After the June sphere interactive sessions with faculty, students, staff, and other stakeholders, the spheres met as a group to reflect on where they were at in the process of identifying what needs to change. Check it out.
Admissions Sphere
In Admissions we are tasked with evaluating, selecting, and recruiting the incoming class of medical students for the School. With that large task we have numerous factors that we consider in holistic review including the applicant’s passion for the profession, academic achievements, commitment to advocacy, clinical medicine and research, as well as their experience in a previous career or an extracurricular activity. Fundamental to this evaluation is a commitment to equity in the process—parsing out how facing bias, having less educational opportunity or fewer mentors may have played a role in an applicant’s trajectory.
There are numerous factors that must be considered in achieving a holistic admissions process that achieves equitable evaluations and builds a diverse class of incoming students. Our image is of a baton being passed from one runner to another. Wework to build a class of 140 unique individuals with diversity as the cornerstone of our efforts. We strive for geographic, racial, ethnic and economic diversity in the class. We recruit applicants with different educational pathways to medicine who have different passions within medicine.
Photography; Bellurget Jean Louis, Getty Images
We build relationships with colleges, high schools, and pipeline programs across the region and the country. We cultivate our ties with young people who are interested in medicine and science and act as mentors and advisors as they proceed on this pathway. We also work with pre-health advisors and high school and college educators to try to guide and inspire young people from all communities. This team approach is analogous to a baton being passed from one teammate in the undergraduate landscape to us in the medical school.
We meticulously tend to the applicant pool to make the class of individuals represent the future health care workforce. Then we pass the class over to our Curriculum and Student Affairs colleagues in the School—much like a teammate passes on the baton to another teammate. Each unique individual makes up an important part of the whole class.
The Admissions Sphere identified the following possible change target areas that have emerged thus far:
- Strengthen the communication and dialogue with those intimately involved with student life, student resources, and student learning to more deeply understand how our decisions in holistic review play out in the student’s lived experience at the School.
- Strengthen the training of Admissions Committee members to more deeply understand equity and to use this lens in evaluation and selection.
- Increase diversity of committee members to better align with our diverse applicant pool.
- Strengthen support for students in pipeline programs including our own programs and our own early assurance program to allow for equity in these programs.
Call to Action
As we continue to build upon the work we have done so far of identifying areas for growth and change we would appreciate any thoughts or feedback, especially from students, residents and fellows who have a unique perspective having been through the Admissions process in recent years. If you are interested in working with us or would simply like to send some input please let us know by emailing Jessica Maysonet, Manjil Chatterji, or Valerie Parkas.
Clinical Sphere
We are currently at a perilous point in our journey to identify change targets. We have come a long way, but still have a long way to go. We’ve mustered the courage to name some of our demons and are poised to confront them.
Photography, Janis
Call to Action
We are currently in the process of reflecting on the information gathered and identifying next steps. Stay tuned for more details.
Curricular Affairs Sphere
Since the inception of this journey we have learned and discovered a tremendous amount. Not only about the underlying symptoms and manifestations of racism within medicine and medical education, but also about how dedicated and committed we need to be to eliminating it.
We could find no image that better represented our journey than the one selected. The image depicts the literal and metaphorical journey we are all undertaking together. The existence of this initiative and the amount of buy-in we have at different levels of the organization denotes a tremendous amount of progress to date. However, while the mountain peak is far, it’s a visible goal that exists as a noble pursuit.
Photography, Jackman Chiu
All members are preparing simultaneously for the arduous task ahead. Each person is ready to carry their own baggage and belongings as they progress. As members of a team, they are happy to support one another. If one member fails to reach the summit then it will not feel like a true victory. We learn and move forward together replacing each other’s weaknesses with our strengths. Commitment to the journey is key; the nobility of the task at hand engenders loyalty to the journey in hopes of a vision that transcends us all as individuals.
Lastly, while members in the image are all in different areas, they are all in the same location. Oftentimes faculty or students may feel as if we are speaking from a point of superiority not only from the standpoint of nomenclature but ethically as well. This is not the case. We are all here, we are all present, and we rise and fall as one.
Call to Action
We welcome hearing from you regarding your racism and bias faculty development needs specific to your roles as educators of our medical students. Please look out for a survey to follow. In the meantime, you can e-mail Marley Akonnor.
