Racism and Bias Initiative (RBI) x Center for Anti-Racism in Practice (CAP) Fellowship for Icahn School of Medicine Students

Racism and Bias Initiative (RBI) x Center for Anti-Racism in Practice (CAP) Fellowship for Icahn School of Medicine Students

Our mission is to support and advance the lifelong pursuit of anti-racism, equity, and racial justice as the organizing principles of medical education at the Icahn School of Medicine at Mount Sinai (ISMMS).

RBI x CAP Fellows will work closely with ISMMS leaders across all functional areas of the school of medicine and report directly to the co-Directors of the Center for Anti-Racism in Practice. Fellows will serve as an invaluable capacity-building resource for school and institution-wide anti-racism initiatives.

 

Applications Open: Tuesday, September 5 at 2 pm

Applications Close: Tuesday, September 19 at 11:59 pm

As a fellow, here’s what you’ll do:

While any of these activities may result in a scholarly product,

the primary purpose of RBI x CAP Fellows is to expand the workforce

focused on anti-racism work for the Icahn School of Medicine

at Mount Sinai. 

 

Fellow projects for the 2023-2024 cycle are:

Building a Mechanism to Track Equity in Policies

  • Unit: Medical Education Administration, Department of Medical Education

  • Project supervisors: Colleen Hayden, EdD, Director of Quality, Compliance, & Accreditation and Leona Hess, PhD, Senior Director of Strategy and Equity Education Programs

  • Project Description: As part of the Racism and Bias Initiative’s guiding coalition change targets, a protocol was developed and implemented to conduct an equity audit on fifteen student facing policies. The next phase of the audit is to develop a mechanism to track relevant data points to determine the extent to which selected policies are implemented and/or enforced equitably. The fellow will collaborate with Student Affairs and Curricular Affairs to design and implement a new mechanism.  

Coordinating Anti-Racist Strategies Across Student Groups

  • Unit: Office for Diversity & Inclusion
  • Project Description: As part of the Racism and Bias Initiative’s guiding coalition change targets, the goal is to provide a space for student group members to dialogue, dream, and design strategies for how to incorporate anti-racism into their programming and efforts. This project will involve the co-planning and project management of 3 annual anti-racist retreats for student groups, in coordination with the Office for Diversity and Inclusion/Center for Multicultural and Community Affairs, the Racism and Bias Initiatives of the medical and graduate schools, the Student Council URiSM Representatives, and other stakeholders as needed. The fellow will schedule and manage meetings with the planning team; maintain detailed notes; organize retreat materials; promote and market the retreats; co-facilitate the retreats; assess feedback; and report back themes and critical findings to the guiding coalition.
  • Project Supervisor: Ashley Michelle Fowler, MEd, Administrative Program Manager
    •  

Establishing a Sustainable Connection between Undergraduate Pre-Health Student Affinity Groups and the ISMMS

  • Unit: Admissions, Department of Medical Education 
  • Project Description: This project aims to create a lasting and beneficial relationship between undergraduate pre-health student affinity groups and the Icahn School of Medicine. The fellow will build relationships, establish a mentorship program, organize campus visits and collaborative events, facilitate connections to enrich research and clinical experiences, conduct professional development workshops, and develop a long-term sustainability plan. Through this project, the goal is to support undergraduate students from historically excluded groups interested in pursuing medical careers, promote diversity in healthcare, and create a nurturing environment that fosters success. 
  • Project Supervisor: Jessica Maysonet 

Sustaining a Community of Practice Among Medical students Across the Country and Canada

Newly selected fellows will work in collaboration with existing Fellows working on this effort.

Designing the Advocacy, Social Justice, and Anti-oppression Thread in the Curriculum Redesign

  • Unit: Curricular Affairs and Center for Anti-racism in Practice  
  • Project Description: In November 2021, the Office of Curricular Affairs began the process of curriculum redesign for the MD program. As part of the new curriculum design there is an Advocacy, Social Justice, and Anti-Oppression (ASA) thread that is designed to equip all students with the knowledge and skills they need to address social determinants of health and promote health equity for all patients with a particular focus on the impact of racism as a social determinant of health. It prepares future physicians to be effective advocates for their patients and to work towards a more equitable health system. The fellow will join the ASA workgroup and partner with the instructional designer consultant to develop an ASA curricular map and relevant learning activities. 
  • Project Supervisor: Leona Hess, PhD, Senior Director of Strategy and Equity Education Programs and Consultant

