By Amanda Holpuch
The Guardian, April 25, 2018
Ten of the top US medical schools including Harvard and Yale do not have faculty and staff that reflect the country’s black, Native American and Latino population, according to a report by the social justice group White Coats for Black Lives (WC4BL).
The medical student-run group, which came together in response to the Black Lives Matter movement, on Wednesday published a 129-page report that grades medical schools on their work to combat racism.
The report, shared first with the Guardian, found that schools fell short of the activist group’s standards for 15 metrics, including providing robust anti-racism training and paying all workers a living wage for the local area.
Kathryn Himmelstein, one of nine people on White Coats for Black Lives’ national working group, told the Guardian they wanted to: “Turn a light on those 10 schools but also open up questions about what other academic medical centers do, and encourage folks at those places to inquire, to research, to question what their institutions could be doing better.”
For the inaugural report, WC4BL assessed:
- Harvard Medical School in Boston
- Icahn School of Medicine at Mount Sinai in New York
- Johns Hopkins School of Medicine in Baltimore
- Perelman School of Medicine at the University of Pennsylvania in Philadelphia
- Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia
- University of California in San Francisco
- University of Michigan Medical School in Ann Arbor
- University of Pittsburgh School of Medicine
- Washington University School of Medicine in St Louis
- Yale School of Medicine in New Haven
WC4BL selected the first 10 schools for its inaugural report because of their prominence and student interest in attending these schools and it plans to grade more schools in the future.
Of150 grades allotted across the 15 metrics for 10 universities, only eight were As, denoting the best record.
Johns Hopkins, UCSF, Thomas Jefferson, University of Pittsburgh and University of Pennsylvania said they embraced diversity and welcomed WC4BL’s report, but felt the analysis overlooked initiatives or had a questionable methodology.
Joseph Hill, senior vice president and chief diversity officer at Thomas Jefferson University’s Enterprise Office of Diversity, Inclusion and Community Engagement, said he was concerned information was missing from the report and highlighted that the school offered the only scholarship in the country for African-American males in medical school.
“We would welcome a discussion with our student members of White Coats for Black Lives about the many ways we are working to address these important issues,” Hill said.
Mary Masson, a University of Michigan medical spokesperson, said the school was looking forward to continued conversations with the group. “We were happy to provide additional details about our diversity, equity and inclusion efforts in several areas that were rated prior to receiving this information,” the statement said. “Together, we hope to continue elevating our shared values for the next generation of physicians, nurses, health professionals and scientists.”
Harvard, Mt Sinai, Washington University and Yale did not respond to requests for comment.
A call to colleges to fight US healthcare disparities
That race bias pervades medical institutions, research and care has been highlighted in studies showing black infants in the US are twice as likely to die as white infants, while black patients are less likely to be prescribed pain medicine. Black life expectancy is 3.6 years lower than white life expectancy in the US.
But only in recent decades has the impact of this bias been extensively researched.
With the report, WC4BL sought to use its power as a force within medical schools to outline how these elite institutions could leverage their power to help disadvantaged people and eliminate disparities in US healthcare.
Since December 2014, the group has led “die-in” protests at medical schools and Black Lives Matter demonstrations, including one held across the country last week in honor of unarmed black man Stephon Clark, who was killed by Sacramento police in March.
Himmelstein, a fourth-year medical student at the University of Pennsylvania’s Perelman School of Medicine, said WC4BL focused its first major report on medical schools because they are often the largest employers in their region, receive government funding for research and medical care and are gatekeepers to joining the medical profession. “Given they control so many resources and have this important social role, there was shockingly little accountability for how medical schools were or were not promoting social justice,” said Himmelstein.
In the report, each school was given a letter grade on 15 metrics, such as its policies toward immigrant patients. A is the best, B is middle and C is the worst.
The first metric assessed in the report is URM representation, the Association for American Medical Colleges term for the populations underrepresented in medicine.
Under the WC4BL criteria, schools receive an A if their student and faculty URM representation was proportionate to the US: at least 13% Black, 1% Native American and 17% Latinx – a gender-neutral term for people of Latin American descent. If a school met the minimum percentage for one of these groups, WC4BL gave it a B. If the school does not have a proportionate amount of any of these groups, WC4BL gave it a C – which is what all of the 10 schools were designated.
Colleges’ strongest at race discrimination reporting
On average, the 10 schools performed best in the area of discrimination reporting, with no school receiving a C because they all had racial discrimination policies. The University of Michigan, Washington University School of Medicine in St Louis and Yale School of Medicine were awarded As because they offer continued, documented support to people who make discrimination claims.
Grades were also handed out based on how the school recognizes people of color; how it involves community health leaders in the coursework; whether it calls race a social, not biological, construct; if it makes data about racial grade disparities public; what support is given to the URM population; if staff are compensated in line with the region’s minimum living wage; if it offers alternatives to police and security forces and what its standards are for how racial and ethnic minorities are incorporated into research.
WC4BL was inspired in part by the Black Panthers’ work to provide alternative healthcare for underrepresented communities.
“We hope there will be greater discussion both within the medical community as well as outside the medical community, about how are we leveraging the resources of academic medical centers to promote racial justice,” said Himmelstein.
WC4BL provided a copy of the report card to each university before the report’s release.
The group said that many of the schools provided additional information that was not previously publicly available to help build out the report, even if they disagreed with some of the assessments.