Bingo. Bingo. Bingo. On multiple levels. There are not going to be a lot of minorities in specialties and subspecialties because there are not a lot of minorities in med school to begin with. Given the fact that most med students overwhelmingly do not choose a specialized residency (they may in fact, specialize later via fellowship) it makes logical sense that overwhelmingly most black med students will not enter a specialized residency.
A confounding factor that most probably don't consider is the gender distribution among black med students. The most recent data have black females applying at a 2:1 rate compared to black males (see
here). And this 2:1 ratio continues to matriculation (see
here). An aside, black males in med school should feel extremely privileged. If you break it down evenly by the 50 states, there are less than TEN black male allopathic doctors produced by state per year, LESS THAN TEN! (don't have the osteopathic data...and of course this is an even distribution not accounting for the fact that some states like NY will have a lot more than ten and a state like Alaska will have much less).
Anyway back on point. The most recent data (see
here) shows that even though women are beginning to outnumber men in total doctors produced, women are overwhelmingly entering certain specialties over others...namely peds, OB/GYN, and family...so the gender distribution in fields like ortho and radiology hasn't changed tremendously. Now, apply this to black med students. Yes, more and more black students are matriculating med schools each year but these students are overwhelmingly female. As we know from the data females favor certain fields over others. This is anecdotal (but far from n=1), but of the black female med students that I came up with I'd say about 80% have gone into either peds, family, or OB/GYN. The reasons for this I believe are 1. As mentioned all females of all races overwhelmingly go into these fields 2. The sensitivity that black doctors have toward having a positive health effect on their communities (easier to do this as a ped or FP than say a radiologist) and 3. Emphasis on family and maneagable career-life balance (although many young black female doctors find themselves unmarried...a topic for the AA dating thread though).
Do scores play a role in self-selection? Of course. Black students on average score lower than their white counterparts on every single standardized test in this country. And of course, specialized residency programs tend to place a higher value on board scores than non-specialized programs. But, that emphasis is over-stated I believe by pre-meds and med students. Even the most competitive specialties like have "soft cutoffs"...there are plenty of people that interview for competitive residency spots without stratospheric board scores. More likely the cause for the self-selection in terms of overall applications to specialized fields are the reasons mentioned in the previous paragraph as well as the lack of or presence of black faculty in certain fields. For example, I said about 80% of black females I know went into peds, FP, OB. Well the other 15% or so that went into a more specialized field had a mentor in that field that was black. That's why I've been a huge advocate for years for special consideration given to underrepresented populations in med school admissions and residency selection. Not necessarily outright AA, because I believe AA implies selecting under-qualified applicants over qualified applicant. But students are more likely to have interest in fields were there is at least one person there that looks like them.