Developing an Equity-centered Approach Graduation Awards Nomination and Selection Process

  • Unit: Student Affairs, Department of Medical Education  
  • Project Description: In Graduation and departmental awards are a long-held tradition in medical schools and have real implications in the academic careers of medical students. This project seeks to identity equity-centered practices in nominating and selecting awardees to inform the development of a framework that can be applied to our medical school’s process. The fellow will review the literature on equity-centered practices, evaluate ISMMS current award selection process with an equity lens, develop an equity-centered framework and protocol that will be applied to the 2024 graduation wards process, conduct a post-award selection evaluation and amend protocol and develop recommendation, if necessary.
  • Project Supervisors: Alicia Hurtado, MD and Ann-Gel Palermo, DrPH

RBI Student Sphere

  • Unit: Department of Medical Education, Racism & Bias Initiative
  • Project Description:
  • As part of the Racism and Bias Initiative’s (RBI) change management plan, our commitment is to establish a diverse guiding coalition of faculty, staff, leadership, and students to determine the change targets, identify options for implementation, make decisions about where energy and resources should be focused, and determine how to hold people accountable, and manage resistance in the medical school and beyond. The guiding coalition is made up of seven spheres or functional areas: Admissions, Curricular Affairs, Student Affairs, Clinical, Resources, Medical School-Wide and Student. The Student Sphere lead will participate in Guiding Coalition planning meetings and processes, and will be responsible for the development, implementation, and monitoring of the change Targets in the student Sphere. The Lead will also serve as liaison for student involvement in Chats for Change, Orientation and other RBI Sphere work.
  • Project Supervisor: Leona Hess, PhD

Propose Your Own Project

This year we are offering an opportunity for a fellow to propose and execute an innovative project of their own. In the application you will have the opportunity to submit a potential project name, supervisors, description, outcomes/deliverables, and responsibilities. We are looking for a project that is:

  • Aligned with our mission to nurture a visionary community of students, staff, faculty and leaders who are committed to advancing exceptional clinical care and science that is free of racism and oppression in all its forms;
  • Designed to address a gap or concern related to our learning environment;
  • Achievable in 8 months; and 
  • Innovative and doesn’t duplicate or complete with the current twenty-four change targets 

Fellows will:

  • be closely mentored by Med Ed leadership and CAP
  • work with or be a liaison to other relevant medical school administrators, students, and partners including but not limited to the Office for Diversity & Inclusion and the Graduate School of Biomedical Sciences
  • be part of a Fellows community of practice and mutual support
  • learn anti-racist and anti-oppressive teaching, facilitation, and reflection practices
  • learn leadership, communication, and conflict resolution skills
  • have opportunities to develop projects into scholarly products
  • develop the capacity to design and facilitate equity programming beyond medical school, in residency training and their professional careers
  • when applicable, manage a modest programming budget and submit required documentation to Med Ed administration
  • receive a stipend of $5,000 for every year that they serve as a fellow

Fellow Requirements:

  • Approximately 20 hours/month for the eight-month commitment.
  • Fellows may apply to renew their commitment in subsequent years, up to their full tenure at ISMMS.
  • Student on Scholarly Year may not apply for a RBI x CAP Fellowship
  • Participate in two training/program planning lunches each semester that will bring together all Fellows.
  • Complete one scheduled check-in per semester with the Dean for Medical Education.
  • Fellows will present their work to the RBI Guiding Coalition, Senior Leadership Committee, and other key stakeholders in a “re-CAP” presentation at the close of the Fellowship
  • Up to eight fellows will be selected to participate.

Application Process

Candidates will be required to submit their CV and answer several questions in a total of 500 words or less.

Submitted applications will be reviewed and scored by a selection committee composed of members of the Racism and Bias Initiative Guiding Coalition (Medical Education faculty, staff, leaders, and students). Each reviewer will consider your alignment with the School’s vision and values, and your track record of contributions/leadership in addressing racism and bias.

Submit all applications by Tuesday, September 19 at 11:59 pm EST.

What’s New with Chats for Change?

