Improving Einstein's Diversity: the Smart Thing, the Right Thing, the Fun Thing to Do
The Challenge to Improve Diversity in Academic Medicine
As the nation rapidly grows more diverse, underrepresented minority physicians are needed more than ever. With 34% of the U.S. population belonging to a minority group and 47% of children under five coming from minority families, healthcare practitioners are seeing an ever-growing spectrum of languages, cultures, and health issues in patients. Yet even as the demand for ethnic and racial diversity in medicine rises, minority doctors—particularly those in academic medicine—remain few.
Image: A celebration of diversity: Department of Medicine faculty and staff at this spring's 2nd Annual Celebratory Gala. full photo
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Seeing this trend in his own department’s housestaff and faculty, as well as a decline in matched minority residents from 2007 to 2008, Dr. Victor Schuster, a Caucasian professor and Chairman of the Einstein-Montefiore Department of Medicine, convened faculty members Clement Tagoe (Rheumatology), Chinazo Cunningham and Marta Rico (General Internal Medicine) to initiate a Diversity Affairs Committee. "Diversity in the Department makes our workplace better and more competitive, raises awareness of racial disparities in diagnosis and treatment, fosters research in these areas, and extends New York City's multiculturalism--precisely the reason many of us choose to live here--into our everyday lives," Schuster said. "It's the smart thing to do, it's the right thing to do, and it's the fun thing to do." full quote
Cunningham, Rico, and Tagoe were joined by Cristina Gonzalez, faculty hospitalist; Oni Blackstock, chief resident; Irene Blanco, fellow; Rita Louard, associate professor of clinical medicine and director of the Clinical Diabetes Center; Alda Osinaga, instructor; Calie Santana, assistant professor and associate director of quality; and Lanny Smith, assistant professor and global health advisor at Einstein.
From Cocktails to Seminars: Reaching Every Audience
The committee hosts five yearly events dedicated to improving minority recruitment and retention at the housestaff and faculty levels, providing a supportive community for minority housestaff and faculty, and enhancing mentoring opportunities.
“Successful diversity starts with a commitment from the institution that needs to be reaffirmed each and every year,” said Louard, an African-American endocrinologist whose research focuses on diabetes in the African-American population. “One of the most challenging aspects we face is creating good pipelines: getting minority students to apply to medical school, and seeing residents and attendings and faculty who reflect the diversity of the patients we serve. In many ways it's a circle that is crucial to our mission.”
Each fall, a half-day open house welcomes underrepresented minority fourth-year medical students interested in internal medicine. Visitors attend seminars that demystify the application process, including tips for obtaining strong recommendation letters, how to create outstanding CVs and personal statements, and effective interviewing. The most recent open house was attended by 24 students from 13 medical schools (including University of Pennsylvania, Columbia, Cornell, and Einstein).
Later in the process, minority students in the residency program's top match list are invited back for dinner and a subsequent “revisit day” in which they attend rounds, tour the hospital and clinics, and meet with faculty members in their areas of interest. Fifteen students from 10 schools attended last year's event.
The process of fostering a supportive community for minority housestaff and faculty begins each summer with a cocktail party for new arrivals. In April 2010, a dedicated Grand Rounds, geared toward building diversity awareness throughout the Einstein community, will focus on barriers to care and health disparities. Following the presentation, the invited speaker will meet with housestaff, fellows, and faculty to share tips for advancement in academic medicine.
The Mentoring Challenge
Mentoring events address a critical issue for minorities in the academic medical field. "When you don't see many leaders who look like you, initiating a frank discussion about career path or advancement can be uncomfortable,” said Cunningham, a Nigerian-Croatian general internist who examines unique and innovative methods to deliver health care to marginalized populations. “I've learned to knock on doors and ask questions, but it's been difficult.”
Cunningham, along with other senior faculty members, participated in the committee’s first "Speed Mentoring Cocktail Party" this past spring. The event, organized by Blanco and Rivera, featured four one-on-one rounds in which junior faculty networked with senior faculty, focusing on topics including hospital administration (Victor Schuster), basic science research (Chaim Putterman), clinical research and grant writing (Frederick Kaskel), becoming an associate dean at Einstein (Paul Marantz), advancing as a clinician educator (William Southern), resident education (Joseph DeLuca), and going part-time and successfully re-integrating (Cunningham).
“It took me about five years to realize that I would never find ‘the’ mentor, years that could have been used more constructively,” said Cunningham, who recently received a Faculty Mentorship Recognition Award at Einstein’s Diversity Gala. “When I learned to seek out different people who showed me how to become a more critical thinker, stronger researcher, and effective program developer, my work progressed significantly. I want others to know this early on, so they don’t lose the valuable time that I did.”
Effective mentorship can also help minority physician-educators find colleagues with similar interests. This issue was particularly important for clinician educators like Rivera, a Puerto Rican hospitalist who recently developed a health disparities elective piloted for first-year medical students. “Health disparities isn’t a traditional part of medical school curriculum, so finding local mentorship can be challenging,” she said. “I want to ensure that people doing work like mine know others with whom they can collaborate.”
The Road is Long, but Well Traveled
The committee’s events have been well attended and strongly supported by senior leaders, despite the competition with heavy workloads and busy schedules of potential attendees. Another challenge is the misconception that the events are open to minorities only. “We want everyone involved on both the giving and receiving ends,” said Rivera. “Anyone who could benefit from our events is welcome.”
“Early in your career, it’s almost unheard of to have the ear of a residency program director or department chair in an informal setting,” agreed Cunningham. “Our events provide an amazing opportunity, and we want everyone to take advantage of it.”
Along with the goal of growing attendance, the committee, now in its second year, is working to strengthen ties with diversity-focused groups throughout the Einstein-Montefiore community, including the Department of Family and Social Medicine and the Office of Diversity Enhancement. With a recovery of underrepresented minorities matched to the Internal Medicine Residency Program in 2009, the committee’s efforts seem to be working. With the representation of minority students, residents, and faculty still but a fraction, however, the journey has but begun. “While there's clearly an emphasis on having more diversity in medicine, it continues to be a challenge that we haven't made enough headway,” said Louard. “However, undaunted we continue to try.”