HRSA Opens Doors for Minorities in Health Professions 

By Claude Earl Fox, MD, MPH


Closing the Gap, Putting the Right People in the Right Places • May/June 1999


Disparities between the health of racial and ethnic minorities 

and Whites persist for a complicated interplay of causes, 

some of which medical science does not yet know or understand. 

But one cause is very clear: inadequate access to quality health 

care, particularly preventive and primary care. Uneven access to care is 

known to be more of a problem for racial and ethnic minorities, who 

tend to earn less, to be uninsured, and to live where health care professionals are scarce. 

The good news is that the Health Resources and Services Administration (HRSA) is helping to change this through a range of programs that improve access to health care for underserved people. 

Because one obstacle that stands in the way is financial, HRSA 

supports health centers, Ryan White Comprehensive AIDS Resources 

Emergency (CARE) Act programs, maternal and child health services, 

and other health care efforts that care for people regardless of their 

ability to pay. 

But access is a matter of more than money. It’s also having the 

right people in the right places. In our increasingly diverse nation, that 

means making sure we have racially and ethnically diverse health care 

providers at work in underserved communities, where minorities are 

more than half the population. 

Minority physicians, nurses, and other health professionals are 

two to five times more likely to care for minority patients than their 

White counterparts. Only about 10 percent of health professionals 

are African American, Hispanic, American Indian, or Alaska Native. 

To assure access to essential health care for racial and ethnic minorities, 

HRSA also mounts an aggressive effort to bring racial and ethnic 

minorities into the health professions, including primary care medicine, nursing, dentistry, allied health, and public health. 

Opening doors for young minorities 

It was in high school that Martha Laura Aleman discovered science. St. Mary’s University sent students and faculty to her school in 

Kingsville, Texas. The goal: to challenge students like Martha to excel 

in subjects that can open doors to health careers. For three years, she 

participated in the St. Mary’s program and set her sights on medical 

school. Although she and her mother always struggled to make ends 

meet, Martha realized her dream and entered the University of Texas 

Medical Branch in Galveston in 1995. 

When she graduates this year, she and her husband, Mario 

Esparza—also a participant in the St. Mary’s program and a medical 

student in Houston—will try to practice medicine in a way that inspires other disadvantaged, minority students to take similar career 

paths. 

Before minorities can become health professionals, they have to 

become health profession students. This is a feat often 

more difficult for racial and ethnic minorities and students from economically disadvantaged backgrounds. 

Math and science requirements are demanding. Test scores must be 

high. Students have to be motivated. They also have to believe they 

can succeed. 

To give promising minority students a boost in both academics 

and confidence, HRSA’s Bureau of Health Professions’ 132 Health 

Careers Opportunity Programs (HCOP) bring health professions 

schools into high schools and undergraduate programs. Students meet 

minority health professionals, learn about the rewards and opportunities in health care careers, and participate in intensive academic enrichment programs that prepare them for the rigors of course work and 

clinical training. Last year, more than 6,000 students participated in 

HCOP. Their acceptance rates into health professions training were 

20 percent above the national average. 

Minority communities wanting to “grow their own” health professionals, look within themselves through “Partnerships for Health 

Professions Education.” In seven regions that are predominantly African American, Hispanic, American Indian, Native Hawaiian, or Pacific Islander, health professions training programs work together with 

local health care providers, schools, and other partners. 

Beginning in elementary school, the partnerships build awareness of health professions and make sure minority children see minority health care providers in action. Summer science programs and 

camps, even health care magnet school programs encourage and prepare young people for health professions training. 

Preparing schools, not just students 

While helping minority students prepare for health professions 

training, we must also help health professions schools prepare to educate a diversity of students. Culturally competent curricula, community-based clinical training, and racially and ethnically diverse faculty 

all create a favorable environment for minority students. 

Just four percent of faculty at U.S. health profession schools are 

minorities. One remedy: HRSA’s Minority Faculty Fellowships, which 

last year enabled two medical schools to train two minority individuals for faculty positions in their departments of family medicine. 

Of course it’s also important to create change on a larger scale and 

make recruitment and retention of minority faculty and students a 

front burner issue at training programs across the Nation. That’s why 

HRSA’s Bureau of Health Professions support 22 Centers of Excellence programs that increase the capacity of training programs at Historically Black Colleges and Universities, Hispanic Serving Health 

Professions Schools, and programs that serve concentrations of American Indians, Native Hawaiians, and other minorities. 

