At Med Schools, a New Degree of Diversity

"In Russia, doctors are much lower status than here," she said. "And they are very low-paid."

So at 18 she left home and moved to Prague, where she studied Czech, English and international relations, but she never really gave up her original idea. She married an American, moved to the United States, graduated from college in North Carolina and got into medical school.

"It seems like a very, very long time," she said. "But it's worth it."

Although the Association of American Medical Colleges asks all medical school applicants and matriculants to describe their race and ethnicity in general terms, there is little published information about national background and none about family history. Anecdotes, however, suggest that immigrants' children are more likely to attend schools on both coasts.

S. Balasubramaniam, a surgeon at Charles R. Drew University of Medicine and Science in Los Angeles who emigrated from India in 1971, recently queried 50 medical schools and calculated that 12 percent of the class that entered in 2006 is of Indian heritage. The highest percentages are in California, Texas, New York, New Jersey and New England.

Na Shen, 25, a second-year medical student at Maryland who was born in Shanghai, calculated that 12 percent of her school's students are from China, Taiwan, Korea and Japan, and 1 percent from Southeast Asia. When South Asians are included, the Asian portion of the school rises to 21 percent.

In contrast, University of Kansas medical school students since 1996 have consistently run about 10 percent "either born overseas or of parents who were born overseas," said Glendon Cox, the vice dean.

The most recent arrivals -- Africans -- are the hardest to quantify.

Morehouse School of Medicine, in Atlanta, has 12 students born in Africa out of about 210 in the M.D. program. Meharry Medical College, another historically black institution, in the past eight years has had an average of two foreigners per year in its incoming classes of about 60. It has no data, however, on students with recent ties to Africa who are U.S. citizens or permanent residents. Howard, the third historically black medical school, did not provide information when asked.

A half-dozen people at the Student National Medical Association -- the main U.S. organization of black medical students -- did not respond to inquiries.

Lauree Thomas, an African American physician who is associate dean for admissions at the University of Texas Medical Branch in Galveston, estimated that "20 to 30 percent of the black applicant pool" at her school is students who were born in Nigeria, or of Nigerian parents. Foxwell, the Maryland dean, estimates that close to half the black students there have recent ties to Africa.

This is a touchy subject in the black medical community.

Albert Morris Jr., a diagnostic radiologist in Memphis who is president of the predominantly black National Medical Association, said he recently talked to black students at Pennsylvania State University's medical school in Hershey. Afterward, several took him aside and quietly complained about the rising number of Africans.

"It was a big topic -- that people were coming in and getting slots that they thought should be going to African Americans," he recalled.

Blacks constitute about 13 percent of the U.S. population, but only 4 percent of U.S. doctors. There has been much effort in the last two decades to remedy this imbalance. Morris, a graduate of Howard, said he understands the students' sensitivities.

"We are happy to see doctors who are ready to treat minority populations, no matter their nationality," said Morris, 56. "But we want to make sure that those of us who have helped open the doors [to medical school for blacks] get to share in the bounty."