“Diversity and inclusion in medicine can save lives.” That was the message from Robert Higgins, MD, MSHA, director of the Department of Surgery and surgeon-in-chief at the Johns Hopkins School of Medicine.
Higgins spoke during Grand Rounds Monday morning in the first lectureship from the Diversity, Equity and Inclusion Committee in the Department of Surgery at the University of Colorado School of Medicine.
Higgins started by detailing his family and personal history with racism and division — how his parents met in the 1950s at Meharry Medical College in Nashville, which was then one of the only medical schools in the country to admit African Americans. And how, after his father died in a car accident and he and his mother went to live with his grandparents, the first house they bought in a segregated neighborhood was burned to the ground overnight.
“These insults and injuries against persons of color have been going on for decades,” he said. “And yet my brothers and I were given the opportunity to grow up in an environment where we got great academic training, and we were taught to be resilient and hardworking. We all went on to academically distinguished environments and had professional careers that showed we can persevere.”
Disparities and lack of diversity
Higgins, who also serves as senior associate dean for diversity and inclusion at Johns Hopkins, spoke about the challenges medical schools face when it comes to diversity and inclusion, and some of the steps Johns Hopkins is taking to address those issues.
“There’s a lack of diversity in terms of our student, resident, and faculty administrative leadership roles, and there is a culture of discrimination and exclusion based on academic elitism.” - Higgins
“There’s a lack of diversity in terms of our student, resident, and faculty administrative leadership roles, and there is a culture of discrimination and exclusion based on academic elitism,” he said, pointing to statistics that show only between 1.5% and 3% of medical school faculty are Black or Hispanic. “That has a significant impact on many of us who are underrepresented minorities in medicine.”
He brought up the health care disparities that exist for patients of color in transplantation, emergency room care, heart failure, cancer care and more, and suggested that increasing the diversity of the health care workforce was the most direct way to tackle the issue. A multifaceted approach that includes research targets, public policy funding, improved access to care and improved cultural competency is important as well, he added.
Importance of allyship
Later in his talk, Higgins brought up the concepts of implicit bias and microaggressions and how they hinder efforts to increase diversity in the medical workforce.
“They extract a psychological and physical toll, with the societal price of harming an already-fragile pipeline of underrepresented populations in medicine,” he said. “We have to do everything in our power to demonstrate respect in our work environments and ultimately help our persons of color who are training nearby and working nearby to feel welcomed and appreciated.”
It’s important for those in the majority to practice allyship, Higgins said, and to speak out on behalf of oppressed and marginalized groups.
“Justice will only be served when those who aren’t affected are as outraged as those who are affected” by racial injustice, he said.
Recruitment and retention
Higgins urged all medical schools to focus on inclusive excellence as a core mission, focusing on recruitment programs to attract members of underrepresented populations and mentorship programs to retain those individuals once they are part of the program.
“We created a group called Women in Surgery at Hopkins, and through that we identified that mentorship really supports and promotes the personal and professional needs of our trainees and our workforce,” he said. “Peer support is critically important to help us grow and develop these programs going forward.”
Johns Hopkins also is putting a focus on academic leadership, he said, and creating an atmosphere where all students, residents, and faculty members feel seen, heard and valued.
“We are trying to create an environment where diversity, equity, and inclusion are a part of our strategic focus,” he said. “We are committed to embracing and celebrating our differences, educating and developing our staff and learners, and engaging in equitable health care delivery and workforce practices. Through recruitment and retention, and through professional and leadership development, we hope to make the environment more inclusive and satisfying for all those who participate.”
Reinforcing and inspiring efforts on campus
Brian Shimamoto, organizational and employee development manager in the CU Department of Surgery and a member of the department’s Diversity, Equity and Inclusion Committee, said he appreciated the focus Higgins put on leadership in his talk, and how he made it clear that in order to develop future leaders, current leaders need to focus on diversity, equity and inclusion efforts.
“We need mentorship — someone who maybe looks like us or might have had similar experiences to what we’re having to be able to be there to guide us — but we also need sponsorship.” - Shimamoto
“It struck me that he highlighted things we were already doing. That was a good feeling,” Shimamoto said. “He talked about the importance of understanding the challenges and recognizing the difference between equality and equity and what diversity actually is. I think we’re on the same page. Any time we can compare ourselves to Johns Hopkins, that’s always a good thing.”
Shimamoto added that Higgins’ focus on mentorship and sponsorship only reinforced the DEI committee’s desire to step up its retention efforts.
“We need mentorship — someone who maybe looks like us or might have had similar experiences to what we’re having to be able to be there to guide us — but we also need sponsorship,” Shimamoto said. “That can be anybody who says, ‘Hey, this is an upcoming rising star, and when there’s an opportunity, I want to put their name forward and sponsor them and bring them to people’s awareness.
“I liked that he said we’re on the right track and doing the same things they are; that felt really great to me,” Shimamoto continues. “He raised the bar to say that not only do we need to recruit these candidates who are underrepresented in medicine, but we need to then support them when they’re here by creating these opportunities for peer support.”