David Muller, MD
Dear students,
We continue to make incremental progress in addressing racism and bias on our campus and in our clinical environments. Below is a list of major initiatives and events since our last update:
Curriculum
- The Medical Education team reviewed all the lecture and small group materials available on Blackboard in considering how categories of race are presented in the first two years of our curriculum. That review included sharing the following overview with all of our Course Directors.
- Information about race, ethnicity, and ancestry is presented in some of our lectures. This information is taken from texts, websites and scholarly articles that provide the current standard for clinical practice and scientific research in this field.
- Racial variations in risk of disease overlook the profound impact of social factors that often account for these variations, including differences in diet, smoking, alcohol use, socioeconomic status and poverty, occupational and environmental exposures, health literacy, cultural and spiritual beliefs, and the ways in which racism affects access to and quality of care.
- Categories of race (for example, Black, African-American, Asian, Latino or Hispanic, White) also overlook the enormous diversity and variation among people who have traditionally been lumped into these artificial constructs.
- Race is a social construct that has no clearly documented biologic basis. This statement from the American Association of Physical Anthropologists nicely articulates an accurate “current understanding of the structure of human variation from a biological perspective”.
We asked the Course Directors to remove references to race that did not appear to be relevant to the content or teaching points being made. If the use of race was relevant, we provided the Course Directors with background information and references that would help them explain why the reference to race was important to the class, and contextualize that use of race in light of all we know about structural racism and the social determinants of health. We have subsequently met with the Course Directors and continue to provide them with faculty development around racism and bias.
This is an important learning process for all of us. While our review was comprehensive, it was not and never will be perfect. We will always rely on our lecturers, Course Directors, students, and medical education leadership to nurture an environment that is continuously improving and open to constructive criticism.
- Helena Hansen, MD, PhD, Assistant Professor of Psychiatry, NYU Medical Center; Assistant Professor of Anthropology, was invited to give Medical Education Grand Rounds on “Structural competency: new medicine for the inequalities that are making us sick.” Dr. Hansen was one of the faculty listed on the bibliography we received from ISMMS Anti-Racism Coalition last spring.
- Thanks to the work of student leaders in the Deconstructing Race in Medicine and Health elective, Dr. Lundy Braun, PhD, Professor of Pathology and Laboratory Medicine at the Alpert School of Medicine, Professor of Africana Studies at Brown University, visited our campus to teach in the elective, meet with students, and speak to faculty as part of our ASM Year 1 faculty development session.
- We have made a concerted effort to include more faculty of color and relevant topics in our Frontiers in Science talks. Recent talks include:
- Jerome Tolbert, MD, PhD, Medical Director for Outreach, Gerald J. Friedman Diabetes Institute, Department of Medicine, Mount Sinai Beth Israel, gave the FIS talk in Endocrinology on diabetes in underserved populations.
- Cardinale Smith, Assistant Professor of Medicine and Geriatrics, ISMMS, gave the FIS talk in Hematology on improving the quality of care for patients with cancer with a special emphasis on minority populations.
- Veronica Rodriquez-Bravo, PhD, Assistant Professor, Pathology; Assistant Professor, Oncological Sciences, gave the FIS talk in General Pathology on genome instability and cancer.
- Gerardo Fernandez, MD, Senior Faculty, Pathology, gave the FIS talk in Sexual and Reproductive Health on multivariate analysis and modeling in predicting prostate cancer behavior.
- Joseph Ravenell, MD, MS, Assistant Professor of Population Health and Medicine at NYU School of Medicine, gave the FIS talk in GI on colon cancer and hypertension screening among African American men.
- Dr. Ann-Gel Palermo, Dr. Reena Karani, and I have begun working with Dr. Sharon Washington, Lecturer, ISMMS, on developing what we hope will be a four year anti-racism curriculum that is modeled after the Deconstructing Race in Medicine and Health elective. We hope to launch the first elements of this curriculum in the fall of academic year 2016-2017.
- We are will be delivering a new session in ASM II this year on Unconscious Bias in Clinical Practice designed to prepare the rising third year students with ways to mitigate unconscious bias in their clinical reasoning, and to provide strategies for navigating experiences of unconscious bias in the upcoming clinical rotations. We are planning this session in consultation with the Office for Diversity and Inclusion and CMCA and with input from ISMMS Anti-Racism Coalition.
Student Affairs
Thanks to a feedback process that was initiated by the ISMMS Anti-Racism Coalition to increase accountability and transparency, Medical Education and CMCA have begun the process of restructuring the MSPE, our ranking system, how students are selected for awards, and developing a more rigorous approach to specialty advising. Updates on these initiatives will be shared with you as they are integrated and implemented. Beginning with the graduating class of 2017 there will be a graduation achievement award for Excellence in Undoing Racism in Health Care.
Consultants Visit
As many of you know, we had the privilege of hosting three outstanding national leaders for a two day site visit that allowed them to take a critical look at our learning and institutional climates. The consultants were Renee Navarro, PharmD, MD, Vice Chancellor, Diversity and Outreach University of California at San Francisco; Fernando Mendoza, MD, Associate Dean of Minority Advising and Programs, Stanford Medical School , and Marc Nivet Ed.D., MBA, Chief Diversity Officer, Association of American Medical Colleges. We anticipate receiving a report from them that will help us finalize a Strategic Plan to Undo Racism and Bias at Icahn School of Medicine. We will be soliciting feedback and input on that plan from the student body. The plan will be the roadmap for our collaborative effort to address racism and bias at ISMMS on an ongoing basis. Many thanks to those of you who took the time and made the effort to paint an honest picture of our school, our successes, and the challenges that lay ahead.
Special Events
- This year’s Alpha Omega Alpha Visiting Professor was Kenneth Ashley, MD, Assistant Professor of Clinical Psychiatry, Icahn School of Medicine at Mount Sinai. His keynote talk address was on “Activism, advocacy and education: expanding the focus of patient care with HIV, LGBT and culturally diverse populations”
- This update would not be complete without kudos and well-deserved recognition for the extraordinary work of our own Kamini Doobay MSIII (Scholarly Year) has done organizing the forum, “Dismantling Racism in the NYC Health System –The Time is Now”. Working closely with the NYC Department of Health Center for Health Equity, the Institute for Family Health, Doctors for America-NY, White Coats for Black Lives, CUNY School of Public Health, medical students from area schools, and others, Kamini brought together for the first time a coalition of leaders from every corner of health care. You can read more about the forum here. We were delighted to serve as a co-sponsor of this important event.
We want to continue to keep the lines of communication open and hope that you will join in this discussion.