 

 At the Icahn School of Medicine at Mount Sinai, Chats for Change was built on the notion that in order to respond to racism and to be anti-racist we must engage in dialogue, learning and action.

 

Beginning in the fall of 2018, the Department of Medical Education launched Chats for Change—a series of sessions that spark dialogue centered on racism and bias in medicine. The idea of Chats for Change was developed in response to medical education staff and medical students who wanted dedicated time to engage in a dialogue as a community to deepen our understanding and ability to address racism.

 All faculty, staff, trainees, students and others within the health system are invited to engage in dialogue and work towards common understanding by contributing their best thinking, knowing that other peoples’ reflections help to improve their thinking rather than destroy it. We are committed to engaging in dialogue in order to help us reveal our assumptions and biases for self-revaluation.

 By participating in Chats for Change, we offer an opportunity for attendees to explore key concepts related to racism and bias and uncover who they are in relation to others. Even though the dialogue is structured, the expectation is for attendees to express themselves from their own lived perspectives and listen for deeper understanding and insight.

 In August 2020, we launched the national edition of Chats for Change, a series of monthly dialogues focused on topics related to racism and bias in medicine. All medical schools from across the country and Canada are welcome—staff, faculty, trainees, leadership and students.

 

The Process

Each Chats for Change follows the same format:

  1. We open each session with a check in and a review of the grounding assumptions.
  2. The facilitators then introduce a concept or topic related to racism and bias.
  3. To level set knowledge we provide a frame and definition.
  4. The group then goes into breakout rooms to discuss the guiding questions related to the concept or topic.
  5. We then return to the larger group for debrief and close the session with a reflection about what we need to learn or unlearn.

Feedback

Out of 311 respondents:

  • 92% of respondents reported that Chats for Change simulates their interest in the topic.
  • 85% reported Chats for Change dialogue will help them take sound action in the future.
  • 95% would recommend Chats for Change to a colleague or peer.

To the right is what a few attendees had to say about their experience with Chats for Change:

I find Chats for Change amongst the most valuable learning sessions that I have ever had at Mount Sinai. I have grown through them. Thank you.”

“This venue allows for respectful open and honest conversations with colleagues and allows me to think of different ways to do my work and hear specific examples of things that have worked in other universities.” 

“What I really appreciated about this was the small bite sized ways that we could engage with the content”

“I’m just fatigued. It helps and feels validating to hear other people experiencing similar experiences and feelings as me.”

Here’s how you can get involved with Chats for Change.

 
Attend Chats for Change

Join the National Chats for Change to conclude the three-part series called In the News. The media is a powerful socialization tool that creates unspoken attitudes, beliefs, and narratives through messages and images. We often do not stop, reflect, and analyze how this tool impacts us as individuals and the environments in which we work and learn. 

Become a Facilitator

If you are interested in learning more about how to facilitate Chats for Change, please sign up to attend one of our upcoming trainings. Space is limited.

  • 10/19 11:00-12:00p EST 
  • 10/20 3:00-4:00p EST 
  • 10/24 1:00-2:00p EST 
  • 10/26 1:00-2:00p EST 
Download New Content

We are making the Chats for Change slide decks available. Please fill out this brief form to gain access to the shared folder. We are launching the Say what you mean, mean what you say series first.

Shout Outs

Last but not least, we would like to recognize the Chats for Change core group facilitator group for their dedication and commitment to this work. We have facilitated over a hundred and twenty topics with over 3,000 attendees. Congrats!

 

Special thanks to:
Alia Barnes, MPH   |  Ashley Michelle Fowler, MEd  |  Leona Hess, PhD, MSW  |  Jay Johnson, CHES  |  Jenn Meyer, MPH, MSW  |  David Muller, MD  |  Ann-Gel Palermo, DrPH  |  Pete Zweig, MPA 

What’s Chats for Change?

Beginning in the fall of 2018, the Department of Medical Education at the Icahn School of Medicine at Mount Sinai launched “Chats for Change”—a series of interactive sessions that spark dialogue centered on racism and bias in medicine.

 

 

Chats for Change is built on the notion that in order to respond to racism and to be anti-racist we must engage in dialogue, learning and action. The idea of Chats for Change was developed in response to medical education staff, students, and faculty who wanted dedicated time to engage in a dialogue as a community and deepen our collective understanding and ability to address racism.

