Student perspective on racism in medicine is a catalyst for change

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University of Arizona College of Medicine Shoulders – Tucson Oumou Bah flinch when asked about racism.

Bah is a former leader of the College’s African American Medical Student Association, a local chapter of the National Medical Student Association (SNMA). SNMA is affiliated with the National Medical Association, a group of largely black doctors founded in 1895 after the American Medical Association refused to include black doctors in AMA meetings.

Bah measures her words carefully, as if tired of having to talk about racism in medicine.

“At least for me, it’s something I’ve been through since I can remember. It’s not just a historical perspective on things that everyone knows, like the Tuskegee study or Henrietta Lacks,” she said. “It is also about the lack of representation of African Americans in clinical trials and their distrust of medicine, poor outcomes for black women in maternal and reproductive health care and the life expectancy of blacks in general. This only presents it as a problem in its own right with the entire healthcare system and how the disparities have been exposed even more glaringly by the COVID-19 pandemic.”

The 2020 murder of George Floyd, which sparked national conversations about the breadth and depth of racism, happened at the end of Bah’s freshman year in medical school. But the Tucson native and daughter of Guinean immigrants, who hopes to train as an obstetrician/gynecologist after graduating, has been involved in advocacy on the subject since her first gathering as an undergraduate student after the death of Trayvon Martin ten years ago this month.

“I was unfortunately very aware of all the deaths. It’s a very long list of people, locally, nationally and internationally, affected by some of the systemic issues we face every day,” Bah said.

“Being in medical school, I just had more thoughts about what my responsibility was to be in this role as a future doctor. There are too few of us on the ground fighting these issues. And I try to be one of those who are at the forefront of the fight against racism. It’s something that excites me.

Bah said the UArizona College of Medicine – Tucson has responded to the challenges of racism on campus in several ways, including creating diversity committees and trainings. An effort that was more visible to him was better security staffing, after-hours escort services, and pass-card entry requirements for areas to promote security. She and other black students say they also appreciate it when university and college leaders mention key events related to racism in emails or newsletters because it helps them feel less isolated.

Take on the challenge

Medical students say addressing the challenges of racism requires robust, continuous and creative efforts. They are pleased that the College of Medicine – Phoenix and the College of Medicine – Tucson have introduced “Anti-Racism in Medicine” action plans, but they also want to see concrete changes that offer solutions to these issues.

As with students at other UArizona health sciences colleges, they would like better recruitment and retention of students, staff, and faculty who are Black, Indigenous, or of color; more scholarships for underrepresented medical students; better mentoring and support services; curriculum changes; and more diversity among standardized patients.

Oumou Bah, a medical student in the class of 2024 and former leader of the African American Medical Student Association at the College of Medicine – Tucson, noted that one of her dreams is to try to address disparities in matter of health.

Standardized patients, often white and older, help with classes and training on specific medical conditions. Students from both medical schools would like more of a mix of colors, ethnicities and ages between them. Both colleges have taken steps to diversify their standardized patient pools, including Tucson’s development of bilingual flyers and a multi-ethnic video to advertise a broader applicant base. Candidates have also been offered unconscious bias training since last year. But some students grow impatient with the change.

“We always hear, ‘We want to teach cultural competence to our medical students,’ and also teach them to serve all skin color types. But, when you teach us, you mainly give us white skin color as a model,” said Fatouma Tall, a freshman medical student at UArizona in Phoenix. “I want to see real progress, not just tiptoe.”

Shannon AlsobrooksFreshman and SNMA Chapter Leader, is the Student Representative for the Class of 2025. As part of this role, Alsobrooks is often asked to participate in interview committees for incoming faculty and staff.

“A few months ago we interviewed a potential faculty member who was African American,” Alsobrooks said. “I said to him, ‘We just appreciate you being here and being here.’ We had a good discussion and hopefully he will be appointed as a teacher. It just shows that the doors are open to change and that our school is receptive to it.

