Medical Education Committee Minutes: April 23, 2002
Report of the Cultural Diversity VIG
Presented by Lori Alvord
MEC Meeting - April 16, 2002
Below are listed, in summary form, the actions recommended by the MEC with respect to the Vertical Integration Group Report #25 on Diversity Training and Cultural Competency for medical students at DMS.
- 1. ADD an item on the survey of our graduates (at 8 years) on how well DMS prepared
students to be culturally competent in their practice of medicine.
**DONE.. - 2. KEEP the Cultural Competency exercise as part of the current Year 2 orientation.
(This is already in place, and handled by the Office of Minority Affairs.)
**This program continues to be in place, and the large group session ran well this year. Dr. Cochran and Dr. Walton also added standardized patients, who work with the Manchester AHEC division, to help model cultural competency in small group sessions. - 3. RECOMMEND that Dr. Cochran seek to add a session on Cultural Competency issues
and skills during Year I of On Doctoring. Also, RECOMMEND that Dr. Cochran seek to
identify and recruit more minority faculty to serve as clinical preceptors and group
facilitators in On Doctoring. The MEC understands the difficulty she has in identifying
and recruiting faculty in general; and the desire of students to go to preceptors
located less than 60 minutes away. (Dr. Jim Bell will discuss these issues with Dr.
Cochran.)
**Dr. Benita Walton, a black physician who will begin a psychiatry residency this summer, was hired (for this year only) to help with On Doctoring. - 4. RECOMMEND that Drs. Nierenberg and Bell seek to include more healthcare issues
related to patients of different ethnic and racial groups, as appropriate and feasible,
in Year 2 PBL cases. (Note: Drs. Bell and Nierenberg agreed to take a closer look at
current PBL cases, and work in such issues when appropriate).
**An asthma case was changed to make it a young Hispanic woman living in the inner city (Manchester) with asthma brought on by cockroach allergy (and complicated by the difficulties of inner city living). - 5. RECOMMEND that HSP in Year 4 develop some type of "culminating experience" in
the Cultural Competency curriculum. This might take the form of a poster presentation,
new case for discussion, etc. (Note: Ginny Reed agreed to work on this possibility
with her course planning group.)
** One of the debate topics for the HSP curriculum indirectly addressed cross-cultural issues: "As a part of fostering competency in interpersonal and communication skills, medical schools should train clinicians to elicit patients' spiritual beliefs, respect those beliefs, and incorporate those beliefs into the patient's care." Students formed teams and debated this statement. - 6. DISTRIBUTE to all faculty and course directors in Years 1-2 a summary of these
recommendations, and ENCOURAGE them to work such issues into their teaching as they
continue to evolve and improve their courses, lectures, etc.
**DONE. ( Dr. Nierenberg's message encouraged faculty to use the VIG group as a resource, but the only groups who took advantage of this were: On Doctoring, Pediatrics, and the Psychiatry Residency program. - 7. REQUEST that the Dean invite all faculty to attend a faculty workshop program
designed to increase faculty sensitivity to these issues, developed by the Office of
Minority Affairs expressly for medical school faculty. Further, encourage On Doctoring
facilitators to be among the first to take this workshop program.
** The dean's office and the office of Multicultural Affairs sent a joint email to faculty/departments to let them know that we were planning to offer sessions related to diversity/cultural competency. This initiative has been on hold until a new Director of Multicultural Affairs has been hired. The following faculty members expressed an interest in assisting with this initiative:- Rosemary Orgren, Richard..Nordgren, Catherine Pipas, Don Kollisch, Victoria Rhodin, Dominic Balestra, John Radebaugh, Sanjoy Bhattacharya, Peregrine Spiegel.
- 8. ENCOURAGE the Admissions Office to develop a workshop or retreat to think about
how to increase enrollment of under-represented minority students. We recognize that
changes and improvements in our formal curriculum in Cultural Competency are important,
but they must be made in the context of a more diverse student community.
Volunteer the MEC to work with the Admissions Office in whatever ways we can to make
this program a success.
**The admission office will incorporate this into their spring workshops. The multicultural affairs office, after consulting with admissions, attended six minority recruitment fairs at summer minority premed preparation courses. We will check with admissions to see if there has been an increase in applications from minority students. - 9. ENCOURAGE the Associate Dean for Faculty Affairs to sponsor and organize a
conference or workshop to brainstorm about ways to improve the recruitment of faculty
members with more diverse backgrounds. We recognize that changes and improvements in
our formal curriculum in Cultural Competency are important, but they must be made in the
context of a more diverse faculty. Volunteer the MEC to work with the Associate Dean in
whatever ways we can to make this program a success.
