Is It Fair to Expect Students From Minority Backgrounds to ‘Give Back’ in Their Careers?

Imagine you are a medical student and you’ve received financial aid based on your status as a member of a minority or low-income group. Should you be expected to pursue a career serving in underserved communities?

Not if society wants to tackle social inequity, according to a recent commentary published in the AMA Journal of Ethics by researchers from the University of Delaware, the University of Toronto and Mayo Clinic.

“Society flourishes when we allow its most talented to be free of our biasing expectations of where and how they should use their talents,” says co-author Jon Tilburt, M.D., a health disparities researcher and professor of biomedical ethics and medicine at Mayo Clinic. “We should challenge the status quo that assumes that talented minority clinicians owe more to society than any other clinicians.”

In the commentary, the authors untangle the expectations on a second-year medical student of Native and Latin American ethnicity. She is enthusiastic about applying for a competitive specialty program, but her fellow students assume she will put to use her cultural and language skills as a primary care provider in underserved communities.

Many assumptions — both conscious and unconscious — are at play, related to gender, race, and even the student’s receipt of a scholarship and federal financial aid, say the authors. And these assumptions create barriers at the personal, institutional and societal levels for students who are members of underrepresented minority groups.

“We shouldn’t hold minority clinicians to a higher standard of service just because they grew up in deprivation. We should address the fundamental drivers of inequities in society and then give individuals the latitude to use their gifts like any other student,” says Dr. Tilburt.

“Conversely, we should revisit and potentially bolster the citizenship expectations of all professionals to serve the common good regardless of their background and ethnicity, so that it becomes a common norm that serving in less economically or geographically desirable locations becomes part of the healthcare culture of services.”

Read the article: “Why It's Unjust to Expect Location-Specific Language-Specific or Population-Specific Service From Students With Underrepresented Minority or Low-Income Backgrounds.”

Authors are:

• Barret Michael, Ph.D., University of Delaware
• Maria Athina (Tina) Martimianakis, Ph.D., University of Toronto
• Jon Tilburt, M.D., Mayo Clinic
• Frederic Hafferty, Ph.D., Mayo Clinic

— Kris Schanilec, Public Affairs