Transform a curriculum

Isabelle Strouse and Elen Mendoza are sophomore medical students and served as co-leaders of Phoenix College’s White Coats for Black Lives chapter for the past year. Strouse and Mendoza, who are Hispanic, also participate in the college’s Anti-Racist Transformation in Medical Education (ART in Med Ed) cohort. The college was one of 10 medical schools invited last year to join ART in Med Ed, a three-year program at the Carl Icahn School of Medicine at Mt. Sinai Medical Center in New York designed to incorporate anti-racism practices in the program and how the colleges operate.

Quin Johnson, Shannon Alsobrooks, Amanda Musvosvi, Chikodi Ohaya and Fatouma Tall – leaders and members of the Student National Medical Association chapter – reactivated the chapter last year after several years of dormancy. “For future generations of doctors who come to train here, they will be trained in an actively anti-racist way,” Strouse said. “The training they receive they can take with them into their future careers and help create a chain reaction to build a more anti-racist medical system.”

Mendoza said she has already seen big changes since her freshman year in how the program changes. As an example, she said they are taught to ask questions about a patient’s sexual orientation and gender or ethnic identity.

“We standardized it so now we don’t just look at the graph. When we walk into a standardized patient’s room, we ask them how they identify. Then we ask about the behaviors that actually correlate with disease processes, rather than being confused by how you ask these kinds of questions,” Mendoza said.

She also saw more use of different skin tones in images used to identify lesions or sores, which were previously all white skin.

We always hear, “We want to teach cultural competence to our medical students,” and also teach them to go out there and serve all skin color types. But, when you teach us, you mainly give us white skin color as a model. I want to see real progress, not just tiptoeing. Fatouma TallFreshman Medical Student, National College Student Medical Association Chapter Leader and Student Diversity Representative, Class of 2025, University of Arizona College of Medicine – Phoenix

Mentors and mentees

For Pierce Longmirea third-year doctoral student in molecular medicine at the College of Medicine – Tucson, widespread shock over Floyd’s death, zero-tolerance policies against racism in the workplace, and campus town halls demanding change after Floyd’s death opened up conversations where he felt freer to discuss his feelings with colleagues who weren’t black, feelings he may have previously hidden.

“That was probably the most impactful change,” said Longmire, who is also a research assistant in the lab in the Department of Immunobiology at Felicia Goodrum, Ph.D.. “I also really appreciate the fact that in my department they now require these diversity, equity and inclusion credits per semester. It’s something we should all be doing to create a more welcoming space for everyone here at the university.

Pierce Longmire, a graduate research assistant in Dr. Felicia Goodrum's lab and a PhD candidate in molecular medicine in Tucson.

Another Tucson native, he was often the only black student in most of his pre-college classes. At UArizona, he started out in biomedical engineering, but found cellular and molecular medicine suited him better. He hopes to be a role model for other black students to consider biomedical research as a career.

“Growing up, I didn’t really see a lot of examples of black people or people of color in medicine. And so, I want to be an example for young people by telling them, “This is something you can do too,” Longmire said.

Efforts to put this into practice include his participation in Colors of STEM, a grassroots group affiliated with the UArizona Science, Engineering, and Math Scholars (ASEMS) program. The group hosts monthly luncheons to encourage more people of color to pursue STEM careers.

Longmire said he is grateful for Michael DL Johnson, Ph.D., as a role model, mentor and resource. A distinguished UArizona Health Sciences immunobiology researcher, Dr. Johnson was honored for his role in establishing the National Summer Undergraduate Research Project to create summer research experiences for students of color who have found those opportunities limited by the pandemic.

“I am very grateful to have Dr. Johnson close as a leading black scientist in my field. In fact, I specifically asked to meet him while I was interviewing for my program to hear about his on-the-ground experience as a black person,” Longmire said.

“I consider him a black researcher and professor who sponsors and organizes multiple initiatives to increase diversity and inclusion in my department and at college and university.”

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