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During the last 25 years cultural diversity has increased dramatically due to global migration. The 2013 International Migration Report from the Department of Economic and Social Affairs of the United Nations revealed that the United States has six times as many immigrants as all of Latin America. The United States also resettles the largest number of migrants in the world and provides more benefits and welfare than any other nation. The United States hosts about 20% of the world’s global migrants.

In 2013, about 39% of the US population identified themselves as members of minority groups. Hispanic and African American groups were the largest minority groups, accounting for 17% and 13% of the population, respectively. By 2050, it is projected that minority groups will account for almost half of the US population (Figure 37-1).

Figure 37-1

Percent of US population by race and Hispanic origin: 1990, 2000, 2025, 2050.

While African Americans and Hispanics are the largest minority groups in the United States, they are also the most underrepresented minorities in medicine. Only 6% of practicing physicians come from these groups (Figure 37-2). These physicians often carry the responsibility of providing health care for these minority communities. Although the number of minority students entering medical school is increasing, it is not increasing at a rate to ensure a culturally competent physician workforce (Table 37-1). The racial and ethnic disparities are an ongoing phenomenon in both medical school enrollment and graduating physicians from US medical schools (Table 37-2). The inclusion of International Medical Graduates (IMGs) into residency programs in different specialties might mitigate some of these disparities. However, the proportion of residency positions filled with IMGs is still small compared to the number filled by US graduates (Table 37-3).

Figure 37-2

2004 US physicians by race/ethnicity.

TABLE 37-1Total US Medical School Enrollment by Race, Ethnicity, and Sex

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