It’s hard to describe the magical feeling of watching someone who looks like you achieve the unimaginable. It’s how I felt the night in 2008 when, as the on-call cardiology fellow, I watched television in one of the hospital’s family lounges as Barack Obama clinched the presidency. It’s also how I felt in 1992 when, as a Latina high school student, I walked through the doors of Cornell University Medical College (now Weill Cornell Medicine) to participate in its three-year-old Health Professions Recruitment Exposure Program. I saw medical students who looked like me and, for the first time, seriously imagined myself as a physician.
Every Friday afternoon, I left my high school in Brooklyn for the Upper East Side of Manhattan, eagerly awaiting that week’s HPREP activities. I heard trailblazing stories of people like Dr. Louis Sullivan, the first black resident at New York Hospital‑Cornell Medical Center, who became the 17th secretary of the Department of Health and Human Services under President George H. W. Bush. I beamed with pride learning that I was standing on the shoulders of giants in medicine.
I recall that it was the first time I learned anything about cardiovascular physiology, which perhaps planted the seed for my future career choice. To be honest, though, I don’t remember much about the science I learned then. The most valuable lesson was in seeing not just one but dozens of medical students and faculty who looked like me.
While in the program, medical students also helped me take my first practical steps in the long journey toward my career as a physician — working on college essays, understanding the financial aid process, and the like.
HPREP’s message was simple yet enormously powerful: You belong here and don’t let anyone sell you short.
The program, which celebrates its 30th anniversary in 2019, was started by medical students at Weill Cornell Medicine with the aim of drawing more underrepresented minority students into the medical field. Now a national program under the auspices of the Student National Medical Association, more than 7,000 high school students have participated in the HPREP program.
Programs like HPREP are often referred to as pipeline programs. I think that’s a faulty metaphor. To me, the pipeline conjures the image of a predetermined linear trajectory. Yet the work of the medical students, faculty volunteers, and staff members who orchestrate these programs is far from linear or simple. HPREP and programs like it are more like complex navigation systems that never stop working. They involve countless hours of nurturing, mentoring, and building communities, all driven by a strong passion for equity and a commitment to give back.
Such programs are still sorely needed. Although the U.S. has become more diverse since I started my HPREP program in 1992, the medical profession hasn’t changed that much. Latinos/Hispanics now make up 18 percent of the U.S. population, but only 5 percent of medical school graduates. African-Americans make up 13 percent of the U.S. population, but just 5 percent of medical school graduates. In my field of cardiology, the percentage may be even lower.
For students from underrepresented minorities who do become physicians, those who decide to pursue careers in academic medicine face other challenges. They are less likely to be promoted, have lower incomes than their white counterparts, and are less likely to receive research grants from the National Institutes of Health.
Just 4 percent of instructors (the lowest rank held by faculty physicians) are Latino. Among full professors and deans, less than 3 percent are Latino. It’s easy to imagine how a young person of color might be dissuaded from entering academic medicine — and along with that the talent lost from a field dependent on innovation.
That’s where HPREP has made a difference.
A physician community that resembles the face of the “American community” benefits everyone. Students trained in racially and ethnically diverse medical school environments feel more culturally competent and prepared to care for the patients they serve. As we treat increasingly complex patients and work within larger multidisciplinary teams, medicine has evolved from an individual to a team sport. A winning team is one that leverages all of its members’ unique abilities and talents and recognizes that “great minds think differently.”
My own path in medicine has been bolstered by HPREP and other programs like it at later stages of my training and career. My peers and faculty members have helped mitigate feelings I mistakenly thought were unique to me: frustration about microagressions, stereotype threat, isolation, and self-doubt. I was not the only one mistaken for anyone but the doctor, or who cringed every time I witnessed someone call my Latina patient “Mami.”
The early affirmations I got from HPREP inspired me for years after I had completed the program, and still motivate me. A few years ago, I was filled with joy and hope while speaking with HPREP students and their families at their annual graduation ceremony in the spring. I reminded them that they not only belonged in medicine, but could truly thrive in it. That’s what HPREP did for me.
Jessica M. Peña, M.D., is a cardiologist and assistant professor of medicine and radiology at Weill Cornell Medicine.