Increasing Racial and Ethnic Diversity in Academic Medicine

Carla Boutin-Foster, MD, MSAssociate Professor of Medicine

Associate Professor of Public HealthAssistant Dean for Faculty Diversity

ObjectivesThe objectives of this talk are:

1.To provide a brief overview of the challenges faced by racial and ethnic minority women in academic medicine

2.Discuss strategies that have been taken at Weill Cornell to address these challenges

Racial and ethnic Minorities

Racial and ethnic minorities represent approximately 15% of medical students(Black, Hispanic, <1% Native Americans) (55% white, 20% Asian)

A greater proportion of women among URM students

Racial and ethnic minorities represent 7%of all faculty (61% White, 13% Asian, <1% Native Americans)

U.S. Medical School Faculty by Gender and Rank, 2007(AAMC)

Gender ProfessorAssociate Professor

Assistant Professor Instructor Other

Male 83% 71% 60% 49% 52%Female 17% 29% 40% 51% 47%

WCMC Faculty by Gender and Rank, 2010

Gender ProfAssocProf

Asst Prof Instruc Total

Men 69% 58% 49% 47% 56%

Women 31% 42% 51% 53% 44%

U.S. Medical School Faculty by Race, Ethnicity and Rank, 2007

Race/Ethnicity ProfessorAssociate Professor

Assistant Professor Instructor Other Total

White 83.7% 76.0% 60.5% 59.2% 54.7% 69.0%Asian 7.2% 10.7% 16.7% 16.2% 19.2% 13.2%Black/African American 1.3% 2.5% 4.1% 4.0% 2.4% 3.0%Native American/Hawaiian/Alaskan 0.1% 0.1% 0.3% 0.4% 1.3% 0.3%Hispanic* 2.9% 3.7% 5.3% 4.3% 3.3% 4.2%Multiple race 1.2% 1.8% 3.3% 2.8% 2.5% 2.4%Other/Unknown 3.6% 5.1% 9.8% 13.2% 16.7% 7.9%

*Includes Cuban, Mexican American, Puerto Rican, Other Hispanic and Multiple Hispanic

WCMC Faculty by Race, Ethnicity and Rank, 2010

Race/Ethnicity ProfAssocProf

Asst Prof Instru Total

White 92% 79% 68% 63% 77%Asian 7% 12% 19% 26% 15%Black/African American 0% 7% 6% 7% 5%Hispanic 1% 2% 4% 5% 3%Multiple race 0% 0% 2% 0% 1%

Challenges to Academic Promotion Racial and Ethnic Minority Women

SocietalBias(gender and racial\ethnic)Gender roles family responsibilities fall on theshoulders of women(children or aging parents)Fewer socioeconomic reserves and resources(higher medical school financial burden)

Institutional Fewer numbers which creates isolationInsufficient mentors Lack of role models in positions of leadership(Common to all women particularly women of color)

Call to Academic MedicineAcademic centers must put strategic programsin place that increase the culture of diversity (comefrom the leadership at the institution and must berepeated, and integrated as part of the core values)

Create a balance that helps minimize or to helpbuffer some of the social burdens on women

Create supporting environments where women andURM can thrive academically and achieve personallysatisfying academic careers

Office of Faculty Diversity The mission of the Office of Faculty Diversity is tocreate a palpable culture of Inclusiveness,Diversity, and Equity in Academic Leadership atWeill Cornell Medical College (IDEAL)

This mission is implemented through programs thatsupport recruitment, mentorship, retention, promotionof diverse faculty

Appointed as representatives on the UniversityDiversity Council to develop a strategic plan fordiversity

Core Principles\Target AreasThe UDC proposed a framework for structuring activities according to four Core Principles. Each unit developed at least 5 initiatives and one had to be composition.

Composition refers to implementing programs and activities that result in a measurable increase in diversity for a target population-pipelines

Engagement creating opportunities for dynamic exchange across diverse groups in all aspects of academic life; build processes for recognizing active engagement in diversity

Inclusion cultivating an environment in which everyone is welcomed and are able to participate fully in the range of educational, clinical , and research activities at WCMC

Achievement building infrastructure that promotes and supports equitable representation of diverse faculty at all ranks, leadership positions, and honors, awards, and professional opportunities

11

Composition

Build pipelines programs from middle schoolthrough undergraduate school

Internal mentorship to support medicalstudents, work through the studentleadership groups

Next steps: Joint Weill –Cornell Ithaca co-mentorship of underrepresented minority students interested in biomedicine\public health

