DermWorld Academy Insider: Championing diversity
Nov. 15, 2021
For the third straight year, the AAD held a Diversity Champion Workshop in 2021 in advance of the Association of Professors of Dermatology meeting, part of an effort to improve the pipeline of future dermatologists who are underrepresented minorities. In this DermWorld Academy Insider Exclusive, Diversity Champion Workshop attendee Sacharitha Bowers, MD, FAAD, discusses what attendees learned and discussed at the virtual event on Oct. 28, 2021. Learn more below and register for 2022’s event now!
DermWorld: To kick off the Workshop, Dr. Amit Pandya gave an update on the state of the specialty. What was the most striking news/data he reported as it relates to health care disparities and the importance of diversifying the specialty?
Dr. Bowers: To me, what was the most striking is how little change we have made over the years, and also hearing about the attrition rate of Black dermatology residents was shocking and appalling. It also shines a light on how important it is for us to focus not just on entry into our specialty, but the culture of inclusion WITHIN our specialty.
DermWorld: The Diversity Champion Workshop is designed for faculty members in dermatology residency programs who are involved in the evaluation and selection of candidates for their program. When thinking about diversifying the specialty, why is it crucial to start at the residency level?
Dr. Bowers: I actually think it is crucial that we start earlier in the pipeline — at least at the medical school level, if not earlier. If we start at the residency level only, it will be too late. We won’t see who never even makes it to our doors. But it is of course critically important to focus on resident selection because this is the biggest gateway to entering our specialty. It’s not the first one, but it’s the major one. Who we pick to join our residency programs determines the dermatology workforce that will be entrusted with the care of our patients. If we want to decrease health care disparities and improve health equity, we must diversify our workforce (and this is based on evidence), and to do this we need to ensure that our residency selection processes are approaching recruitment from a holistic and equity-based perspective.
DermWorld: Workshop speakers discussed new diversity, equality, and inclusion initiatives. Which initiatives stood out to you? Was there a common theme that made initiatives successful?
Dr. Bowers: To be honest, there is no initiative that isn’t needed, and everything that different individuals and programs are doing is going to help our specialty move the needle forward. Whether it’s curriculum based, such as the initiatives Dr. Susan Taylor spoke about, or holistic review, that Dr. Laura Rubinos spoke of, or mentorship, it’s all necessary and important. This work will take all of us and many approaches — holistic, if you will!
DermWorld: What changes do you plan to implement in your program/practice as a result of participating in the Diversity Champion Program? If you have already implemented changes, what barriers have you faced? What has been successful?
Dr. Bowers: In 2020, I started a pilot version of a new health equity curriculum for our residency program, called HEAL, which stands for Health Equity Awareness and Learning. This year, we have a newly formed committee in our program called the SIU Dermatology Health Equity Committee and we are going to take HEAL to a full learning series in a collaborative manner. I believe it’s important for health equity learning to happen at all levels of the program, from residents, faculty to staff and administration. But often learning about health equity means facing some topics that may be uncomfortable for some people, and working through that discomfort can be challenging. Additionally, it’s hard to carve out the time in an already very full schedule. But the stakes are high and equity work deserves to be a top priority in my book so finding ways to craft my schedule so that this work can get done is a necessary task.
As part of the curriculum, I’ve discussed unconscious/implicit bias and its effects in patient care as well as in residency selection. I’ve also discussed the importance of implementing holistic review, performing residency interviews in a holistic approach, and using a holistic lens for the ranking process. As a program, we have been implementing holistic review and it’s been a process that’s been evolving over the last few years. One of the barriers is that it can be hard to change processes that have been in place for a long time, and different people have different perspectives and approaches when it comes to residency application review. Trying to change set-in practices and get people to look at things a different way, especially if that different way takes more time and effort, is challenging. But I’ve also realized that some change is better than no change and it’s ok for progress to move slower than maybe what you’d like to see, as long as you are still moving forward. This year, more people in our program, residents and faculty alike, reviewed applications holistically than ever before. And our pool of applicants we selected for interview includes more underrepresented in medicine candidates than it ever has before. So I consider this a big success!
