Taking action

How osteopathic medical schools are fostering an anti-racist culture

“We want to encourage schools to develop the kind of culture where being diverse is a mark of excellence,” says Barbara Ross-Lee, DO. “If we can do this, we can position osteopathic medicine as being a leader in this area.”

The tragic death of George Floyd last May sparked a national outcry against racial injustice in the U.S. Across the country, people of all races came together to protest and speak out against systemic racism.

The osteopathic medical community has a long history of supporting diversity and inclusion. Before May 2020, many osteopathic medical schools were devoting significant resources to developing an anti-racist culture.

But the events of last spring and summer have demonstrated the critical importance of diversity, equity and inclusion (DEI) work, says Gary Hill, DO, the diversity officer and associate dean for multicultural affairs at Edward Via College of Osteopathic Medicine’s Auburn campus.

“This is a time when we have an opportunity to move forward and make changes to correct some of the disparities that have been demonstrated, not only socially but also in the health care arena,” he says.

Below, leaders at three osteopathic medical schools share the steps their institutions are taking to foster an anti-racist culture, and Barbara Ross-Lee, DO, the first African-American woman to serve as dean of a U.S. medical school, discusses efforts within the American Association of Colleges of Osteopathic Medicine (AACOM) to develop anti-racism initiatives across all COMs.

OU-HCOM

Tanisha King, PhD

When Tanisha King, PhD, became the first Chief Inclusion Officer at the Ohio University Heritage College of Osteopathic Medicine (OU-HCOM) in 2019, she joined the school’s dean, Kenneth Johnson, DO, in the check-in meetings he had started having with underrepresented minority students.

At these meetings, which also included the school’s executive team, dean of faculty and curriculum director, students expressed an overarching desire for a more inclusive curriculum, a more diverse faculty and required DEI training for all faculty, staff and students.

Dr. King and OU-HCOM leadership began working on these initiatives right away, scheduling six month follow-up meetings with students for accountability purposes. So far they have done the following:

  • Created an anti-racist culture committee, which is examining the curriculum and making recommendations for changes.

    “In medical education, there’s a tarnished history when it comes to the treatment of black and brown people in medicine,” Dr. King says. “There are a lot of subtle ways educational content can reiterate and perpetuate stereotypes and harmful attitudes. So we’re looking at all of it with a critical eye.”

    For instance, the committee recently identified pejorative language in a presentation about substance use and recommended wording changes to make it more empathetic.
  • Developed a pilot faculty pipeline program, which will begin this fall. In the program, OU-HCOM will hire students to teach and mentor underrepresented minority students, with the ultimate goal of eventually hiring some of those students as faculty members in the future.

    Research shows that students of color who have mentors and faculty who look like them have a greater chance of success,” Dr. King says.
  • Made DEI training mandatory for all faculty, staff and students. Previously, OU-HCOM’s DEI training had been optional.

In addition to these initiatives, Dr. King and her colleagues also developed an Anti-Racist Culture Commitment for faculty, staff and students. So far, 289 people have signed it.

RowanSOM

Yvonne Torruella Ortiz

The anti-racism work at Rowan University School of Osteopathic Medicine (RowanSOM) is also driven in part by student feedback, says Yvonne Torruella Ortiz, RowanSOM’s director of DEI.

“We have received critical feedback from our students, particularly students in the Black collective, that has really helped us look at ourselves and think about how we can be a better institution,” says Ortiz, who chairs RowanSOM’s DEI committee.

One change RowanSOM has made recently is developing a holistic admissions process, which included training everyone involved in admissions on implicit bias.

“We’ve also taken steps to level the playing field,” she says. “When we interview candidates, we have them use a virtual screen so that we can’t, for instance, tell from their surroundings that they have a child. We know with implicit bias, there are things that influence people’s perceptions of other human beings, that really gets in the way of us making a really fair assessment about what someone’s potential is.”

While admissions are currently ongoing, Ortiz says she expects next year’s incoming class to include a higher number of underrepresented minority students than the school has ever had.

With the support of the school’s leadership, Ortiz also led a climate survey for faculty, staff and students last fall that examined the inclusiveness of the educational experience at RowanSOM. She also hosted listening sessions with students, faculty and staff.

One issue that came up during those discussions is the fact that medical school is difficult for low-income students to afford. There is an upcoming Rowan University Board of Trustees tuition hearing coming up, and some RowanSOM students are hoping the board will approve measures to make out-of-state training there more financially accessible to create a more diverse physician workforce.

“Most medical students come from the upper quintiles of income, and that hasn’t really changed in almost 30 years, not significantly,” she says. “And our country needs doctors who have different lived experiences.”

Ortiz is also planning to help lead an effort to incorporate education about racism in medicine into RowanSOM’s curriculum in the next several months.

VCOM-Auburn

Gary Hill, DO

The Edward Via College of Osteopathic Medicine’s commitment to DEI is underscored in the school’s mission, notes Dr. Hill, the diversity officer and associate dean for multicultural affairs at VCOM-Auburn.

