health care providers – pathway programs to introduce and reinforce the concept of becoming a provider, and visible mentors/role models. I’m proud to say that we have both the programs and the people here at the SMHS to accomplish this. To promote American Indian applicants, our Indians Into Medicine (INMED) program sponsors a Summer Institute to introduce youngsters to the possibility of a health career. And Dr. Warne and his colleagues are working on developing similar pathway programs for college students. Similarly, our Center for Rural health sponsors summer events called Scrubs Camps and the on-campus Scrubs Academy to introduce rural kids to the option of an eventual health career. By the way, both of these pathway programs have been curtailed during the pandemic, but we are hopeful they will return this summer.

As far as mentors and role models, the SMHS is proud to be one of a very few medical schools in the country with an American Indian associate dean (Dr. Warne). We also boast one of the larger contingents of American Indian faculty members of any medical school. These folks provide not only guidance to younger students but also serve as examples of what is possible.

We have an equivalent cadre of mentors and role models for our rural students. Dr. David Schmitz, for example, who is the Dr. Verrill & Ruth Fischer Professor and Chair of the Department of Family and Community Medicine, has a long career of practicing in rural regions, so he can not only “talk the talk” but also “walk the walk.” Additionally, all of our medical students, and most of our health sciences students, spend some time during their clinical years interacting with rural providers.

The bottom line is that the way to grow the production of a diverse health care workforce is to simultaneously increase the size of the slice of the pie that is underrepresented as well as to increase the size of the pie itself. We are trying – and succeeding – in doing both!

Finally, thanks to all the doctors in the state (and other health care providers as well) as we celebrated National Doctor’s Day this past Wednesday. Reportedly celebrated on the anniversary of the day when Dr. Crawford Long first used ether for anesthesia, the day is intended to thank all those health care providers who work so diligently for the public good. The SMHS would like to especially recognize and thank those providers who not only care for patients but also help train our students. Many thanks – and congratulations!

Joshua Wynne, MD, MBA, MPH
Vice President for Health Affairs, UND
Dean, UND School of Medicine & Health Sciences