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On Life Support

Congress has erased the funding for dozens of minority-focused medical training centers, leaving them scrambling to stay afloat.

By Jamal Watson

At the Hispanic Center of Excellence, located on the sprawling campus of the Albert Einstein Medical Center in the Bronx, no one is singing the blues. The lights are on and the students are busy at work. The center’s staff remains focused on its primary goal — to mentor and train a new generation of Hispanics to enter the medical profession.

That’s not an easy task, particularly when only 3.2 percent of doctors in the United States are Hispanic, according to the American Medical Association’s statistics. The job becomes even more difficult when one of the few federally funded programs in the country charged with producing new Hispanic physicians gets its entire funding cut.

The Office of Management and Budget, a federal department that assists President Bush in overseeing the preparation of the federal budget, recently told the staff at the Center of Excellence that they would not receive the three years of funding that they had been promised because the services they offered were considered “ineffective.”

“I think they’re just wrong,” says Dr. Hal Strelnick, the center’s
director and a 25-year veteran of the college, which is based at Yeshiva University. Yeshiva is ranked 18th for awarding medical
degrees to minorities in Diverse’s Top 100 Graduate edition (see Diverse, July 13).

Strelnick says the five-year-old center, which supports about 800 students each year, successfully achieved 17 of its 18 stated objectives for the year. The problem, he says, is that Washington bureaucrats don’t understand the specifics of rigorously training students — many of whom are the first in their families to go to college — for a life in the medical field.

“It’s been a challenge to take what Congress said these programs should be and translate them into simple numerical numbers like ‘how many more Hispanic physicians would we not have if we didn’t have this program,’” Strelnick says.

The center is a multi-level program aimed at improving student performance and training, providing them with information and resources and expanding faculty development. Officials at the college say that, in addition to recruiting Hispanics for careers in medicine, they have also created a curriculum addressing the unique health care needs of the Hispanic community.

The center received $563,000 for the 2005-2006 academic year, but has lost the subsequent two years of funding, budgeted at $785,000 and $650,000, respectively. Officials at the center say they were counting on those funds to provide academic counseling, scholarships and professional networking opportunities for their students.

“We have been seeking private funding,” says Strelnick. “A number of foundations have reached out to us and have offered assistance.”

The center has already eliminated a two-year program intended to train minority faculty members in research areas. Ultimately, the hope was for the faculty members to earn a master of science degree in clinical research methods.

The Hispanic Center of Excellence was not the only program to suffer such drastic cuts. Over the past two fiscal years, Congress has severely cut funding for the Centers of Excellence grant program. That move effectively zeroed out almost all federal money available to the majority of academic institutions that have similar programs. In 2005, Congress approved $33.6 million in grants to the 34 centers. This year, only four of those centers received federal funding, which amounted to $11.8 million. With 30 centers losing their entire funding, some Democrats have questioned how committed President Bush and the Republican-controlled Congress really are to minority education.

While the Centers of Excellence grant program recipients do not all cater exclusively to Hispanic students, all of the programs in some way seek to encourage minority students to pursue advance degrees in the medical profession. The four programs that did receive funding are based at Howard University, Morehouse College, Tuskegee University and Xavier University of Louisiana, all historically Black institutions.

“The Hispanic Center of Excellence at the Albert Einstein College of Medicine is a vital component in improving health care for under-represented and underserved minority communities,” says U.S. Rep. Joseph Crowley, a Democrat who represents the Bronx and parts of Queens. “It has also provided minority students with the opportunity of realizing their dreams of becoming doctors, often returning to practice medicine in the communities of their origin.”

Crowley, along with 50 other members of Congress, recently sent a letter to Michael Leavitt, the Secretary of the U.S. Department of Health and Human Services, and Elizabeth Duke of the Health and Resources Services Administration asking for 12-month extension grants for all of the Centers for Excellence. Duke agreed to provide nine-month extension grants for the centers, allowing them to operate until May 2007. Crowley says he hopes more funding will be allotted in next year’s appropriations bill, which is scheduled to be voted upon by the House of Representatives in November.

“We need more, not less from the federal government,” says Dr. Maria Soto-Greene, director of the Hispanic Center of Excellence at the University of Medicine and Dentistry of New Jersey. The center has been on UMDNJ’s campus since 1991, but, like the center at Einstein, it lost all of its funding.

“By taking these funds away, it’s going to hurt at a time when we have started to make modest gains in recruitment and retention,” says Soto-Greene.

Last year’s incoming class of students at UMDNJ included 170 Black and Hispanic students, the largest in recent memory. The institution earns the top spot on Diverse’s Top 100 list for medical degrees.

Soto-Greene says the academic institutions across the country that have Hispanic Centers of Excellence are strategizing to petition for additional funds. They also plan to develop a model that helps to demonstrate the effectiveness and need for such programs. 

Students at Albert Einstein, who learned of the cutbacks during the first week of school, seemed hopeful that the full funding will eventually be restored but were still clearly angry.

“I think the priorities in funding by the Congress is distorted,” says Rene Kohlieber, 24, of Los Angeles. Kohlieber journeyed to Einstein to study medicine after recognizing the profession’s racial disparity.

“The Hispanic Center has affected me and is helping me to get through medical school,” she says. “The center and the staff have been great advocates.”

Sophia Rodriguez, 22, a first-year medical student at Einstein, says she is contemplating volunteering at the Hispanic Center in case it is forced to lay off some of its personnel.

“I’m hoping and praying that we get the money that we need because this center is really important,” says Rodriguez, who graduated last year from Manhattan College. She and her fellow classmates are contemplating writing to members of Congress for additional funds.

The center’s Bronx location is symbolically important, as 53 percent of the borough’s residents are Hispanic. Many residents there are poor and have taken advantage of a free student-run clinic supported by the center. 

Given the under-representation of Hispanics in the medical field, Strelnick wonders why Congressional leaders haven’t made funding programs like the Hispanic Center of Excellence more of a priority.

“When the Census Bureau has told us that Hispanics are widening their lead as the nation’s largest minority group, and the Agency for Healthcare Research and Quality has told us that health disparities are worsening for Hispanics, it makes absolutely no sense to eliminate the only federal program explicitly designed to recruit and train Hispanic health professionals,” he says.

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