Diversity, Equity, and Inclusion in Radiology


Mount Sinai was named the 2017 #1 "Hospitals and Health Systems" by Diversity Inc. Our residency is doing our part to support the institutions diversity goals.


The case for diversity:

While there are many reasons to encourage diversity in the health care workforce, one of the most compelling is:

In 2002 the Institute of Medicine published "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care". In 2004 the IOM published "In the Nation’s Compelling Interest: Ensuring Diversity in the Health-CareWorkforce". This report noted that one way to reduce racial and ethnic disparities in health care is to increase the diversity of the Health-Care workforce.

The Association of American Medical Colleges (AAMC) is doing its part to improve the diversity of medical students and has a section of its website devoted to the topic https://www.aamc.org/initiatives/diversity/

The ACGME compiles statistics on diversity amongst the various residencies. Across all residencies between 2015-2016, only 9.6% of residents were underrepresented minorities (versus about 20% in the US population) and 44% were women. Within the field of Radiology, only 5.8 % of residents were underrepresented minorities and 27% were women. (These statistics can be found in the ACGME Data Resource Books)

What can we do to improve diversity in Radiology?

  • Radiology should be promoted during third year medical clerkships as a field that embraces diversity, and be presented as a career option to all students, including underrepresented minorities and women.
  • Radiology program directors should review and be mindful of the percentage of underrepresented minority applicants and women that have applied, are invited to interview, interviewed, ranked, matched, and retained.
  • Program directors should learn about unconscious bias and holistic review and then share this with their interview team.
  • Program directors should consider the use of techniques, such as a structured interview, which reduce unconscious bias and are a more fair method of evaluating applicants.
  • Program directors should be mindful of how residents are chosen for leadership positions. e.g. if a review of the last 5 years shows that there have been no women chief residents, one could ask why??
  • Participate in social media to promote diversity.
  • Get involved in diversity activities at your hospital, e.g. Diversity Councils, Employee Resource Groups.

 As the 2004 IOM report states:

 “Knowing is not enough; we must apply.

Willing is not enough; we must do.”

—Goethe


Programs for interested Medical Students

Mount Sinai encourages underrepresented minority students to consider electives at Mount Sinai through their VEPSUM program:

https://erap.mssm.edu/Public/VEPSUM.aspx


This page was put together by our former Program Director:

Nolan Kagetsu, MD, FACR

Vice Chairman, Quality
Department of Radiology
GME Diversity Council
APDR Diversity Task Force, Co-Chair
ACR Committee for Diversity and Inclusion
ACGME Diversity Task Force


I would be interested to know what you think about this page.
Please e-mail me at nolan.kagetsu@mountsinai.org

follow me on twitter @nkagetsu


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Additional Resources:

NIH: The NIH has many resources devoted to diversity. They support "the science of diversity": https://diversity.nih.gov/


Mount Sinai: Message on diversity by Dean Charney: http://icahn.mssm.edu/about/diversity/dean


Disparities:

Article posted 715/16 on the Commonwealth Fund website: http://www.commonwealthfund.org/publications/blog/2016/jul/closing-the-equity-gap


Unconscious Bias:


This is a nice short video (recommended by our colleague Brenda Allen) introducing us to fast and slow thinking, this will help you to understand unconscious bias.
https://www.youtube.com/watch?v=JiTz2i4VHFw&sns=em

For those interested in more you can read Daniel Kahneman's "Thinking Fast and Slow"

An article in the Harvard Business Review by Howard Ross, expert on Unconscious Bias (thanks to Pam Abner, Mount Sinai Office of Diversity and Inclusion, who gave me this reference): https://hbr.org/2015/04/3-ways-to-make-less-biased-decisions
This article is a good intro to UB as well as discussing ways to mitigate bias.

This is a brief article by Richard Gunderman and Dr. Kagetsu that recently appeared in JACR. We focus on steps to mitigate bias in the interview process.
http://www.jacr.org/article/S1546-1440(17)30209-0/fulltext


From Fast Company: http://www.fastcompany.com/3037359/strong-female-lead/how-unconscious-bias-affects-everything-you-do

Facebook has made their resources available on line: https://managingbias.fb.com/

NIH has resources related to mitigating bias as well:  https://diversity.nih.gov/sociocultural-factors/unconscious-bias

UCLA resources: https://equity.ucla.edu/programs-resources/educational-materials/implicit-bias-resources/

The AAMC website has resources on unconscious bias:  https://www.aamc.org/initiatives/diversity/322996/lablearningonunconsciousbias.html

Interesting reference from some Boston colleagues: http://www.brighamandwomens.org/Medical_Professionals/career/CFDD/Images/UnconciousBiasTipSheet.pdf

Is Race Genetic or a "Socially Constructed:" http://bigthink.com/videos/philip-kitcher-is-race-genetic-or-socially-constructed


Holistic Review:

From the AAMC website:  https://www.aamc.org/initiatives/holisticreview/

From the New England Journal of Medicine:  ttp://www.nejm.org/doi/full/10.1056/NEJMp1300411


Mindfulness:

An organization that uses mindfulness techniques to reduce unconscious bias is Be More (They are based in New York City and made a presentation at a recent ACGME meeting): http://www.bemoreamerica.org/

Another article from the Harvard Business Review that supports the use of mindfulness techniques:  https://hbr.org/2014/12/mindfulness-mitigates-biases-you-may-not-know-you-have

Interesting article on Mindfulness-Based Color Insight Practice:  http://greatergood.berkeley.edu/article/item/how_mindfulness_can_defeat_racial_bias

Interesting article on the intersection of minfulness and unconscious bias training: https://hbr.org/2017/01/how-mindfulness-helped-a-workplace-diversity-exercise

A presentation addressing the issue of disparity in residencies created by UPMC: https://www.acgme.org/acgmeweb/Portals/0/PDFs/2015%20AEC/Presentations/SES086.pdf

"Why diversity matters in Radiology" a 2014 article from "Health Imaging": http://www.healthimaging.com/topics/practice-management/why-diversity-matters-radiology


AUR 2016

We also had a poster presentation at AUR 2016:

Diversity and Imaging 3.0: Is There an Alliance

Diversity.pdf

The session I moderated at the 2016 AUR meeting on now on-line: https://www.youtube.com/watch?v=-fu82fBVoCs