Howard University College of Medicine (MD) Medicine InterviewFormat, Questions & Prep Tips

Why Howard — what is it about the school’s mission and legacy that makes this your choice, and what do you intend to contribute to that legacy?

Reference Howard’s founding in 1868, its role in training Black physicians during segregation, the health equity mission, and specific aspects of the curriculum or community. Avoid generic answers — this is about a historic and mission-driven institution.

Black Americans experience significantly higher rates of hypertension, maternal mortality, and mistrust of the medical system compared to white Americans. What structural factors explain this and how do you intend to address them as a physician?

Reference redlining and residential segregation, historical medical experimentation (Tuskegee, J. Marion Sims), implicit bias in clinical treatment, environmental racism, and income inequality. Show you have engaged with the scholarship on structural racism in medicine, not just surface statistics.

Tell me about an experience serving in a Black community or other underserved community. What did you learn about structural barriers that clinical medicine alone cannot fix?

Be specific and analytical. Howard expects applicants who have moved beyond observational service to genuinely grappling with systemic root causes — connect your experience to policy, history, and structural change.

A Black patient in the emergency department is undertreated for pain compared to a white patient with similar presentation. You observe this as a medical student. What do you do?

Address it — patient advocacy is a core physician responsibility. Raise the disparity with the attending: frame it as a patient safety and quality of care concern. Document. Know the evidence on racial bias in pain treatment (Hoffman et al., 2016). Don’t be silent.

A patient tells you he has decided to stop taking his HIV antiretroviral therapy because he read online that 'the medication is designed to keep Black people sick.' How do you approach this conversation?

Do not dismiss the patient’s mistrust — it is historically grounded. Acknowledge the legacy of Tuskegee and medical experimentation. Use motivational interviewing to explore his specific fears, provide accurate information, and build trust incrementally. Do not lecture.

Sickle cell disease disproportionately affects Black Americans and has historically been underfunded relative to diseases of similar severity affecting predominantly white populations. How should the US address this inequity?

Reference NIH funding disparities (documented in research), the FDA approval of newer SCD treatments (voxelotor, crizanlizumab, gene therapy), insurance coverage gaps, and the advocacy role of the American Society of Hematology and sickle cell community organisations.

You are reviewing a clinical algorithm that recommends different treatment thresholds based on patient race — specifically, the eGFR correction for Black patients that was recently debated. What is your view?

The race-based eGFR correction was removed by the NKF/ASN in 2021 because race is a social, not biological, variable and the correction led to delayed diagnosis of CKD in Black patients. Show you know this specific controversy and can reason from evidence to equity principles.

Howard welcomes students of all backgrounds. For non-Black applicants: why Howard specifically, and how do you understand your role within a historically Black medical institution?

Honest and humble self-reflection required. Demonstrate genuine alignment with the mission — not tokenism or alternative-pathway thinking. Articulate how your background equips you to contribute to health equity.

You are a student on a team. An attending uses a racial epithet when describing a patient’s community. How do you respond?

Addressing bias from senior physicians is challenging but essential. A private, immediate, and non-hostile intervention is appropriate. Reference the AAMC guidance on professional conduct and bystander intervention in clinical settings.

Should US medical schools implement explicit reparative measures — such as waiving tuition for students from communities historically excluded from medical education — to address the legacy of segregation in medicine? Defend your position.

Directly relevant to Howard’s mission. Argue a position that acknowledges the documented legacy of exclusion, engages with counterarguments, and demonstrates principled reasoning about structural versus individual justice.

You are shown the data behind the now-retired race-based eGFR correction: applying it delayed CKD diagnosis and transplant referral for Black patients. How do you reason from this example about using race as a variable in clinical algorithms?

Know the specifics: the NKF/ASN removed the race coefficient in 2021 because race is a social, not biological, construct and the correction caused real harm. Generalise carefully — interrogate whether a variable is a proxy for something measurable (ancestry, social exposure) and demand evidence that any race adjustment helps rather than harms. This is squarely Howard's territory.

Role play: You are a student at a Howard University Hospital outreach event. A patient says he stopped his blood-pressure medication because 'doctors have always experimented on us and I don't trust what they give me.' (The interviewer plays the patient.)

Do not dismiss the mistrust — it is historically grounded (Tuskegee, J. Marion Sims). Acknowledge that history honestly, avoid defensiveness, explore his specific fears with motivational interviewing, and rebuild trust incrementally rather than lecturing. Connect him to care he can believe in.

A pregnant Black patient tells you that at a previous hospital her pain was dismissed and she nearly had a serious complication missed. How do you respond and what do you do differently?

Validate her experience as consistent with documented patterns of dismissing Black women's pain, commit explicitly to listening and acting on her concerns, and demonstrate vigilance. Tie it to the maternal-mortality disparity Howard's mission targets — trust is built through changed behaviour, not reassurance alone.

Howard has trained more Black physicians than any institution in the country since 1868. What do you intend to add to that 150-plus-year legacy, beyond benefiting from it?

Move from receiving to contributing: name what you will build — mentorship, community partnership, equity-focused research or practice. Show you grasp Howard's specific historic role rather than speaking in generic mission language.

NIH funding has historically lagged for conditions that predominantly affect Black Americans, such as sickle cell disease, relative to comparably severe conditions in white populations. How should the US address this research-funding inequity?

Engage the documented funding disparity, the recent advances it slowed (newer SCD therapies, gene therapy), insurance and access gaps, and the advocacy role of bodies like the American Society of Hematology and patient organisations. Argue a structural position grounded in evidence — Howard expects systemic analysis, not just sympathy.