“Our mission is to prepare globally minded, community-focused physicians to meet the needs of rural and medically underserved populations and promote research to improve human health,” Dr. Hill says. “To enroll students who understand the mission of the school is an action that will minimize or curtail some of the systemic issues of racism in the U.S.”

In addition to prioritizing diversity in enrollment, VCOM also has programs in place to ensure underrepresented minority students have a voice when they are on campus, Dr. Hill says.

Each of VCOM’s four campuses has a diversity officer; each diversity officer is or will soon be in charge of a diversity and inclusion steering committee, which includes students who serve on subcommittees that examine different aspects of DEI at VCOM (diversity officers are in the process of setting their committees up at VCOM’s Carolinas and new Louisiana campuses).

Dedicating leadership resources to DEI is very important, notes Dr. Hill, who is, to his and the AOA’s knowledge, one of the first deans of an osteopathic medical school to have the title of diversity officer.

“Deans often wield a lot of power to implement and move forward ideas to address diversity, equity and inclusion,” he says.

Minority Access Inc., a nonprofit focused on diversifying campuses and work sites, has recognized VCOM as an institutional role model for the past 10 years; VCOM has also received the Insight into Diversity Higher Education Excellence in Diversity award for the past two years, Dr. Hill notes.

Anti-racism efforts across all COMs

Barbara Ross-Lee, DO

Dr. Ross-Lee leads an AACOM adaptive workgroup on addressing racism in health care education. Created last fall, the workgroup is comprised of leaders in osteopathic medical education and seeks to identify opportunities to facilitate the adoption of strategies that promote inclusion and diversity at all COMs.

The workgroup is currently focused on developing incentives for COMs to engage in the improvement of population and minority health outcomes by enhancing physician workforce development.

“We want to encourage schools to develop the kind of culture where being diverse is a mark of excellence,” says Dr. Ross-Lee, who is also the president-elect of the American Osteopathic Foundation. “If we can do this, we can position osteopathic medicine as being a leader in this area.”

The workgroup is also planning to develop a series of virtual certificates for third-year students on population health, health disparities, health policy, telemedicine and precision medicine.

“The certificates are designed to create graduates who are better prepared to understand and address current and projected systemic issues, and also to provide them with the necessary tools to positively impact minority health disparities,” Dr. Ross-Lee says.

In March, the workgroup plans to present the certificate program to AACOM’s Board of Deans. If approved, Dr. Ross-Lee expects the first certificate module, which will be on population health and minority health disparities, to be available by summer 2021.

3 comments

  1. I went to D.O. School when there were only 5 schools. I’ve been able to climb through the medical world. In Detroit as a GP, I was in an informal group that shared call, and lo and behold Dr. Lee was one with whom I shared call. No racism that I knew of. Now I see we have racism in D.O. Schools. Exactly how is that? What is owing on in D.O. Schools that is racist? I read that most of the students come from the “ upper quintiles of income”. Really? What is this based on. As for me coming from Detroit and going to COMS I certainly wasn’t from the upper levels, as were many of my classmates. However I am white, and I’ve recently learned that makes me a man of privilege even though I’ve paid for 100% of my education, and worked to pay it back.

    Please tell me AOA what exactly makes our schools racist? When did we become a occupation that the color of one skin counts more than the content of one’s character and brain. I suggest you listen to MLK’s “I have a dream speech”. He would pass the test in the world you describe. I am simply shocked by reading this from the AOA.

    1. Dr. Rein, your statement of “no racism that I knew of” is precisely the statement of someone who is privileged enough to not know of either the overt or subtle forms of racism that must have existed in your earlier medical days, and certainly still exists today. I wonder if you asked Dr. Ross-Lee what her experiences were at the time you shared call? I can say as a student of color, it’s sometimes the sidelong glances, the surprising assumptions of your background based on skin color, or the changes in voice inflection that reflect bias. It’s not always the exclusion of opportunities, name-calling, or other dramatic demonstrations of racism that we experience. Yet, we can experience both. If I may suggest one thing, it is to look deeply into the experiences of those of color to know what may not be so obvious to your eyes. You may be surprised to learn of happenings just under the surface.

  2. I’m not “AOA”, but I am on the faculty at a DO school. For context, I am also white. I have examples of how a DO (or MD) education can be non-inclusive or racist:
    1. The only photos of skin conditions are of people with white skin
    2. When faculty don’t know what skin conditions would look like on people with darker skin.
    3. When a faculty person says that “Black people are at higher risk for diabetes” without approaching the reasons for that, that’s not inclusive; that is just putting forward falsehoods that physicians think they “know”.
    4. When faculty reference “differences” between races, as though race were a biological fact rather than a construct created throughout history by white people.
    5. When faculty write teaching cases and the patients of lower SES are always people of color.

    And that’s just in the curriculum we teach our students.

    No one is saying that skin color is more important than character; however, we need to make sure that we are equitable in our approach. We need to show our students pictures of skin conditions on all shades of skin. We need to include context around things like “The GFR levels differ depending on the patient’s race” – we need to talk about how we came to create the different “normal” for different skin colors.

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