Richard Baker, MD, senior associate dean of medical education at Wayne State University School of Medicine, helped develop a series of workshops on diversity, equity, and inclusion in the health professions. health for the National Academies of Sciences, Engineering and Medicine.
Dr. Baker, professor of ophthalmology, served as vice-chairman of the planning committee that produced “Exploring a Culture of Fairness, Respect, and Anti-Racism through Diversity, Equity, and Inclusion in Health Professions Education: A Workshop Series” for the organization.
Dr. Baker’s committee brought together a diverse group of educators, students, administrators, and health professionals to explore diversity, equity, inclusion, and anti-racism across the spectrum of health professions education. Participants shared ideas and educational materials that culminated in an interactive webpage tool for educators and healthcare professionals to explore ideas and answers by considering:
• Accreditation as a mechanism for change
• The importance of language to trigger action
• How metrics and funding bodies are, or could be, used to measure and promote anti-racism structures of institutions
Each session explores forms of institutional structures as potential mechanisms for influencing or eliminating discriminatory practices in the education of health professionals. All three workshop sessions are summarized in the resulting free interactive educational resource, complete with downloadable content.
In addition to overseeing the committee that planned the workshop, Dr. Baker presented “Five fundamental points”, which form the core of the program. His five points, which he described as “admittedly ambitious”, are “helpful in facilitating a common understanding of the topic for more focused and intentional discussion”.
1. DEI – diversity, equity and inclusion – is not the same as “anti-racism”
Make a clear distinction between DCI efforts and anti-racism efforts. DEI is extremely important. This can be a pathway or platform for anti-racism, however, progress related to IDE should not be replaced or confused with the achievement of anti-racism related goals.
2. Race is not a biological construct
Race is not a biological construct, it is a social construct. Race as a biological construct is a pervasive and strongly held, but inaccurate belief and assumption. Science has definitively demonstrated that race is not based on meaningful biology, it is at best a poor and often misleading indicator of the true biological determinants of health, such as ancestry or genetic predisposition. Misrepresentation, especially among our faculty and students, is highly problematic and provides a basis for perpetuating false beliefs, misinformation, inappropriate curricula, and improper care.
3. Health inequalities stem from racism, not race
Health inequities experienced by specific marginalized ethnic and racial groups are primarily the product and consequence of racism, not race. Racism is a powerful social determinant of health. Despite the undeniably powerful impact of racism on health, historically the term racism has generally been downplayed, ignored, or actively avoided in health-related discussions.
4. Distinguish between structural racism and interpersonal racism
It is useful to distinguish between structural and institutional racism and interpersonal racism. Discussions, activities, and proposed interventions related to anti-racism efforts in the health education setting focus primarily on structural and institutional racism, as opposed to interpersonal racism conducted at the level of the individual.
5. Structural racism extends far beyond the educational environment
Given the reality that structural racism extends well beyond today’s educational environment, the overriding issues are twofold. First, what is the role in the challenges of accreditors and the recognition and dismantling of structural racism in the health professions arena? Second, what are the roles and challenges of creditors and mitigating the pervasive and highly damaging effects of structural racism on the students, faculty and patients we serve?