Diversity and Inclusion. These “buzzwords” are often met with dismissal by some medical school applicants, but these principles should be embraced by anyone who wants to dedicate their lives to the service of others. We must promote diversity and work to eliminate the biases that perpetuate worse healthcare and outcomes for marginalized populations. We must be more inclusive and appreciative of other cultures and perspectives in order to prevent disparities and disenfranchisement. The question of how we as medical students plan to promote “Diversity & Inclusion” on many secondary applications is a legitimate one.
One of my closest mentors at UAB taught me many lessons about research, one of which was that to be a good scientist one must be well-read in the literature. He stressed how critical it is to know who is publishing in your field of research, and he frequently name-dropped principal investigators (PIs). In my own ignorance, I almost always assumed the researchers he mentioned were older, white men. In research, you can become familiar with someone and their work through manuscripts and grants without seeing their face. It wasn’t until my mentor taught me another lesson that I realized his concerted efforts in being inclusive: networking at conferences.
At my first international conference, I was able to put faces to some of the names often mentioned by my mentor. And yes, many of them were white men, but I also met people who looked like me too! Seeing faces and hair like my own in spaces where I often felt like the “only” affirmed that I could someday be an expert in a specific niche of research. I asked my former PI about why he didn’t tell me that some of the researchers whose work he introduced me to were Black. He said that it was not relevant to their research; simply put, they published good science. To me, that was a powerful way of being inclusive. He didn’t make a big deal out of an underrepresented person being a scholar in the field. Instead, he focused on uplifting those scientists by citing their papers and giving positive recognition of their work.
While representation is important and affirming, there are other times when my complexion is perceived as “dangerous.” No matter how many letters are after my name, I am a part of a socially defined group where many of the statistics don’t work in my favor. I have a one in four chance of being incarcerated in my lifetime. The leading cause of death for folks who look like me in my age group is homicide. I carry this with me when I walk through institutions of higher learning. I often feel like I’m invisible and that people see me like I’m just another one of “them.” It’s even tougher when I see myself, family, and friends reflected in the patient population and support staff but not the medical team.
The consequence of “other”-ing is quite dangerous. When Emergency Management sends out an alert saying a “Black Male” has committed a violent crime on or near campus, I know it’s a good idea for me to just stay inside until an “all clear” is issued in order to minimize the likelihood of being accosted because I “fit the description.” Even in the absence of these alerts, I’m constantly making sure people don’t feel unsafe because of my presence. I always make sure to wear my badge in plain sight, especially during the early morning or late at night. There’s potential danger that comes from a stranger being uncomfortable with my presence in certain spaces. My father once said to me, “Cops don’t shoot Black men in suits and ties. That’s our camouflage.” But a friend countered that sentiment: “We can’t wear a suit and tie all the time and everywhere.”
There are material and psychological consequences of not having a diverse environment. When we are not exposed to “others”, our biases, not experiences, determine our perceptions of people who differ from us. The benefit in having a diverse and inclusive environment is that it allows people to dismantle those biases, even the unconscious ones. We begin to see each other through our commonalities, as fellow humans.
Going into the healthcare field means you will have to be your patient’s advocate. Even in private practice, patients’ morals and viewpoints won’t necessarily align with yours. Yet you will still have to advocate for them, whether it is to consulting physicians, insurance companies, hospital administrators, or even their loved ones.
So how can you be a patient advocate and foster inclusion? First, expose yourself to cultures and backgrounds that are different from your own. Step out of your comfort zone and talk to people. This does not mean that people in those communities are obligated to teach you, but that is where cultural humility comes in. Learn about the vast heterogeneity that exists across social groups. Multiple perspectives are important for good science. If we all think the same way, we will inhibit progress. A multi-talented team of people with different strengths makes for more efficiency. Diversity is critical for solving problems effectively.
The Diversity & Inclusion question on UABSOM’s secondary application and many other schools requires a thoughtful response. Explaining how your culture or background is “unique” does not contribute to the diverse environment at UAB. What you need to articulate in your response is an answer to the question: “what is the empirical evidence of you understanding and caring for other perspectives?” The clearest response to this question can elucidate how your culture has impacted how you interact with others of the same and different cultures. It is important be honest and balanced as you describe your privileges and disadvantages.
There are of course several contributing factors to why diversity and inclusion lag behind in many institutions. However, advocating for equal representation in even the smallest ways can make a positive impact. It is paramount to appreciate that diversity and inclusion are necessary for medicine and science, and embracing these concepts benefits everyone by moving the fields forward.
Lamario Williams, GS-1