This story was originally published by Undark and is reproduced here as part of the Climate Desk collaboration.
Aaron Bolds didn’t consider becoming a physician until he tore a ligament in his knee while playing in a basketball tournament when he was 15. His orthopedic surgeon was Black, and they hit it off. “He was asking me how my grades were, and I told him, ‘I’m a straight-A student,’ and he was, like, ‘Man, this is a great fallback plan if basketball doesn’t work out,’” recalls Bolds, who is African American.
“He looked like me,” Bolds says, “and that was even more encouraging.”
If not for that chance encounter, Bolds, 34, a doctor at Mount Sinai Health System in New York, might never have gone into medicine, he says. When he was growing up, there were no physicians in his family or extended social network to model that career path. And at the schools he attended, he says, his aptitude for science didn’t trigger the kind of guidance young people often receive in more privileged contexts.
What Bolds did get attention for was his athletic ability. He got a full basketball scholarship to Lenoir-Rhyne University in North Carolina, where his team won a conference championship. But when he transferred to Bowie State University in Maryland, where he also played basketball, an academic adviser discouraged his pre-med ambitions, Bolds recalls, saying his grades were low and he lacked research experience.
Bolds is not alone in finding in athletics a fraught lever of educational opportunity. Whereas Black players comprise more than half the football and basketball teams at the 65 universities in the top five athletic conferences, and bring in millions of dollars for their schools year after year, the graduation rates for Black male college athletes are significantly lower—55 percent as compared to 69 percent for college athletes overall—according to a 2018 report from the USC Race and Equity Center. Many Black college athletes end up without either a professional sports contract or a clear career path.
Now some educators and advocates are looking to reverse this trend by connecting sports, an area in which African American men are overrepresented, and medicine, where the opposite is true. As of 2018, 13 percent of the U.S. population, but just 5 percent of doctors—according to the Association of American Medical Colleges—identified as Black or African American. (The AAMC data notes that an additional 1 percent of doctors identified as multiracial.) Decades of efforts to increase diversity at medical schools have made progress with other demographics, including Black women—but barely any with Black men. “No other demographic group is broken down with such a large split between men and women,” says Jo Wiederhorn, president and CEO of the Associated Medical Schools of New York. “And none of them have stayed stagnant, like that group has.”
According to data the AAMC provided to Undark, the proportion of Black men enrolling in medical school hasn’t changed much since 1978—with only some headway being made in the past few years.
The absence of Black male medical professionals ripples across the health system, experts say, contributing to widespread health disparities. African Americans tend to be diagnosed later than White people with everything from cancer to kidney disease, leading to more advanced disease and earlier deaths. Meanwhile, a recent study suggests that Black men who see Black male doctors may be more likely to follow medical advice. Other research also suggests that racially concordant care, in which patients and doctors have a shared identity, is associated with better communication and a greater likelihood to use health services.
“We are in a crisis point, nationally,” says Reginald Miller, the dean for research operations and infrastructure at Icahn School of Medicine at Mount Sinai. “I don’t think it’s a stretch to suggest that the health of communities of color are directly proportional to the number of practitioners available to see,” he says. “It’s just that straightforward.”
Last year, the National Medical Association, a professional organization representing African American physicians, embarked with the AAMC on a joint effort to address the structural barriers to advancement for Black men. “We need to look at this with a unique lens,” says Norma Poll-Hunter, senior director of workforce diversity at the AAMC.
There is no single solution to such an entrenched and multifaceted problem, Poll-Hunter says. According to her, some medical schools have adopted a holistic admissions process that evaluates many personal factors rather than relying on standardized test scores, which can exclude promising Black candidates. In addition, she says, students of color need better access to high-quality K-12 science education, particularly in under-resourced public schools. “There are a lot of barriers that exist early on,” she notes, “and that then creates this narrowing of the pathway to medicine.”
But the novel strategy of wooing athletes is slowly gaining traction. Advocates point out that high-performing athletes possess many of the skills and attributes that doctors, psychologists, physical therapists, and other medical professionals need—things like focus, a commitment to excellence, time management, and problem-solving skills, as well as the ability to take constructive criticism and perform under pressure.
“When you say, ‘What’s your ideal medical student?’ it’s not just a kid who’s academically gifted. It’s a kid who’s got resilience, attention to detail, knows how to work on the team,” Miller says. “Because science and medicine are team sports.” And by virtue of being athletes, these young men are already attuned to nutrition, fitness, and other aspects of human biology.
Two former NFL players, Nate Hughes and Myron Rolle, recently became physicians. And there is evidence that competitive sports experience contributes to medical success. A 2012 study of doctors training to become ear, nose, and throat specialists at Washington University, for example, found that having excelled in a team sport was more predictive of how faculty rated their quality as a clinician than strong letters of recommendation or having attended a highly-ranked medical school. Likewise, a 2011 study found that having an elite skill, such as high-achieving athletics, was more predictive of completing a general surgery residency than medical school grades.
