College of Medicine, USA Health implement Justice Initiative to fight racism in medicine

The USA College of Medicine's Justice Initiative is built on the framework developed by White Coats for Black Lives, a national student-led organization working to dismantle racism in medicine.

In response to the ongoing unrest sparked by the death of George Floyd in Minneapolis that continues to resonate throughout the world, the Office of Diversity and Inclusion at the University of South Alabama College of Medicine has been tasked with identifying and addressing areas for improvement in the culture and climate of both USA Health and the USA College of Medicine.

“Our nation had a really intense couple of weeks,” said Franklin Trimm, M.D., associate dean for diversity and inclusion at the USA College of Medicine and assistant vice president for medical affairs at USA Health. “We are going to take this momentum and turn it in to something that is long term by supporting meaningful conversations and developing very specific goals with measurable outcomes.”

The first phase of the USA College of Medicine’s response is the development of the Justice Initiative. The initiative is built on the framework developed by White Coats for Black Lives – a national, underrepresented minority medical student-run organization working to dismantle racism in medicine and promote the health, well-being and self-determination of people of color. The Office of Diversity and Inclusion has identified 14 areas of focus that are significant in addressing injustice within the context of training future physicians and scientists. The assessment is in the form of a report card, with description of A, B and C level performance on each metric.

“These areas address both the academic and clinical learning environments,” Trimm said. “For each area of focus, there is at least one metric that can be used to assess current status and guide action plans for improvement.”

The 14 areas of focus are:

1. Underrepresented minority student representation
2. Underrepresented minority faculty representation
3. Underrepresented minority recognition
4. Underrepresented minority recruitment
5. Anti-racist training and curriculum
6. Discrimination reporting
7. Underrepresented minority grade disparity
8. Underrepresented minority support/resources
9. Campus policing
10. Marginalized patient population
11. Equal access for all patients
12. Immigrant patient protection
13. Staff compensation and insurance
14. Anti-racist IRB policies

According to Trimm, the experience of other medical schools and health systems who have incorporated this framework shows that a number of the metrics are aspirational, meaning goals that will take time and work to achieve. “By incorporating aspirational goals, we will be able to continue the conversations about equity and justice, in contrast to only setting a few goals that might be attained in a short period of time,” he said.

The areas of improvement will become part of the Continuous Quality Improvement (CQI) processes of the USA College of Medicine and the metrics will be assessed through the perspectives of four groups: USA COM medical and graduate students, residents and fellows in the graduate medical education programs, the College of Medicine faculty and staff, and health system employees.

The metrics, which have been developed into a pending survey, will be distributed to USA medical and graduate students and COM faculty and staff via email in early August. Residents and fellows at USA Health will follow. Additional areas of focus for USA Health are being developed. 

“The next step is to issue a call for student volunteers,” Trimm said. “The volunteer groups need to be a diverse representation of graduate students, post-doctoral fellows and all four years of medical students. These students will be responsible for reviewing the data collected by the survey and making recommendations on how to move forward.”

Once the recommendations are prioritized, they will become part of the CQI plan for the College of Medicine and will be tracked by our CQI committee to make sure the conversation continues.

“We must move forward so that everyone within our medical school and health system feels he or she can be themselves and bring their unique perspective to the table,” Trimm said. “The process is difficult, and change takes time. It involves us having tough conversations and, in many cases, it requires us to change in some fashion. We implore each of you to keep talking. Keep asking questions and speaking up. The sharing of information and experiences is an important way to continue to learn and create a future that is better than our past.”