Achieving Inclusivity

A subset of the Dean's Diversity Leaders (l-r): Alejandra Rincón, PhD, Tung Nguyen, MD, Eddie Cruz, MD, MPH, Meshell Johnson, MD, Markita Mays, MSW, Aimee Medeiros, PhD, and Suzanne Kawahara, MBA.
Photo: Mark Wooding

Posted: May 8, 2017

By Mitzi Baker

The concepts of “diversity” and “inequities” are at the forefront of the news in topics ranging from housing strategies to criminal justice, and for good reason: the reality is that the lives of everyone in the United States are not equitable.

People in general recognize the moral imperative to reduce inequities – but there are other layers to the issue that affect academic medical centers such as UC San Francisco directly, says Vice Dean for Education Catherine Lucey, MD. Overwhelming evidence points to a number of diversity issues that affect health care. Lack of equality in every imaginable realm contributes to poor health for patients.

And if this wasn’t enough of a case, Lucey points out that achieving a diverse, equitable and inclusive culture is imperative from a business perspective. Numerous studies have shown that diverse teams consistently solve problems more creatively and productively.

“When you think about what academic medical centers do – solve complex problems, care for people at their most vulnerable, ask research questions and educate the next generation of professionals – there are a lot of data that say to us that without diversifying our workforce, we will not be able to be the best academic medical center we can be,” she says.

With the commitment that diversity, equity and inclusion are critical to the success of UCSF, last year the School of Medicine launched Differences Matter. This initiative is taking a comprehensive look at how to make the School – and entire University – inclusive to all, regardless of race and ethnicity, or any other dimension that can differentiate people from one another, such as gender, sexual orientation, religion or disability.

Breaking Down Barriers

Through a collaboration with ENACT Consulting, Differences Matter Action Group 2 will launch a comprehensive training program for faculty educators and staff designed to enhance individual and group awareness, alignment, action and accountability in order to drive sustainable improvements to diversity, equity and inclusion at UCSF. 

The scope of what Differences Matter proposes to change will be a daunting task, says Lucey, so the team has chosen to systematically orchestrate the operations by tasking multiple groups to target different populations. A 26-member Executive Advisory Board – which includes several members external to the School of Medicine – oversees a group of faculty and staff members who direct the initiative’s efforts as “Dean’s Diversity Leaders” in six primary focus areas.

A sustained, comprehensive approach with leadership engagement and accountability will be required to meet the goals of Difference Matter. UCSF Vice Chancellor of Diversity and Outreach J. Renee Navarro, PharmD, MD, likens the mission to changing the campus culture.

“We have a ‘culture of innovation’ at UCSF and we accomplished that consciously by breaking down the walls between specific scientific disciplines to ask better scientific questions and to get the best and most creative solutions,” Navarro says. “In the same way we have to break down the current barriers that prevent us most effectively achieving diversity, equity and inclusion.”

Sweeping changes ahead include how to deliver culturally competent care that eliminates health disparities, how to educate students in the best ways to care for diverse patient populations and how to think of issues of research and health equity in our country in new and innovative ways.

At the end of the day, changing culture and climate requires an investment of time and energy, but also hard resources: money and bandwidth,” says Lucey.

To that end, the School of Medicine Dean’s Office has made a multi-million dollar investment in Differences Matters to support each of the six focus areas and release time for their faculty and staff leaders, with additional investments funding education and training.

Currently, Differences Matter is focused on the School of Medicine, but it builds upon the groundwork laid by the campus strategic plan, “Roadmap to Inclusive Excellence” of the Office of Diversity and Outreach, as well as a multitude of prior and ongoing projects across the campus.

“Differences Matter expands ongoing and previous initiatives with a substantial investment that promises to elevate the issues and support the sustainability necessary to change systems and patterns of how we do things,” says Navarro.

One specific change would be increasing the diversity of faculty, learners and staff, and in the number of minorities included in clinical research.

Another goal is to identify core competencies for teaching, caring for and managing diverse populations and then to prepare comprehensive programs to ensure that faculty, staff and residents master these competencies.

“I think Differences Matter highlights the fact that getting the word out and raising awareness is not enough,” says Dean’s Diversity Leader Elisabeth Wilson, MD, MPH, professor of family and community medicine. “What we need to do is help people to develop skills – through some pretty rigorous training programs – so they can take conscious action and really start addressing some of these issues.”

The initiative will also identify ways in which changes in the medical school curricula can lead to a more inclusive learning environment and also can prepare students to work effectively with people different than themselves.

Fostering engagement between UCSF and communities to eliminate opportunity disparities and to diversify participation in clinical trials is an additional prime objective.

Putting Ideas Into Action

Differences Matters leaders are committed to building upon a number of existing programs that are already working to address diversity issues. The School of Medicine Chairs and Directors Council on Diversity is a prime example. It has encouraged the development of a number of School of Medicine diversity recruitment and retention programs and has established the Dean’s Diversity Fund to support the recruitment and retention of eight faculty per year as John A. Watson Scholars, who embody the university’s commitment to diversity and service to underserved or vulnerable populations.

Other measures that have taken on diversity and inclusion issues at UCSF include a new medical student orientation that addresses diversity, the Multicultural Resource Center, the LGBT Resource Center, a variety of diversity and inclusion trainings (including the Unconscious Bias Training Initiative and the Academy of Medical Educators diversity program) and the Diversity Hub, a database that consolidates UCSF's ongoing initiatives that support diversity and outreach.

Differences Matter is really exciting because we are now collecting enough people so that our voices are amplified or heard, as opposed to only one of us talking at a time.

Tung Nguyen, MD

Professor of Medicine & Dean's Diversity Leader

Differences Matters is poised to implement real change by putting into action all these existing ideas and adding other great ideas as they are identified. This month, an ambitious faculty development training program will be launched in partnership with Enact Leadership, an outside firm with expertise in diversity training. More than 200 faculty and staff whose positions involve frequent or high-stakes interaction with learners will participate in a full day of training on creating an equitable and inclusive learning environment. From this group, a subset of faculty will be identified to lead further training.

“Differences Matter is really exciting because we are now collecting enough people so that our voices are amplified or heard, as opposed to only one of us talking at a time,” says Dean’s Diversity Leader Tung Nguyen, MD, a professor of medicine. “We are now at a pivotal time in our society based on all the recent events, so hearing and understanding the degree those issues and emotions exist at this university will give us the knowledge to create change.”

Because of everything going on in the U.S., more people are aware now and want things changed right now, says Dean’s Diversity Leader Andrea Jackson, MD, MAS, an assistant professor of obstetrics, gynecology and reproductive sciences, who leads the focus area group devoted to cultivating the highest quality, most inclusive learning environment.

Health and education inequities are affecting people now, and Differences Matter is driven by that sense of urgency to not just plan how to have an ideal climate, but to take action.

“Rest assured that change is happening,” Jackson says. “People will start to notice small and tangible real changes through Differences Matter. In a couple of years, I think we are going to look back and marvel at how far we have come.”