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President's Column

How ACP-ASIM is strengthening ties with IMGs and African American doctors

From the October 1999 ACP-ASIM Observer, copyright 1999 by the American College of Physicians-American Society of Internal Medicine.

As President of ACP-ASIM, it is my privilege and pleasure to interact with other medical organizations. Recently, I attended the annual meetings of two organizations with which the College plans to work more closely: the American Association of Physicians of Indian Origin (AAPI) and the National Medical Association (NMA).

While attending both organizations' meetings, I noticed how many of their highly qualified members have never applied for membership in the College. I suspect that there are also members of the College who have not joined the AAPI or the NMA but would benefit greatly from membership.

All organizations know that their existence is threatened unless their membership continually grows. In addition, we all depend on new members for their original ideas, energy and support.

One of our goals, then, will be to boost the memberships of ACP-ASIM, AAPI and the NMA by sending out joint mailings. In this month's column, I would like to introduce you to these organizations and some of the areas in which I think we can work together.

IMGs

At the June annual meeting of AAPI, which represents the interests of the more than 32,000 physicians of Indian origin practicing in the United States, physicians voiced concern about the treatment of international medical graduates (IMGs). Of particular concern was the Educational Commission for Foreign Medical Graduates' clinical skills assessment exam, which requires all IMGs to be tested for clinical competency before beginning residency training.

In part because of the large number of IMGs in its ranks, internal medicine has long advocated on behalf of IMGs. In 1996, the College's Board of Regents passed a position statement calling for equitable treatment of IMGs, including education, licensure and training. The paper concluded that IMG residents and fellows should receive compensation equivalent to that of U.S. and Canadian housestaff, that documentation barriers should be eased when possible and that support programs should be established to help IMGs adjust to U.S. society. The paper also stated that the College encourages IMGs to participate in leadership roles in the organization. (The full text of the paper is available in the "Where We Stand" section of ACP-ASIM Online.)

When I talked to AAPI leaders, it became obvious that we have much more in common than just our concerns about how IMGs are treated. Both our organizations actively support universal health insurance, a patient bill of rights and managed care reform. We also both strongly support CME programs for our member physicians. In August, the College endorsed an international conference in Srinagar, Kashmir, at which Regent Faroque Khan, MACP, lectured.

While we have shared similar concerns for many years, AAPI and the College have just begun to actively work together. College staff and leadership have attended AAPI meetings, and AAPI's past president, Kalpalatha Guntupalli, FACP, who is a valuable member of the College's Scientific Program Subcommittee-2000, has spoken at several Annual Session events. We look forward to new projects and new ideas.

Minority physicians

At NMA's national meeting in August, I met with the Board of Trustees and attended the presidential reception.

NMA, which represents African American physicians, is committed to preventing diseases and conditions that disproportionately affect African Americans and underserved populations. One of the ways it hopes to achieve those goals is by working to increase the number of African Americans in medicine.

Though racial and ethnic groups comprise a full 21% of the U.S. population, they make up only 8% of the U.S. physician population. To make matters worse, that number is shrinking.

The Association of American Medical Colleges (AAMC) has reported that the enrollment of underrepresented populations (African Americans, Mexican Americans, mainland Puerto Ricans and American Indians) into medical schools grew between 1986 and 1994, when it peaked at 2,014. In 1995, there was no increase, reflecting actions in several key states to dismantle affirmative action admissions policies. By 1996, minority enrollment had decreased by 5%, and in 1997 applications by underrepresented minorities dropped by 11.1%. The number who decided to enroll declined by 6.8%.

This trend is devastating to the public health of many communities. Studies show that minority physicians are more likely to provide care to minority populations and to practice in underserved areas. Physicians from low socioeconomic backgrounds also provide more services to poor and minority patients and Medicaid beneficiaries. It follows, then, that improving the health status of all Americans depends to some degree on ensuring access to physicians who reflect the nation's increasingly diverse population.

The College is currently working with NMA in a number of ways. Leaders from the organization have spoken at Annual Session events, and NMA liaisons sit on the College's Membership Enhancement Subcommittee. That subcommittee recently decided to invite a small number of minority students from local high schools and colleges to the Annual Session African American Reception each year to learn about medical careers. We hope to work with local NMA chapters to identify schools and students.

The College also exhibits at NMA meeting each year and has invited NMA's Cardiology Section to comment on appropriate clinical guidelines under development. Currently, we are planning joint Board preparation courses for practicing physicians in spring 2000.

Our mission

ACP-ASIM's stated mission is to "enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine." The programs and collaborations we're now working on with AAPI and NMA speak directly to that mission. If we're to successfully accomplish our goals, we must continue to seek out valuable partnerships and to combine resources to create programs that make a meaningful difference to the practice of medicine.

I would like to hear from members with thoughts on our efforts with these two organizations. You can reach me at waddingt@rsh.net.

—Whitney W. Addington, FACP

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