Pipeline programsThe Student Affairs office supportsCornell Kids: middle schoolsHPREP: high schoolTravelers Program : undergradsGateWay Program: undergrads MD\PhD

Office brings these groups together: Each year we bring these students together to discuss academic careers and network

To help students take the next step and actually apply to these programs

The Achieving Successful and Productive Academic Research Careers (SPARC) initiative is designed to provide academic social networking and research skills building. SPARC is a collaboration between Weill Cornell Medical College, Memorial Sloan-Kettering Cancer Center, and Rockefeller University. May 13th next

SPARC Initiative(Inclusion\Engagement)

17

SPARC I and II

Mentorship: finding a mentor, recognizing when it may be time to become independent or time to change mentors

Establishing an academic research portfolio:

Publications and grant submission, provided attendees an opportunity to present their research and get feed back

SPARC III –May 13th

Creating productive partnerships:

How to connect with industry

Connecting with foundations

Connecting with community partners

Elevator speech

Mapping your social networks

AchievementPioneers Award: highlights the achievement of students, residents, faculty, and staff whose work has contributed to promoting diversity and community service: keynote speakers

Dr. Alvin Poussaint: Harvard psychiatrist, author, consultant to Bill Cosby

Dr. Anne Beale: Chief Operating Officer Patient-Centered Outcomes Research Institute

Dr. Barry Smith: Director of Rogosin and president of Dreyfus Foundation

Achievement

Research and publications remain as the main route for promotion and tenure

Women and underrepresented minority faculty hold fewer NIH grants

The problem is fewer grants are submitted

Fewer grants are revised and resubmitted

AchievementSeminar on career training award K-awards

Invited previous recipients of K awards

Emphasis on women and underrepresented minorities

Invited Martha Bruce as speaker to discuss successfully applications for awards

Shared strategies

Diversity by Design

• Creating programs that are likely to attract women and URM

• Of the 15 Centers of Excellence in Women’s Health 13 are directed by women

• URM are more likely to address issues on disparities, vulnerable health, public health, women’s health, aging

Plans to practice in underserved area

Association of American Medical Colleges survey reported that

•24% of all school students planned to practice in an underserved areas

•54% of Black students

•35% of Latino\Native American

•20% of White and Asians students

Focusing on areas with personal relevance to applicants and creating opportunities for scholarship in these area can be used to recruit more diverse students and faculty mentors and create opportunities for leadership.

(Carnes, M. Journal of the American Geriatrics Society, June 2006; 54:6)

Women’s Health Research

Attracts more women

Attracts women as mentors

Addresses health concerns and health problems largely faced by women

Interdisciplinary (basic biology and molecular biology of breast cancer to public health policy on domestic violence)

Creates opportunities for academic leadership

Summary

• Recognize numbers are small

• Facilitate networking

• Share information

• Create opportunities for shared interest

• Recognize and highlight accomplishments

ChallengesFunding for programs

Student stipends, travel, lodging

Sustaining mentors: recognition as part of promotion

Systematic data collection for benchmarking

Thank you

Total Faculty at Weill

Total FacultyGender 56% Male

44% Female

Race/ Ethnicity 73% White22% Asian/Pacific Islander3% Black Non-Hispanic1.8% Hispanic Latino0.2% Multiracial

Rank 11% Instructor42% Assistant Professor23% Associate Professor24% Professor

Women in Medicine

Women represent approximately50% of first year students40% of all residents30% of all faculty42% of assistant professors30% of all associate professors18% of all full professors14% of all department chairs12% of medical school deans

Underrepresented in Medicine Definition

On March 19, 2004, the AAMC

"Underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population."

Adopted by the AAMC's Executive Council on June 26, 2003, the definition helps medical schools accomplish three important objectives:

a shift in focus from a fixed aggregation of four racial and ethnic groups to a continually evolving underlying reality. The definition accommodates including and removing underrepresented groups on the basis of changing demographics of society and the profession,

a shift in focus from a national perspective to a regional or local perspective on underrepresentation, and

stimulate data collection and reporting on the broad range of racial and ethnic self-descriptions.

• Before June 26, 2003, the AAMC used the term "underrepresented minority (URM)," which consisted of Blacks, Mexican-Americans, Native Americans (that is, American Indians, Alaska Natives, and Native Hawaiians), and mainland Puerto Ricans. The AAMC remains committed to ensuring access to medical education and medicine-related careers for individuals from these four historically underrepresented racial/ethnic groups.