By participating in Chats for Change, we offer an opportunity for attendees to explore key concepts related to racism and bias and uncover who they are in relation to others. Even though the dialogue is structured, the expectation is for attendees to express themselves from their own lived experiences and listen for deeper understanding and insights that will promote learning and unlearning.

We invite all faculty, staff, trainees, leaders, students and others within the health system to join us and engage in dialogue as we work towards a common understanding and contribute our best thinking, knowing that other peoples’ reflections help to improve our thinking. We are committed to helping each other reveal our assumptions and biases for self-revaluation.

Inside the Student Healing Circle: A Lesson in Dignity

After many months of online lectures, tele-health physical exams, and learning how to cope with the responsibilities of becoming a health professional during a pandemic, I ventured out back onto the hospital wards for the first time this week. I went to a cardiothoracic unit where most patients had recently undergone an invasive procedure and were being closely monitored during their recovery.

When I first introduced myself to my assigned patient, I explained that I was a second-year medical school student there to practice my history-taking and physical exam skills, and that I hoped to spend the next hour with him getting to know him better. He interrupted me before I could finish, “Excuse me, miss, let me find you a chair to sit in. I don’t know where they all went,” and proceeded to press his “call” button to alert the floor staff that he needed assistance. 

He inquired about the chairs to the nursing staff on the floor with no resolve, and so I took a comfortable stance and began my interview. In common practice, I began by inquiring what had brought the patient in initially. I learned about his medical history, which was largely uncomplicated until the summer of 2020, and we shared about how God grants us the gift of forgetfulness to allow us to endure pain. Time after time in our conversation, he would express his frustration with his missing chairs. In the end, this elderly Black man sat in front of me with an assistance device working to keep him and his heart alive, and an infection that had kept him in and out of the hospital for 3 months now – and still, he was the most upset about the chairs that were missing from his room. He was most concerned about his dignity as a patient. 

Donna Hicks, a renowned expert on the role of dignity in conflict, defines dignity as the internal state of peace that comes with the recognition and acceptance of the value and vulnerability of all living things. As social beings, our survival is linked to the quality of our relationships, and honoring dignity in ourselves and others is the foundation of any functional, healthy relationship – whether it be with our patients, our peers, family, friends, etc. However, our evolutionary legacy of self-preservation and systemic oppression often puts us at risk of violating our own and others’ dignity.

My patient, Mr. L spent most of his days in the hospital bed longing for a genuine conversation, and in many ways, the chairs represented connection for him – one that we all crave and are deserving of. Not surprisingly, no one bothered to get a chair and the moment stuck with me. In the Hippocratic oath, we, as health professionals, vow to “remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.” As a physician-in-training, medical school has often made me question my own dignity and reckon with how I/we see and acknowledge the dignity of those we interact with every day. We assume the responsibility for managing patients’ care while frequently serving as leaders to apply our unique knowledge-base, skills and training, and to do no harm. Yet our biggest challenge seems to be the most simple one— treating one another with dignity. 

The power of dignity gives us the awareness and skills to avoid unknowingly harming others, while allowing us to recognize the fullness within ourselves and our relationships. Racial healing, which is grounded in indigenous circle and community-sustaining practices, recognizes the need to speak truths about past wrongs, including those created by individual and systemic racism, and to address the present consequences. It is an experience and a tool that can facilitate trust and build authentic relationships as we draw on our stories to learn from and with one another about how we can heal, rather than cause harm to ourselves and others.

Every month in our circle, we cultivate and harvest wisdom about what is on our hearts and what dignity feels like. Even if we feel a lack of dignity, in our healing circle we can garner the capacity to imagine what it might feel like together and continue to share that practice in our profession. Join us for our next racial healing circle on Friday, March 19 as we stitch together moments of vulnerability to remind each other of our own value and dignity in a safe space.

A community poem, generated from the collective wisdom in our circle and prompts from our Healing Circle session held on February 19.

Dignity feels like

Groundedness

Anchoring

Sureness of self

Curiosity, 

Respect from others,

Feeling physically full,

Nakedness

Authenticity

The power of imagining what it could feel like.

 

My relationship and sense of belonging is grounded in dignity when

It has a name

We are dignified over the conflict over it and the need for it

When it’s chosen and unchosen;

Like the dignity of a child or newborn.

