Just imagine being invited to your first year medical school class party. There are 160 students in the class, 80 men and 80 women. You have accomplished all the rigor of college and entrance requirements for medical school. You MADE IT! Upon entrance into the reception hall, you notice that everyone looks different than you. Some are blonde, brunette, red-headed, while some wear braids, dreadlocks, beards, short skirts, long skirts, suits, jeans, saris, and chadors. One important observation: it is completely silent in the room. Your classmates are smiling, dancing, and having a good time. They are all signing. You have no idea what they are saying. You happen to bring diversity to the group, because you bring verbal language to a deaf group of medical students. However, you are now excluded because of the inability to communicate with your peers. How will you get through medical school in this most unusual environment? The environment is unusual for you, not the deaf medical students.
What is diversity in this situation? There are different cultures and customs represented by their attire. Different ideas will be contributed to this diverse first-year medical school matriculants.
What is inclusion? Inclusion means not just being invited to the party, but being asked to dance. An invitation to be counted in is important for a healthy relationship with your colleagues.
The University of Mississippi Medical Center (UMMC) is committed to diversity and inclusion (D&I). The Department of Medicine has formulated a D&I committee to align with the university’s commitment to diversify medical staff, residency, and fellowship programs. Our focus of providing excellence in the field of research, education and patient care would be best accomplished with diversification. Consider the absence of physicians from different backgrounds such as:
- Daniel Hale Williams, an African American male who was the first physician to perform a pericardiotomy in treatment of tamponade;
- Pedro and Josep Brugada, Spaniard physicians described the Brugada syndrome;
- Elena Sgarbossa, a Argentinian born female physician who described Sgarbossa criteria in recognizing acute myocardial infarction with a left bundle branch block.; and
- Virginia Apgar who described the newborn Apgar scoring.
There would be many pieces of the medical puzzles missing if we ignored diversity. Numerous diverse backgrounds played a part in the history of medicine. We will continue those trends here at UMMC.
February is a short month, however it is the Cardiologist’ signature month of our “Go Red” campaign to inform every one of the risk of cardiovascular disease among women. It is also Black History Month. Additionally, February 3rd is designated as National Women Physicians Day. African Americans and women are important to the framework of our country. The year 2020 marks the 100th anniversary of women’s voting rights in the United States. Over the past hundred years, women have been leaders, innovators and role models to our generations. The field of medicine is no different. Our first woman Vice Chancellor for Health Affairs and Dean of the School of Medicine, Dr. Lou Ann Woodard, has challenged our institution to align ourselves with Association of American Medical Colleges’ (AAMC) impetus to diversify the medical staff and trainee programs. We must look at our population prior to dissecting data from AAMC and UMMC.
The Association of American Medical College reports in 2018, the most active physicians were White (56.2%) and male (64.1%). Among younger physicians, ages 34 years and less, women outnumbered men in most racial and ethnic groups. While comparing national physician statistics to the state of Mississippi’s physician cohort, we must consider our population’s racial breakdown.
The population of Mississippi comprises of 59% non-Hispanic Whites, 38% Black, 0.95% Asian, 0.46% Native American, and less than 2% two or more races. Statistics on our Office of Diversity and Inclusion’s website is an excellent source of information to review breakdowns of race/ethnicity and gender percentages of house officers and medical staff.
There has been an increase in the number of female house officers at our institution. There were 58.17% males and 41.67% female house officers in the UMMC School of Medicine in 2018. In the Department of Medicine, there were 63.22% males and 36.78% females. Departments with majority females include OB/GYN, Dermatology, Family Medicine and Pediatrics. The racial breakdown for the DOM was 70.11% White, 14.37% Asian, 9.20% Black, Hispanic 1.15%, and 5.17% other or unspecified. While comparing the population as a whole, the term underrepresented in medicine refers to a comparison with the general population. Therefore, Blacks, Hispanics, and Native Americans are considered underrepresented. Also for the DOM, the clinical faculty dashboard reveals 70.9% males are associate professors or professors and 29.03% are women. Among Black or African American professors, 100% were males, which was <5% of the DOM population. Despite having more women in the DOM, there are less in a higher academic ranking order. An explanation cannot be given at this time. Our committee will continue to explore these factors.
According to the Washington Post, the number of female medical students surpassed male students in 2017 nationally. This is the case as well at UMMC School of Medicine, depicted in the graph below.
UMMC’s School of Medicine accepted 80 men and 85 women in the 2019 first year class. We hope to see more female internists and specialists through our mentoring endeavors.
As a cardiologist, a national subspecialty group with the American College of Cardiologists, Women in Cardiology (WIC) promotes increasing female representation in cardiology as well as guidance toward promotion and academia There has been improvement in gender equitable representation in medicine, although a diminishing representation of underrepresented minorities (URM) persist. URM are individuals from racial and ethnic category shown to be underrepresented in health-related fields. This group consistent of African Americans, American Indians/Alaska Natives, Pacific Islander Americans, and Latinos. African American and Hispanic males have the lowest representation among all the ethnic groups. As mentioned earlier, diversity is essential to developing health care providers, educators, and researchers to improve outcomes of our citizens. As we cheer for the accomplishments of young women in medicine, we would lend a hand to the URM; African American, Native American, and Hispanic males.
Change is inevitable. Some of you may recall Blockbuster video stores. Instead of going to the movies, we could stay in the comfort of our homes and watch a rented video for days. There were lines waiting for video tapes return. Attached to the video rental were enormous late fees. Those stores are now obsolete and replaced with the local Subway restaurants. UMMC would not want to be the Blockbusters of the past; on the contrary, we’re the Netflix of the present.
Imagine the acquisition of a medical education by a verbal medical student in a majority deaf student class. The experience could be depressing, confusing, miserable, however given the right tools the experience may even be exciting and more educational than originally planned. An intentional effort to reach out for inclusivity and diversity is the key to success. It just takes an open mind for change. Being intentional to diversity is the only way of making these changes for our department.
Myrna Alexander Nickens, M.D. FACC
Vice Chair of Diversity and Inclusion
Department of Medicine