A majority of medical schools have holistic admissions policies; include diversity, equity, and inclusion (DEI) as part of their mission or vision statements; and have formal policies in place for managing discrimination, bias, and harassment complaints. But few reward faculty and staff for their work to further DEI goals; have institutional plans to elevate DEI initiatives; or make their DEI data widely available to the campus community.
These are just a few of the findings from the first-ever report on DEI policies and practices at U.S. and Canadian medical schools. The Power of Collective Action: Assessing and Advancing Diversity, Equity, and Inclusion Efforts at AAMC Medical Schools was released November 10 by the AAMC and includes a snapshot of what schools are doing well and where they can improve — as well as what DEI practices are being used by some schools.
The report represents the culmination of months of work by 101 medical schools that elected to complete the AAMC Diversity, Inclusion, Culture & Equity (DICE) Inventory, a tool designed to assess an institution’s polices, programs, and practices related to DEI. The AAMC Council of Deans (COD) led the initiative, and medical schools spent an average of 29 hours completing the assessment.
“In the wake of the social upheavals that we have gone through, especially right after the George Floyd murder, and the inequities that were exposed during the pandemic … our medical schools, particularly the medical students and faculty, as well as staff, felt that we should do more to promote social justice in a comprehensive manner,” says Henri Ford, MD, COD chair and dean of the University of Miami Miller School of Medicine. This report “allows all of us to see where we are today and how we compare to one another, and also what types of opportunities exist to begin to put in place the infrastructure necessary to create … an optimal environment to support diversity, equity, and inclusion.”
Malika Fair, MD, MPH, a co-author of the report and senior director of equity and social accountability at the AAMC, says that having a comprehensive assessment of DEI policies and practices at medical schools can help institutions — and the AAMC — develop programs to assist in further advancing DEI goals. “We thought we knew what we, as an academic medical community, were doing well, and it was confirmed in the data. … Conversely, it wasn’t as obvious before what some of the challenges were. Now we know where to focus our attention and how we can assist our member institutions.”
Some major highlights of the report include:
- 100% of participating medical schools have admissions policies that support a diverse class of students.
- 97% of participating medical schools have senior leaders who show commitment to DEI in their personal actions, as well as their internal and external communications.
- 94% of participating medical schools provide equitable access to employee benefits; 91.1% provide flexible parental/family leave with equal accommodation regardless of gender or sexual orientation; and 85.1% have inclusive and equitable paid leave for medical or other family caregiving responsibilities.
- 89% of participating medical schools report that DEI is prioritized in their school’s mission, vision, or values statement.
Areas for improvement identified in the report include:
- Just 63.4% of participating medical schools have a faculty diversity recruitment plan and 67.3% require departments to assemble a diverse pool of candidates for faculty positions.
- While 80.2% of medical schools make demographic data available to facilitate DEI planning, just 48.5% said that data is readily available to the campus community.
- Just one-third of schools have performance incentives for the school or its departments to achieve DEI goals.
- Less than half of medical schools (43.6%) have promotion and tenure policies that reward faculty scholarship and service related to DEI.
“If you’re mentoring 10 students who happen to come from the same background as you, meaningfully engaging with under-resourced local communities, and serving on one or more DEI committees at your institution, you are not going to be able to publish at the same rate as your colleagues who may have no demonstrated commitment to DEI based on their mentorship, committee, or service-related activities. And yet they will be promoted over you,” Fair notes. “So the ‘minority tax’ is very real. And I feel like these data actually show that with the lack of commitment to DEI in promotion and tenure.”
The report also identified shared practices among schools, though individual schools are not specifically cited. Among those institutional practices:
- Some schools use a data-driven approach to increase the recruitment of faculty from backgrounds underrepresented in medicine, including requiring the selection of a diverse pool of candidates for faculty positions, including a DEI advocate as part of the hiring committee, and providing appropriate training and guidelines.
- In order to support faculty promotion and advancement, some schools recognize and reward faculty DEI scholarship and service, support tenure clock stoppages (for parental leave or extended leaves of absence), and offer professional and leadership development trainings.
- In recent years, many medical schools have made intentional efforts to integrate DEI content within the curriculum, including content regarding health equity, social determinants of health, and issues related to racism in medicine and social justice.
- Many medical schools also have invested resources and time into updating their admissions policies, expanding scholarships, and growing their pathways programs to attract students from under-resourced or marginalized backgrounds.
“Assessing policies, practices, and programs at the institutional level — and identifying and sharing innovative practices — is a first step toward ensuring that academic medicine is well-positioned to attract, promote, and retain a diverse health professions workforce,” says Alison Whelan, MD, chief academic officer at the AAMC.
Adds David Acosta, MD, AAMC chief diversity and inclusion officer: “Having this data creates a number of opportunities for our member institutions to consider and possibly leverage. For example, in the near future, this data could allow us to formulate a standardized set of DEI benchmarks with targeted goals that medical schools can aim for to achieve excellence. Developing DEI benchmarks for academic medicine is long overdue and could assist us in developing the right metrics to measure the effectiveness of all of the DEI efforts … and that’s exciting.”