May You Be Happy.

May You Be Safe.

May You Be Well.

 

I will recognize the fullness in myself and others by

Appreciating that there is no right answer and we are figuring it out;

Holding fullness with mystery,

Feeling expansive

Even in our own family, with strangers and those we can count with our fingers,

Expressing gratitude.


This post was written by Jennifer Dias, a second-year medical student at the Icahn School of Medicine at Mount Sinai. 

On the Pulse: Desegregating Healthcare Systems

What does a desegregated health care system look like and how can we get there? This was the theme for the Chats for Change on March 2, 2021.

We gathered.

Nearly 100 students, faculty, care providers, hospital leadership, and administrators gathered to share their perspectives and knowledge on the issue. We had representation from across Mount Sinai’s campuses as well as folks from other institutions in NYC!

We framed the conversation.

We began our conversation by setting a common framework for the dialogue by defining segregated care: the separation of patients based on insurance status. This exists when patients who have public insurance are seen by different physicians, in a different location, or at different times than patients with private insurance. This segregation by insurance negatively impacts patient experience and how students learn about medicine. This separation occurs both within institutions and between the public and private hospital systems. 

The systemic effects of racism, white supremacy culture, and capitalism are embedded into differences in insurance status. As a result, by segregating by insurance, we are segregating patients by race. One-in-four non-elderly New Yorkers have medicaid, and among those Medicaid enrollees, white people are under-represented and people of color or over-represented. Segregated care perpetuates racism and inequity.

As the theme suggests, our goal was to imagine a desegregated, equitable system, which requires us to move beyond the way the system is currently set up. So we moved on to brainstorming the different avenues of care in New York City to acknowledge what is currently in place. Responses ranged from the community health centers, urgent care, private practice, to the internet, with hospitals making up the overwhelming majority. 

We dialogued

In small groups, we discussed the following questions:

  1. What would a desegregated system look like across NYC, assuming there are truly no boundaries? 
  2. Who might benefit from a desegregated health care system?   
  3. What is an immediate actionable change that can be made to bring us closer to a desegregated system? 

The point wasn’t to be bogged down in the barriers. The point was to envision a better future. As such, we framed the conversation as aspirational. Our dialogue didn’t need to be feasible or realistic. We focused the purpose on envisioning who and how people would benefit from a desegregated system and what that would look like, rather than how we would get there. Then, we spoke about changes that could be made to get us closer to what we envisioned. 

We aspired: 

Individuals brainstormed and logged in their responses. Here are some of the themes that arose:  

Desegregated care would mean:

  • Equity in access to resources and longitudinal care 
  • Educating physicians to treat a diverse patient population
  • A renewed focus on preventative care
  • All people, regardless of insurance or immigration status, would be able to access care

We brainstormed ways to get there together: 

  • Mount Sinai should/will publicly denounce Segregated Care both institutionally and across NY.
  • Full price transparency mandated to all hospitals/clinics/healthcare systems to promote using money in a more equitable manner. 
  • Lower the debt burden for medical students to prevent the physician financial stress that contributes to segregated care and diversify our physician network.
  • Move towards a single payer model for healthcare. 

We will take action: 

  • Acknowledge and actively address biases. 
  • We will continue the conversation and note differences in our training, work, and community that are grounded in structural racism and segregated care
  • Talk to peers working at different institutions to see how we can work together towards a desegregated, more equitable system
  • Instead of focusing on barriers, we will focus on the immediate actionable changes that can be made. 

We will continue the conversation: 

If you are working on desegregation and integration at Mount Sinai or any other institution, the Segregated Care Work Group would love to hear from you – please email Emily Xu (emily.xu@icahn.mssm.edu) and Paige Cloonan (paige.cloonan@icahn.mssm.edu) to set up a time to meet with us! Please also reach out if you’re interested in working on a project with us! We welcome everyone – regardless of role or institution. 

Do you have any experiences with segregated care as a provider, patient, or trainee (student, resident, fellow) that you would like to share? Feel free to contact us directly, or submit your story anonymously here


This post was written by Emily Xu and Paige Cloonan, medical students and co-facilitators of the Chats for Change session, “Desegregating Care: Imagining an Equitable NYC Healthcare System.”

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