The views and opinions expressed are those of the author and do not necessarily represent the views or opinions of EAB.
Cooper Medical School of Rowan University (CMSRU) is a relatively new medical school (2012), located in Camden New Jersey, one of the country’s poorest cities. Our mission and core values include diversity, advocacy, and service to our community. We actively recruit students who are a match to our mission and require that all of our students engage in service learning during all four years of their matriculation.
Immersion in the community in this manner helps our students see how the social determinants of health impact access to care, the quality of care, and the overall health status of our community members. Understanding and addressing the needs of the diverse population we serve is of great importance to our institution. During our first eight years, we felt we were making a significant difference in diversity, inclusion, and health equity matters, through our pipeline programs, community partnerships, and free health clinic.
However, in the year 2020, we witnessed the racial trauma experienced by members of our community and other communities of color following the murders of George Floyd, Breonna Taylor, and Ahmaud Arbery. We also saw how significantly different COVID-19 impacted these communities. It became clear that our efforts to date, while admirable, were not enough. Our students and many others from across the country began to demand that medical schools do more.
We realized that it’s not enough to simply recognize the existence of health inequities and treat the down-stream consequences. We must dig deeper and get at the root causes. We need to journey up-stream and learn how to disrupt the systems that have allowed these inequities to continue. As health care educators and researchers, do we not have an obligation to advance health equity? After multiple town halls and discussions, CMSRU ultimately pledged to become an anti-racist institution and acknowledged that our curriculum should be revised to better train physicians who could help bring about change.
Future physicians should recognize racism as a social determinant of health and understand the potential consequences for health outcomes. As the former dean of diversity and community affairs, member of our anti-racism task force, and person of color, this work has great meaning to me. Now as the interim associate dean for medical education, I have the opportunity and motivation to help lead this important curricular change.
Question: How can anti-racism be effectively incorporated into our medical school curriculum?
Figuring out how and where to incorporate anti-racism into our medical curriculum is no easy task and faculty readiness was identified as an early obstacle. We decided that to have real meaning, anti-racism needed to be included in all four years of our curriculum, not just in an isolated lecture or single course.
Change is always hard, but in the case of racism in medicine (RIM), it is even more challenging because of the varying levels of knowledge on the topic among faculty. To complicate things further, many of our medical students are well versed in this subject matter.
Through small group discussions, we learned that there was great disparity among faculty in their understanding of racism, terminology around race, and general comfort in discussing racism and/or racial disparities. It became clear that a strategy for faculty learning must be addressed in addition to our students.
Curricular change is a team effort. Key to the success of moving things in a positive trajectory was working as a member of anti-racism task force and partnering with educational stakeholders. The task force was instrumental in the creation of the RIM Educational Program Objectives (MPOs). Linking discussions of RIM with the school mission facilitated faculty buy-in. During my fellowship, the task force met every two weeks. We made recommendations for faculty development to the dean, provided consultation sessions for faculty regarding curricular content and assessment, and identified numerous resources for student/faculty reference. We outlined immediate, short-term, and long-term goals, recognizing that slow and steady likely beats fast and furious.
As a result, clinical clerkship directors have already added RIM assessments and those for basic sciences courses are in process. All faculty have completed required unconscious bias modules and our active learning group facilitators have started focused DEI training to prime them for leading discussions regarding race. EAB staff members were particularly helpful in providing resources that were helpful in our planning, especially the custom research brief, “Promoting Diversity and Inclusion in the Classrooms” (2013) and the Institutional DEIJ Plan Starter Kit.
Our librarians worked with students and the task force to contribute to a CMSRU Libguide for RIM that all CMSRU members may use to expand their knowledge base. We are currently in the process of forming a peer faculty support (PFS) group that will receive advanced training through the Rowan University DEI certificate program. This will allow faculty members to have dedicated support in anti-racism pedagogy. Long-term plans include on-going faculty development on race and racism for all teaching faculty, quarterly updates of RIM at subcommittee meetings, and annual reviews of anti-racism progress at the Curriculum Committee retreat. There is still much work to be done but we are off to a great start.
Effective discussion about race and racism is important in the training of future healthcare professionals. To ensure successful incorporation and delivery of these topics, planning must be thoughtful and have broad institutional support. The CMSRU offices of faculty affairs, medical education, and diversity and community affairs will work in concert to ready our faculty to tackle this challenge. Together we can help train physicians that have more awareness and confidence in addressing these subjects, which may in turn promote more equitable healthcare.
I would like to thank EAB for the opportunity to participate in the Rising Higher Education Leaders Fellowship. It has allowed me to connect with experts in their organization, as well as educators from a wide variety of educational institutions. These interactions allowed me to hear different perspectives, gain knowledge, and share ideas. I am sincerely grateful to my university leaders: President Houshmand, Provost Lowman, Dr. Connor, and Dean Reboli for their nomination and confidence in my abilities. Thanks also to my capstone partner, Randall Ojeda, for his encouragement and support.
See the fellows' blogs from the capstone projects
Jocelyn Mitchell-Williams and others participated in EAB’s Rising Higher Education Leaders Fellowship in spring 2022