TAMPA, Fla. — When Dr. Dexter Frederick graduated from medical school, he achieved something no one in his family had done. That feeling of accomplishment led him to create the BEST program, an acronym for Brain Expansions Scholastic Training.
"I'm a first-generation college student, high school student, medical student, and I can tell you, because of what I learned, what I went through, and now as a physician, my total family relies on me for good health," Dr. Frederick said. "I am from the Virgin Islands; I am from a low-income family. And during the summer, I volunteered at hospitals in the Virgin Islands. And during that time, I got to see a doctor that looked like me, who would encourage me to continue that goal of one day, maybe even being a doctor, and they told me you can do it."
In 2004, Dr. Frederick launchedBEST. Since then, he said 5,000 students have gone through the program and more than a hundred graduated medical school.
"I think of my life, and in my young training, young years, I have taken care of maybe, I would say, maybe so far, 25,000, 30,000 patients. I'm hoping we can duplicate that with every student," Dr. Frederick said. "When I think of the work we do as an organization, one student at a time, but that one student turns into 60,000 patients in their lifetime, which we heal in millions and millions of people in our country."
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Diversity in healthcare matters. Dr. Frederick said his program could set the standard for other schools and hospitals.
"We've got to create opportunity for Black and brown kids because the foundation sometimes is not there. And we've got to give them a hand up," Dr. Frederick said. "The neat thing about it is that healthcare is the great equalizer. As Americans, we all deserve quality, compassionate, culturally competent health care. There is a known fact that in the next three, four, or five years, we will have a 50,000 doctor shortage. So I bring this up to say, well, if we know that, if we continue the same course, more people are going to die. More citizens in the U.S. are going to die. And the national statistic for underrepresented, disadvantaged citizens are going to quadruple."
According to a recent Association of American Medical Colleges survey, only 5.7% of doctors identified as Black or African American.
"What worries you the most when you see these studies and the lack of diversity?" Paluska asked Norma Poll-Hunter, the Senior Director for Workforce Diversity at the Association of American Medical Colleges.
"What concerns me the most is that many people still think these obstacles are not real and don't exist. It's almost like this kind of mythology that, you know, Americans can pull themselves up by their bootstraps and make it, you know, and achieve their dream. But the reality is that we have such systemic barriers that started as early as you know, the differential rates of infant mortality, as I mentioned, access to quality education, you know, access to, you know, good jobs for families," Poll-Hunter said. "So a lot of these issues are systemic. And we need to take that approach rather than thinking about putting the onus on the individual or a specific community to make the change. We're all responsible for this change."
Studies show that patients that see doctors that look like them end up having more beneficial medical outcomes.
A 2019 report in theAmerican Economic Reviewfound that Black doctors caring for Black patients could lower cardiovascular deaths among white versus Black patients by 19%.
"I am very optimistic that we could get there as long as we're very focused, that we understand that right now, in many of our states, we are facing attacks against, you know, diversity-focused programs," Poll-Hunter said. "And, we have to understand that this is not about preferential treatment; this is really about addressing the needs of communities that need our support. We cannot ignore the history of racism in our society. But when we look at our data, and we see that the overwhelming majority, over 80%, of entering medical students have come from the highest quintiles of U.S. income, we have to ask ourselves, what is it that we need to do differently to improve access to opportunity for those who are most interested in?"
According to the NIH (National Institutes of Health), "African Americans still experience a lower average life expectancy at birth and have higher death rates for many conditions, including coronary disease, stroke, and cancer, and infant mortality rates."
"As physicians, we make decisions every day. And, sometimes, if you are not in a diverse community, if you're not in a diverse medical school, if you're not training with diverse health professionals, you can make treatment plans based on your perspective. Sometimes that's not always the best," Dr. Frederick said. "Racism will continue in healthcare, and it comes with the term biases, right? So there'll be more bias in healthcare. And I think if we are intentional about creating opportunities, if we're intentional about creating funding, to bring into programs like ours, and programs throughout the U.S. that do the same thing. And if we're intentional about mentoring, to reverse this, we can create a movement to allow more health professionals from all backgrounds to enter."
We talked with two former BEST students. One is about to enroll in medical school the other will graduate from the University of Florida Medical College in May.
"What did you do, and how did you react when you learned that you got into med school?" Paluska asked Darrys Reese.
"Oh, my god. It was funny because I was at work. Running around the entire hospital. I was like, 'Oh my god, I got accepted.' I was calling people, trying to keep it low-key. Every time I wake up, I have to remind myself you got accepted to medical school."
Reese starts at the University of California Irvine School of Medicine this fall.
"Without BEST being in your life, and without Dr. Frederick realizing that he could inspire something, where do you think you'd be right now?" Paluska asked.
"Oh, probably not where I'm at right now without him like it; I couldn't attribute being accepted again without his help. Even if I did, it would have been way, way harder. Like there were definitely points where I was like.... it was a struggle," Reese said. "It's hard without having somebody like, like, in your corner to help you out. So he got the printer for me. He was the guy in the corner for me, so I couldn't really accomplish as much as I did without him."
UF medical student Mitsy Audate felt the same way.
"I truly don't know just because of all the barriers and things I know I didn't have to encounter because I had Dr. Frederick as a resource. I feel like my medical trajectory was exponentially easier and smoother than most people because I had that mentorship and guidance from BEST and Dr. Frederick," Audate said.
"For you, being so diverse and bringing your voice and what you look like to the medical field, what does that feel like? Once you get to that point?" Paluska asked.
"I feel honored. And I never even realized the significance of it until you walk into the patient room and see how much more relaxed they get, or like, they tell you, they're proud of you. I'm on this journey, you know, just to become a doctor," Audate said. "But, I didn't realize, especially not until this last year in medical school, that just my presence is like healing to some people; it gives hope to some people. And so, you know, sometimes the hope I can give might be more healing and more powerful than the medicine I administer. There are just some connections you don't even realize are fostered just from looking like your patient."
Dr. Frederick said they are trying to secure funding to reach every student they can.
"We need the help; we currently run a program from nine to 12. But there is a gap between six and eight, where there are currently no summer programs for them," Dr. Frederick said.
We met with Jo-Lee Lewis, a 13-year-old who dreams of becoming a surgeon.
"I think it's really sad as well that I can't do it. Because I was excited at first when I heard about it, like, oh, gosh, a medical program, and I'm getting help to get in? I want to be in that!" Lewis said.
The pathways program is only offered at Sligh Elementary and middle school, along with Tampa Bay Tech, schools outside Lewis' school district.
"How confident do you feel that you're never going to give up on this dream to be a neurosurgeon?" Paluska asked.
"I will never give up, 100% never give up on the dream," Lewis said. "I am passionate about being a surgeon, and anytime anyone has ever asked me what I wanted to be was a neurosurgeon."
Audate had this advice for anyone who feels marginalized and wants to become a doctor.
"If you don't see many people that look like you don't think, that doesn't mean you can't get to where I am or where those people are that don't look like you," Audate said.
