Has the well run dry? Priming the diversity pump in PhD programs.

America has always described itself as a melting pot of people and cultures. Perhaps it has become more of a "boiling pot" as assaults against affirmative action and charges of racism run rampant. Underrepresented minorities in the United States remain well below the national average with regard to education, employment, and health status. While today these minorities make up nearly 25% of the US population, historically they continue to be underrepresented in the medical and research professions. Some progress has been made during the last several decades, but it has stalled. And there is reason to believe that we are facing potentially rapid reversals of what has been painfully achieved. There is a significant pipeline problem in the production of minority doctorate recipients in America today. A review of a cohort of 17-year-old white and black students using a national longitudinal survey of the high school class of 1980 determined that 28% of white students graduated from college, compared with only 11% of black students--a 60% difference. Less than 1% of this original cohort of black students went on to earn science degrees. Doctoral programs now increasingly compete for the same small group of academically qualified minority students. The only long-term solution is to improve the educational opportunities starting from the early stages of the educational pipeline, beginning in elementary school. High school is too late. This process is complicated and will be costly. Pipeline initiatives will demand creativity, flexibility, and a commitment from all of us. We must increase the motivation and preparation of minority students regarding careers in science, engineering, and health care. We in academic health centers must play a key role in strengthening science education and in changing our behavior. We need to address the reasons why more than half of black students who enter college fail to graduate, why there is so little interest in science, and why minority students are not better prepared in science while they are in secondary school. And we need to address these issues now.