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School of Medicine partners help advance our medical education mission Differences matter: Building the most equitable, inclusive medical school nationally

Diversity is a critical component of our institutional success. But achieving our goal of advancing health worldwide and across our city requires us to continuously work to ensure that the environments in which we learn, care, and discover are not only diverse but open, equitable, and inclusive. This work requires forming and nurturing extensive partnerships across mission areas and among learners, faculty, and staff and into our communities.

“UCSF and its School of Medicine believe that equitable and inclusive environments are essential to high-quality patient care, effective learning, and cutting-edge discovery,” says Catherine Lucey, MD, Executive Vice Dean, Vice Dean for Education. “As a community, we are committed to measuring and continuously improving equity in education, patient care, and faculty and staff careers—just as we measure and work to continuously improve quality, safety, and healthcare value. This work is challenging for all medical schools and teaching hospitals but I am confident that the UCSF community can lead the way.”

Last year, that commitment was formalized with the launch of Differences Matter, a five-year, multimillion dollar initiative supported by the School of Medicine Dean’s Office that’s taking a comprehensive look at how to make the School inclusive to all people within our community.

“We want to ensure that people with identities that are diverse in race and ethnicity, gender, gender identity, sexual orientation, economics status, religion, and disability not only survive but thrive in our School,” says Dr. Lucey.

Differences Matter is comprised of six action groups consisting of students, faculty, and staff led by Dean’s Diversity Leaders. The initiative was tasked to develop and implement strategies that will increase diversity in our academic community, optimize the equity and inclusiveness of our educational programs, train all learners to more effectively treat diverse patient populations, deliver more equitable care to our communities, design clinical research that is more inclusive of minority populations and people from underserved groups, and eliminate disparities in accessing medical education opportunities.

Differences Matter arose in response to White Coats for Black Lives (WC4BL), a national organization formed in 2014 by UCSF medical students driven to shed light on the impact of police brutality and increasing healthcare disparities in the United States. Their first action, a “Die In” in December that year, was organized in protest and solidarity with the victims of police brutality in the Michael Brown and Eric Garner cases.

“The inception of WC4BL was the result of students underrepresented in medicine wanting to raise awareness of the spectrum of institutional racism that affects the health of communities both inside and outside of the hospital,” says fourth-year medical student Sidra Bonner, who helped form WC4BL at UCSF. “Since then, students have worked with many faculty to address systemic forms of racial bias that affect patient care as well as the experiences of medical trainees and faculty here. These issues have been valued by School of Medicine leadership and have contributed to the high level of dialogue and institutional transformation around the topics diversity, equity, and inclusion that UCSF is working to address through Differences Matter.”

UCSF Vice Chancellor of Diversity and Outreach J. Renee Navarro, PharmD, MD, likens the mission to changing the campus culture.

“We have a ‘culture of innovation’ at UCSF and we accomplished that consciously by breaking down the walls between specific scientific disciplines to ask better scientific questions and to get the best and most creative solutions,” Navarro says. “In the same way we have to break down the current barriers that prevent us most effectively achieving diversity, equity and inclusion.”

“Differences Matter expands ongoing and previous initiatives with a substantial investment that promises to elevate the issues and support the sustainability necessary to change systems and patterns of how we do things,” says Dr. Navarro.

Collaborative work between Differences Matter, UCSF’s Office of Diversity and Outreach, and WC4BL is underway to address both structural racism and interpersonal biases that contribute to inequities in healthcare for patients and education for students. The Differences Matter ethos has already resulted in:

• Full-day training workshops on equity, inclusion, and bias, coordinated by Differences Matter Dean’s Diversity Leaders Michelle Guy, MD, Eddie Cruz, MD, and Suzanne Kawahara, MBA, which were attended by over 200 faculty and staff over the past several months and are scheduled to reach an additional 1000 people over the next 18 months.

• New student competencies focused on equity, inclusion, and the elimination of healthcare disparities created by WC4BL students and Dean’s Diversity Leaders Andrea Jackson, MD, MAS and Alejandra Rincón, PhD, Assistant Vice-Chancellor and Chief of Staff, Office of Diversity and Outreach. These competencies supplement the School of Medicine Graduation Competencies. Students partnering with this group are working to eliminate inadvertent stereotypes in patient cases and to diversify patient panels and experiences.

• A committee focused on supporting educators to engage in equity pedagogy, created by the Academy of Medical Educators.

• The launch of a new School of Medicine anti-microaggressions campaign focused on diversity, inclusion, and the cultivation of a positive learning environment in classrooms and clinics.

Other measures that have taken on diversity and inclusion issues at UCSF include a new medical student orientation that challenges students to commit to addressing health care disparities by individually and collectively learning about equity, inclusion, and bias, the Multicultural Resource Center, the LGBT Resource Center, and the Diversity Hub, a database that consolidates UCSF's ongoing initiatives that support diversity and outreach.

Health and education inequities are affecting people now, and Differences Matter is driven by that sense of urgency to not just plan how to have an ideal climate, but to take action.

“Rest assured that change is happening,” says Dr. Jackson. “People will start to notice small and tangible real changes through Differences Matter. In a couple of years, I think we are going to look back and marvel at how far we have come.”

Diversity, Equity, and Inclusion Champion Training

Differences Matter is working to foster an inclusive educational environment where all students succeed. Deans Diversity Leaders partnered with an outside firm, ENACT, to create an impactful day of active learning around topics that faculty and staff must understand to be inclusive in their teaching, patient care, research, and management roles.

Over 200 medical education faculty and staff have completed diversity training, with ongoing sessions scheduled next year. From the original group of faculty and staff attendees, a subset will undergo intensive training to become institutional trainers for this work going forward. By expanding the number of people who can teach and coach about issues of unconscious bias, privilege, microaggressions, and other manifestations of inequity, we will achieve our goal of offering training to over 1,000 UCSF faculty and staff.

“We are energized to further staff and faculty understanding of and commitment to the Differences Matter strategy and greater clarity of their role as leaders in driving this strategic initiative forward,” says Dr. Rincón, who helped lead the development of core competencies presented during the training sessions.

In each workshop, participants were educated on implicit biases and microaggressions, coached in skills to address related issues, and trained in how to apply thoughtful, active listening and empathy supporting a more inclusive environment.

The workshops closed with participants encouraged to make personal commitments to fostering a more inclusive, equitable environment in their learning communities, in essence creating a ‘learners’ bill of rights’.

The training sessions were developed by Differences Matter leadership and staff comprised of Eddie Cruz, MD, MPH, Michelle Guy, MD, Andrea Jackson, MD, MAS, Suzanne Kawahara, MBA, Catherine Lucey, MD, Holly Nishimura, Michael Reyes, MD, MPH, Alejandra Rincon, PhD, Allison Savage, Teresa Scherzer, PhD, George Taylor, DMD, MPH, DrPH, and Beth Wilson, MD, MPH.

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