Advocates of the athletics-to-medicine pipeline point out its practicality. Thousands of Black men are already in college, or headed there, on athletic scholarships. It would only take a small percentage of them choosing medical careers to boost the percentage of Black male doctors to better reflect the proportion of African American men in the general population, they say.
No one thinks it will be easy. One obstacle, advocates say, is a lack of role models. Black sports celebrities are household names, but some young athletes may never encounter a Black medical professional. “People don’t believe they can become what they don’t see,” says Mark R. Brown, the athletic director at Pace University.
And for the best chance of success, many say, these young men need to form and pursue medical aspirations as young as possible, along with their athletic training. “Those kids who are able to do both, the rewards at the end are enormous,” Miller says. But the adults in their lives may not believe the dual path is possible. “The second that a kid says to a science teacher or someone else that he’s an athlete,” Miller says, “they go into a different category. ‘They’re not really serious about science and medicine, they’re just here, and so I don’t expect this kid to really achieve.’”
Rigid course and practice schedules also make it challenging for busy athletes to undertake demanding and time-intensive science majors, observers say. What’s needed is “a cultural change, and not just a cultural change with the athletes. It’s a cultural change with the whole structure,” Miller says. “Everybody’s excited about the idea” of the physician athlete, he adds, “because it makes sense. But when the rubber hits the road, it is challenging.”
Donovan Roy, the assistant dean for diversity and inclusiveness at Homer Stryker M.D. School of Medicine at Western Michigan University, was one of the first people to envision the potential of directing Black athletes toward medical careers.
Roy, 48, who is Black and a former college football player, grew up in the working class, primarily Black and Latino community of Inglewood, California. Attending an elite private high school on a football scholarship was eye-opening. He vividly remembers the first time he ever saw a walk-in pantry, at a friend’s home. “It was stocked like a convenience store,” he recalls. “Five different types of Hostess, Ding-Dongs, sodas, every type of snack that you ever wanted.” Equally startling was speaking with another friend’s mother, who was a lawyer. “I’d never seen a road map to success in my community,” he says.
Roy’s athletic talent continued to open doors—at 18 he got a scholarship to the University of Southern California—but poorly prepared by the under-resourced public schools he had attended through ninth grade, he struggled academically, and left both USC and later another university that he also attended on an athletic scholarship.
Eventually Roy found his footing, and when he did, he became a learning specialist. After working through his own academic struggles, he wanted to help others with theirs. Roy took a job as a learning skills counselor at UCLA’s medical school. There he helped the students who were struggling with classes like anatomy and genetics. In early 2015, he returned to USC as the director of academic support services at Keck School of Medicine.
Something Roy noticed at both these medical schools stuck with him, though it would take a few years for the observation to crystallize. A certain kind of student sought help despite, by ordinary standards, not needing it. These were the athletes, and many of them were Black or Latino. “They always talked about, ‘How can I excel? How can I get better?’” he recalls. They “were getting 90s and they wanted to be 100.”
Roy began a doctoral program in education in 2015, the same year the AAMC published a damning report about the lack of Black men entering medical school. This was a crisis Roy understood both personally and professionally. For his dissertation, he decided to interview 16 Black male students at Keck School of Medicine. What was it about them, he wanted to understand, that had gotten them there against all odds?
The answer, he discovered, was what academics call social capital. For medical students from privileged backgrounds, social capital might take the form of a family friend who arranges a summer internship at a biotechnology lab, or a well-funded high school that offers advanced placement science classes. The young men Roy interviewed did not, for the most part, have access to those sorts of resources.
“Growing up, I didn’t see a Black male with a college degree until I got to college,” medical student Jai Kemp said in a separate interview Roy conducted for a documentary he’s making on the topic. The social capital these young men leveraged to get to medical school took the form of parental support, science enrichment programs and clubs, peer social networks, faculty mentors—and the perks that come with athletics. “For me it was just sports that got me through,” Kemp said.
The pieces started to fit together. Roy knew from his own experience all the benefits athletes get, not just entrée to educational institutions, but travel, enrichment, and academic advantages like tutoring and early class registration. Athletes also tend to possess social cachet on campus and, with more exposure to different types of people, may feel comfortable in environments that seem foreign and forbidding to other young people from disadvantaged backgrounds. Roy also recalled the drive for academic excellence he had observed in the athletes who came to his tutoring programs. “I got this epiphany,” he says. “Why don’t we look at student athletes in order to increase Black males’ representation in medicine, because they have the most social capital and the most network on predominantly White campuses.”