Centers of Excellence are models of infusion. They recruit and 

retain minority faculty and students, carry out research specific to 

racial and ethnic minorities, provide culturally appropriate clinical 

education, and develop curricula and information resources that respond to the needs of minorities. 

continued>>>> 

Office of Minority Health Resource Center 1 U.S. Department of Health and Human Services 
HRSA Opens Doors for Minorities in Health Professions 

By Claude Earl Fox, MD, MPH


Closing the Gap, Putting the Right People in the Right Places • May/June 1999


Centers of Excellence make a difference

 Florida A & M University College of Pharmacy and Pharmaceutical Sciences: The school’s Center of Excellence promotes career 

opportunities in pharmacy to African American high school students 

and counselors throughout Northern Florida. African American students in the pharmacy program are matched with mentors. Faculty 

and students also work together to conduct research on pharmacy in 

the African American community. 

University of California at San Diego: The Center focuses on 

increasing the number of Hispanic students and faculty in its school 

of medicine and forging a strong link with nearby Hispanic neighborhoods. The Center promotes science studies among Hispanic middle 

and high school students, provides primary health care in community-based clinical training sites, and conducts research into the health 

issues that affect Hispanics. 

University of Washington School of Medicine: American Indian 

traditional healing and modern medicine complement each other in 

the classroom and clinic. Students serve clerkships at rural and urban 

providers that primarily serve American Indians. Fellowships support 

American Indian physicians’ research and prepare them for academic 

careers. 

Critical links: scholarships and loans 

Disadvantaged minority students who dare to dream of enrolling in health professions still need one more link to complete the 

chain. To make the connection between student and school, HRSA 

provides financial assistance in the form of scholarships and loans to 

disadvantaged students. HRSA’s National Health Service Corps places 

health care professionals in underserved areas, where they fulfill a 

service commitment in exchange for tuition assistance or student loan 

repayment. 

Students who overcome financial barriers to health professions 

training, we have found, are much more likely to work in medically 

underserved areas and care for underserved people. Patients report 

that these health providers also understand firsthand how cultural 

and economic differences affect health. Two programs, “Exceptional 

Financial Need Scholarships” and “Financial Assistance for Disadvantaged Health Professions Students,” cover the full costs of medical and 

dental education, including tuition, fees, and related expenses, for 

students with exceptional financial need. In fiscal year 1997, 1,060 

scholarships were awarded, More than half (57 percent) of the recipients were minorities. In exchange for their scholarships, students commit to at least five years of primary care practice. 

The National Health Service Corps also awards scholarships for 

medical, nurse practitioner, nurse midwife and physician assistant 

training in exchange for practicing primary health care in shortage 

areas upon graduation. In fiscal year 1998, 34 percent of the 326 

students who received Corps scholarships were minorities. More than 

2,000 Corps providers are currently caring for underserved people. 

Also, in exchange for service in shortage areas, the Corps offers a 

loan repayment program. In 1998, 33 percent of the program’s participants were minority physicians, dentists, nurse practitioners, nurse 

midwives, physician assistants, and mental health providers. HRSA’s 

Bureau of Health Professions makes low-cost loans to disadvantaged 

health professions students directly or through participating primary 

care training programs. More than a third of these loan recipients are 

minorities. 

Health professionals may also receive help from HRSA in repaying their student loans. Physicians, dentists, veterinarians, optometrists, podiatrists, pharmacists, nurses, and public health professionals who have not served as faculty in a training program within 18 

months may contract to serve as faculty for at least two years and 

qualify for loan repayment or faculty fellowship. 

This year, HRSA will invest $416 million in health professions 

training to increase diversity and improve distribution. This relatively 

small investment will yield more than 10,000 new health care providers who are attuned to the needs of racial and ethnic minorities. The 

high quality care they provide, the role models they become, the 

cultural sensitivities they possess—these are the vital connections 

needed to eliminate racial and ethnic disparities in health in the next 

century. 

For more information about HRSA Bureau of Health Professions 

training programs, visit: http://www.hrsa.gov/bhpr, or call 301-443­

2100. For information on the National Health Service Corps, go to 

http://www.bphc.hrsa.gov/nhsc, or call 1-800-221-9393. 

Dr. Fox is Administrator of the Health Resources and Services Administration, U.S. Department of Health and Human Services.

Office of Minority Health Resource Center 2 U.S. Department of Health and Human Services