**See list of new minority faculty members below, and the dean's statements (Attachment A) about efforts to recruit minority faculty members through collaborative efforts with AA/EO and the Department Chairs.
Kiflai Bein Ph.D.
Medicine
Black
Yvonne Cheung M.D.
Radiology
Asian
Alok Gopal M.B.B.S.
Anesthesiology
Asian
Ajay K. Nangia M.B.B.S.
Surgery
Asian
Sujatha Sundaram Ph.D.
Surgery
Asian
Surachai Supattapone M.D., Ph.D.
Biochemistry
Asian
Bassein 1. Zaki M.D.
Medicine/ RADONC
Asian
Zhenwu Zhuang M.D.
Radiology
Asian
- 10. RECOMMEND that faculty and students work together to expand extracurricular
opportunities relative to culture and diversity.
**I don't know if this was issued as a recommendation from the MEC. We have had four speakers in the past year who have addressed issues of cultural relevance sponsored through the dean's office and multicultural affairs:- Barbara Ross-Lee, MD-VP for Health Affairs at New York Institute for Technology -- distinguished speaker for MLK day.
- Jeral Athone-Native American, former public health director in Pakistan for the U.N. High Commission on Refugees.
- Shi Yi Lu, MD-Chinese, "An Introduction to Chinese Medicine."
- John Rich-Black-"Voices of Forgotten Victims: Young Black Men Talk About Violent Injury"
- Katsi Cook-CNW-Native American, "Culture, Cosmogony, and the Power of Birth."
- Gregory Strayhorn, MD-Black, Chair of Family Medicine at Moorehouse School of Medicine, came to DMS and met with multiple groups.
- The Koop Institute brought David Satcher to Dartmouth College to speak this past month.
- Dr. Robert Nassau. a Brattleboro pediatrician who works part of each year in Cambodia.
- 11. REQUIRE that all medical students complete four weeks or more of a clinical
experience at a site that offers patients who differ significantly cultural, ethnic,
socioeconomic, or other backgrounds from patients more commonly seen in New Hampshire and
Vermont. This experience is designed to be part of a much broader four-year curriculum in
cultural competency.
The following specific points also apply:
- This requirement applies first to students who matriculate in August 2001, so that notice of this requirement can be included in the recruitment brochure for the applicants.
- For students already at DMS, this is not a requirement, but such an experience is strongly recommended for the students' benefit.
- We should have discussions with the Office of Financial Aid to try to provide help to students who need it to cover travel expenses to such distant clerkship and elective sites.
- Eligible experiences could include some required clerkships, some clinical electives, and some experiences during the summers following Years I and 2.
- Dr. Shirley would be the judge of which clinical experiences would qualify in this regard, and would also be the judge of which rare requests from students for exemption from this requirement might be appropriate.
- We will continue to work to develop such clinical experiences with diverse patient
populations within 60-75 miles (commuting distance) of DMS.
**This has been implemented, though I think the final language was "strongly recommended." - A new CFM 4th year DMS elective was added: Asniya is a teaching/service elective for third and fourth year medical students in which students travel to one of twelve reservation schools on seven different Native American reservations. Dr. Alvord met with Asniya coordinators during a trip to the Univ. of S.D. last spring, and the addition of the elective was facilitated by Steve Abbott.
- This is an elective advertised by DIHG: Child Family Health International is a not-for-profit organization promoting primary care, integrative medicine and Spanish literacy among US medical students through clinical electives in Ecuador, India and Mexico.
- Opportunities are available for medical students (yrs. 1-4), pre-medical, public health, and nursing students.
- For details, check the DIHG bulletin board in Student Affairs or their website www.cfhi.org.
- 12. REQUEST that 2-3 members of the current VIG volunteer work over the coming year to move these recommendations forward through conversations with key faculty and committees, and prepare a progress report for the MEC in 12-18 months. (Note: Lori Alvord, Jim Bell, Patty Carney, Jack Lyons, and Steve Abbott have volunteered to do this.)
- **Members have worked independently toward achieving most of these goals.
Back to Medical Committee Minutes for April 23, 2002