Dr. Mark Henderson on Creating a More Diverse Physician Workforce of the Future

Mark Henderson, MD, is the associate dean for admissions and the vice chair for education in the department of internal medicine at the University of California, Davis, School of Medicine. Over the past 18 years, he has been instrumental in making UC Davis School of Medicine one of the most diverse in the United States.
Dr. Henderson recently paid a visit to Albert Einstein, where he presented at the department of medicine’s Grand Rounds, on “Clinical Microteaching: Making It Stick.” enCOMPASS spoke with him about how UC Davis has succeeded in raising the bar in its efforts to train a more diverse physician workforce—one that will better meet the health needs of our communities.
Here are three key steps medical schools can take.

  1. Start with your selection committee. “If you don’t change the decision-makers, you will get more of the same,” Dr. Henderson says. “Part of how we created a more diverse selection team was to look beyond our faculty. We had people from the community, including patients, participate in the multiple mini-interviews for our medical school applicants. One was a police officer who worked on our campus. At first you might think, that's crazy—these people don't know anything about medicine. But that's not true. Every person who's ever been to a doctor knows something about medicine.”
  2. Look beyond the traditional acceptance criteria. “One key factor we added is what I call ‘lived experience of healthcare,’” says Dr. Henderson. “If an applicant or their family member has had trouble accessing healthcare, cared for an ill relative, or worked in a community healthcare setting, maybe as a medical assistant, we prioritize that. By doing this, we wind up including more students from lower income backgrounds, and we need people from those backgrounds in our physician workforce because they understand the healthcare challenges that many of our patients face. We also developed a socioeconomic scale that indicates how economically advantaged or disadvantaged an applicant is. A student with a lower GPA who had a job in order to support their family, or is the first generation in their family to attend college, should be considered differently than a student with a higher GPA whose family could afford tutors. This is not the only metric we use in choosing our students, but it provides context.”
  3. Create new pathways. “Twenty-five percent of Californians live in rural areas. Yet only 10 percent of physicians practice in these communities, which often have low educational and economic resources,” says Dr. Henderson. “We started accepting students from rural areas, prioritizing their lived experiences growing up there. They understand the culture of a patient from a rural background and the disparities encountered there. And they're much more likely to eventually practice in a rural area. We built five of these programs under the overarching rubric of Community Health Scholars. One recruits future doctors from the Central Valley, which is home to many migrant workers. We have one focused on underserved urban areas, and another for tribal and Native American communities. Lastly we have a three-year degree program focused on primary care, with most graduates staying on for residency in the local community, thanks to relationships we’ve developed with local hospitals and healthcare providers such as Kaiser Permanente. A third of our students are enrolled in one of these medical school pathways. We’ve also cultivated upstream (pre-medical) partnerships, including with local community colleges. These programs help us recruit medical students from a wider range of backgrounds, who will go on to practice in areas where the need is greatest.