DURHAM, N.C. -- Medical school admissions directors face a
continuing dilemma -- the nation's long-running economic
expansion has lured many of the country's most talented
students into such professions as business or law, resulting in
a shrinking pool of the "best and brightest" applicants for
medical schools.

Under-represented minorities (URM), who make up a small
fraction of that pool, are as a group the hardest hit by the
decline.

This worries Dr. Brenda Armstrong, director of admissions at
the Duke University School of Medicine. While Duke's track
record in attracting URMs to its medical school is one of the
best in the country, there is a growing realization that in
order to increase the numbers of URMs in future applicant
pools, promising students must be identified and nurtured
earlier in their education.

For that reason, Armstrong and colleagues developed a summer
institute that has been funded by a five-year, $1.5 million
grant from the Robert Wood
Johnson (RWJ) Foundation, Princeton, N.J. Duke is providing
$2.8 million in matching funds for the Duke University Summer
Biomedical Science Institute, a Minority Medical Education
Program. The program provides support for travel to and from
the institute, room and board, books and supplies for
participants.

The residential academic program for gifted
under-represented minorities will open its doors in June 2001.
It is expected that 125 college freshman, sophomores and
juniors as well as a limited number of post-graduate students
will participate each year.

The RWJ Foundation, in conjunction with the Association of
American Medical Colleges, has funded eight such programs since
1988, including sites at Yale University, the University of
Virginia, Baylor College of Medicine, Vanderbilt University,
the University of Washington, Case Western Reserve University,
the University of Alabama at Birmingham and the Consortium of
Chicago Medical Schools. The foundation has provided funding
for three additional universities this year: Duke, Columbia
University and the University of Medicine and Dentistry of New
Jersey Robert Wood Johnson School of Medicine.

"The Robert Wood Johnson Foundation program has shown that
participating minority students were significantly more likely
to be accepted to medical school than those who didn't
participate," Armstrong said, citing a study published in the
Sept. 2, 1998, edition of the Journal of the American Medical
Association.

"While all the programs have similarities, each is unique in
its own way," she said. "For example, our institute will be the
first to offer a completely web-based curriculum which includes
course work in advanced biology and chemistry, calculus and
biophysics. The integration of course work over a web-based
format will enable the students to experience the kind of
academic environment typical of modern medical education."

Armstrong said the program will be an intensive experience
whose goal is to prepare students to move ahead in their
pre-medical preparation in academics, clinical exposure and
other skills necessary to successfully compete for medical
school acceptance. While on campus, the students will wear
white coats and Duke badges identifying them as institute
scholars, a distinction that is important for Armstrong.

"These are very bright kids whose talents have been
identified early, and those in whom everything to date points
to the potential for great achievement and success," she said.
"We are here to help them realize their potential in
medicine."

It is estimated that URMs -- African-Americans,
Mexican-Americans, native Americans and mainland Puerto Ricans
-- make up about 21 percent of the U.S. population, but less
than 9 percent of U.S. physicians.

"It is important to train more physicians of color because
we know that as a group they tend to return to their
communities to practice medicine," Armstrong said. "These
communities are typically populations at the greatest risk for
negative outcomes from disease, and they present the greatest
challenges to the health care system."

Institute faculty will be chosen from Duke Ph.D.s, many of
whom are minorities. The resident advisers (RAs) in the dorms
and the teaching assistants (TAs) will be drawn from the ranks
of third-year medical students, many of whom will be minority
students enrolled at Duke and other medical schools.

"The RAs and TAs provide very important reinforcement,"
Armstrong said. "Our medical students will provide role models
in that they are tangible evidence of the success and
productivity that URMs are enjoying at the nation's top-tier
medical schools."

Currently, about 20 percent of students in Duke's school of
medicine are URMs, and 95 percent graduate in four years or
less -- among the highest rates in the country.

The institute will focus on courses in the basic sciences,
oral and written communications, computer competency,
opportunities for supervised patient contact, preparation for
medical school entrance exams and ethical issues in
medicine.

Institute scholars will be divided into two groups, each
named after a minority who has made important contributions to
medicine. The Dr. Daniel Hale Williams Scholars -- named after
the African-American surgeon thought to have performed the
first successful heart surgery in 1893 -- will be for those
with introductory knowledge of the sciences. The more advanced
students will follow the Dr. Rebecca Lee Crumpler track, named
after the first African-American woman to receive a medical
degree from a U.S. medical school.

Duke's Calvin Howell, associate professor of physics, is
responsible for curriculum development and oversight and is one
of the few African-American nuclear physicists in the country.
He will be teaching physics at the institute.

"I have learned in my years of teaching that when students
can accomplish something, it builds self-confidence," Howell
said. "When they return to their home institution in the fall
and can do complex physics problems easily, their
self-confidence will be tremendously high. I believe in
self-fulfilling prophecies -- if you can succeed, you will
succeed."