Diversity and inclusion have become a focal point in healthcare. A healthcare workforce that mirrors the diverse fabric of our society—including race, ethnicity, gender, sexual orientation, immigration status, physical ability, and socioeconomic background—is crucial for delivering superior care to all patient groups. The adage, “diversity is being invited to the party; inclusion is being asked to dance” offers insight into the challenges of actualizing these concepts in the medical field. It is vital to assess the present landscape of diversity and inclusion in healthcare and identify effective strategies we can take to improve it.
Why Do We Need Diversity in Healthcare?
Integrating DEI (Diversity, Equity, and Inclusion) initiatives into medical education equips future physicians to understand and address patients’ unique challenges, enhancing care quality. These efforts are crucial for overcoming persistent healthcare disparities and improving health outcomes across diverse populations. Diversity extends beyond race and ethnicity, encompassing veterans, different religions, rural residents, and individuals with disabilities. Doctors with knowledge of these varied experiences can offer more personalized and effective care.
Despite a focus on DEI initiatives, the results are mixed. According to data from the Association of American Medical Colleges, Black or African American students made up 10.0% of total matriculants (first-year enrollees in medical school) in 2023-24, a slight decrease from 10.2% in 2022-23 but up from 8.4% in 2016-17. The number of Native Hawaiian or Other Pacific Islander matriculants fell 6.9% since last year. Clearly, there is work to be done.
Challenges of Diversity in Healthcare
What are the underlying factors contributing to the challenges of achieving diversity in healthcare? Research indicates there is a complex web of issues. While many students may be discouraged from aspiring to healthcare professions due to a lack of role models in the field, accessibility remains the number one hurdle for minorities. These factors combine to create a barrier to the profession, which needs to be addressed to create a more inclusive and representative medical workforce.
So, what can be done? As part of the 2024 MedHub Virtual Medical Education Summit, Dale Okorodudu, MD, the founder of Black Men in White Coats, hosted a session on Diversity in Medicine. Dr. Okorodudu spoke on his own experiences as a Black doctor. He shared some of the reasons behind challenges of diversity and presented attendees with three challenges to employ at work.
Challenge 1: Give Trainees Permission to be Great
While many medical residents face their new roles with confidence, many more deal with the feelings that they are in the wrong role. One study shows that approximately 30% of medical residents struggle with imposter syndrome.
“You have to remember that in Black America for centuries, Black people were told they couldn’t do things. ‘You can’t sit here, you can’t drink out of this water fountain,’” Dr. Okorodudu said. “So, imagine what that does to psyches, and imagine this being passed down from generations.”
Dr. Okorodudu believes that showing a little support can go far.
“Those from marginalized backgrounds are already feeling a certain way,” Dr. Dale says. He challenged attendees to praise residents. “Even something as simple as, ‘I’m really impressed with the differential diagnosis you had…That was awesome. I just want to let you know that you’re really shining in that area. I believe in you.’ When you tell a trainee, when you tell a young doctor that they have permission to be great, you have no idea what you’re igniting in them.”
The praise goes beyond a short boost of confidence. “They might mess up the next day, like we all do in healthcare, but they know that you believe in them. They know that you see potential in them. You just made them take that white coat off and feel like Superman.”
Challenge 2: Expose the Hidden Curriculum
Learning involves more than what happens in the classroom or during rounds. Dr. Okorodudu discussed the idea of the hidden curriculum. “It’s this idea that there are certain things that aren’t necessarily directly taught. Certain things that are just picked up on from passive communication. These are the rule that aren’t necessarily in the medical textbooks that are going to help me survive.” These lessons are vital for all trainees, but they are often missed out on due to a lack of inclusion.
“A lot of people from marginalized backgrounds, when they come into medicine, they feel like they’re standing at the gates waiting to be let in. To them, it’s a different situation and a different environment where they may not feel welcome.”
One example Dr. Okorodudu gave involves the conversations that happen on the golf course.
“I feel uncomfortable going out on the golf course, so I missed all those conversations. But I don’t want to miss out on the information on the golf course.”
To remedy this, he challenges leaders to expose this hidden curriculum.
“Literally get a piece of paper. Write down the conversations. Put them out there for everybody. You can impact the trainees so much if you can help them understand the hidden curriculum.”
Challenge 3: Mentor Someone Who Does Not Look Like You
In Passing It On: Growing Your Future Leaders, Myles Monroe said, “the greatest act of leadership is mentoring.” Dr. Okorodudu believes that effective mentoring can lead to improved patient outcomes and a more inclusive healthcare environment. Mentoring is a crucial step in acknowledging and addressing the lack of diversity in healthcare.
His final challenge to attendees is to mentor someone who doesn’t look like they do.
“In academia, for the trainees coming through, who they see is who they seek. Bringing education from various perspectives to students of all backgrounds. And that has an impact for role modeling and the internal belief in what you can and cannot be.”
Dr. Okorodudu cautioned attendees to go the extra mile and not confuse mentoring with advising.
“You hear people saying, ‘yeah, I mentor 30 kids.’ No, you don’t. You might be advising 30 kids, but you’re not mentoring 30 kids. Mentoring is not, ‘I gave you advice, you didn’t listen.’ Mentoring is that extra step, like, ‘Hey, I’m going to look out for you.’ It’s a different level of relationship than a counselor, an advisor, or a coach.”
Fostering diversity in healthcare is not just a moral imperative but a practical necessity to ensure equitable and effective medical care for all. By addressing the barriers that deter minority participation in the healthcare sector, we can pave the way for a more inclusive future where every patient has access to culturally competent care and every aspiring medical professional can succeed.