Student Sphere
At this point in time we are continuing to consolidate the viewpoints of the students actively engaged in the Guiding Coalition, as well as students underrepresented in medicine within the study body. We recognize that as a student body, all students, and particularly students of color, have had unique lived experiences as they have traversed through the social and medical environment. Thus, students have highlighted a wide range of incidents that could be addressed with specific changes in policy and structures within this institution, however, as an effort to create an environment free of racism and bias, this work has created an opportunity to think more broadly. In this process we have been reflecting upon the need to define patterns, structures, mental models, and values that promote racism and bias in both implicit and explicit ways throughout this institution. 
Call to Action
Are you curious about what the Racism and Bias Initiative is up to? We are the students involved in the ongoing Guiding Coalition meetings and we want to remain transparent and accountable to the students, so we need student input! We are currently in Phase 3, where we want student feedback to help determine what needs to change in order for us to provide health care and education that is free of racism and bias.
How do we get there? Please contact us with questions and concerns at students.rbi@icahn.mssm.edu.
Student Affairs Sphere
Despite the feeling that we are unsure of what change will look like, we are hopeful that we will be able to serve URiM students better. We are grateful to be engaging in this process and trust that the process will lead us to change targets that will improve the medical experience for URiM students. The process is both ambiguous and amorphous while being directive and purposeful. We are sure that more student input is necessary. Over the next month, we are developing a more detailed call to action specifically targeting students.
The Student Affairs Sphere identified the following as potential areas of change:
Build Trust
To be effective, Student Affairs needs to earn the trust of students of color. That is our number one priority. We have found through student feedback that there are certain interactions and approaches that we can improve upon. Through this initiative and self-reflection and discussion, we will be able to address these issues. We are becoming more aware of the needs of disenfranchised students and how established policies may at times not take into consideration or be in conflict with their individual needs (i.e., housing, financial, and child care needs). How can we be equitable and consistent across Faculty Advisors? How to be more effective balancing support with making sure students meet milestones and expectations?
Increase Student Resources and Support
Part of this is marketing (many students don’t know who we are and what we do), and part of this is the fact that medicine is a culture where it is still taboo to admit vulnerability and ask for help. How do we reconcile our message to reach out for help with the larger culture of medicine perception that doctors and other high functioning individuals do not need help or ask for it?
Photography, Robert Crawford
Other reflections:
Prevalence and Surprisingly Powerful
Recently, we discussed identifying and trying to get ahead of polarizing events that occur among the student body, Medical Education faculty and staff. We discussed that certain events are inherently divisive, as individuals tend to identify with the alleged aggressor or the person that has been victimized. Developing strategies that can minimize splitting will also help us be more equitable as students often feel that at times, we are inconsistent when setting limits. Strategies include having a messaging plan, face time with relevant parties, transparency in decision making, and closing the loop about decisions or actions.
Ripple Effects
We want to address the student body’s resistance to seeking mental health services. Seeking mental health treatment is a difficult decision to make, but medical students are particularly resistant to obtaining mental health services. Imagine the impacting and wonderful, lasting ripple effects that destigmatizing mental health treatment would have on our students? This might be particularly relevant for our URiM students who may not seek treatment because of the culturally bound beliefs that are associated with obtaining such services, and the lack of resources. What are the spoken and unspoken messages that we convey that perpetuate the strongly held belief in medicine that high functioning individuals do not seek help or need mental health services? We also need to make sure our mental health services are more accessible, and that we recruit providers of color.
Togetherness
We realize that we need to become a haven for students of color, financially disadvantaged students, and students who face obstacles in achieving their goals and potential. Our job must be to help them overcome barriers, to remove obstacles, and celebrate successes.
Student Resources Sphere
After our two sphere sessions, which included Housing, Security, IT, and other stakeholders, we felt that the we needed a larger presence of students in our process. The scope of our sphere is much more multifaceted than originally anticipated. We are beginning to chip away at the many dimensions that intersect with the Student Resources Sphere.
What has emerged is that the voice of students is essential to complete this phase of our work. We will invite members of the Student Sphere, along with three students who initially signed up for our sphere, to attend a focus group session. 
Our goal for this session is to get a deeper understanding of the student experience and to assist with identifying our change targets from all perspectives.
We will then be better equipped to begin identifying our change targets.
Call to Action
The Student Resources Sphere is actively working towards identifying change targets by eliciting feedback from students, faculty, and staff. Our sphere encompasses many areas that affect the student experience including Housing, Security, Financial Aid, and health care. If you are interested in participating, please e-mail Dean For Med Ed.