Creating and Capitalizing on Multicultural Communities

An Interview with Dr. Joyce Sackey – in her own words

Associate Professor of Medicine, Dean for Multicultural Affairs and Global Health at Tufts University School of Medicine (TUSM)

“I think that the more diverse the student body is, the more diverse the faculty, the more likely it is that you will be able to attain institutional excellence that you gain from all the variation of thought.”

Clinical medicine creates a compelling case for why every physician should try to be more culturally sensitive. I don’t like to use the word culturally competent because it suggests you know it all, and you are an expert on everyone’s culture. There is a fair amount in the literature about diversity and excellence, and specifically on problem solving skills. It shows that students who attend schools that have a diverse student body when assessed upon graduation appear to have more problem solving skills. They seem to have the ability to approach problems from different perspectives, and demonstrate a deeper understanding of the nuances of perspectives. Many of them may have experienced a shift in the perspective they held before matriculating. If you are exposed to people who think differently, you are more likely to look at the different aspects of an issue. Simply put, the more diverse the student body, the more diverse the faculty, the more likely it is that you will be able to attain institutional excellence that you gain from all the variation of thought.

From compositional diversity to inclusion: faculty, students, and interactionsWhat is generally referred to as “compositional diversity” doesn’t always translate into a climate of diversity and inclusion. You have to be deliberate about creating a community of inclusion. If you just throw a bunch of people who don’t know much about each other into a room, unless you create the space and opportunity for them to get to know each other, it may not happen. The situation can actually backfire sometimes. Without a deliberate effort to create meaningful dialogue, people might feel alienated, disrespected, or feel like they don’t belong. So it is very important to create the right supportive environment to support a diverse student and faculty body.

Making it real and relevant from the beginning

Some of the ways we are doing that are that right from the first week that the medical students show up here, we have an orientation for all students. One day is dedicated to diversity, and we select second year medical and MPH students to be part of a panel  where they talk about their background and how that background, set of beliefs, cultural difference, have interfaced with their work as students. This past year we had a panel with a student who is a Mormon, who talked about her health beliefs as a Mormon woman in a place where she was definitely a minority from a religious stand point and how the ways that students are social in medical school are not always open to her. It was a fascinating insight into a religion that many of us don’t know a whole lot about. There was another student who was a gay student talking about his choice to live off campus in a gay community in town because he wants to have a place where he feels supported and has a network. He talked about what his life was like being in the gay community but also being a medical student and having to shuttle between the two worlds. He was funny about talking walking and dressing as a gay man when you know you have to come here and do your patient interaction – he had to think twice about whether he was going to wear something or not. There was another student who was an African American woman from New York who talked about her experience at Tufts. Every student on that panel had a compelling story. What was important was that these first year medical students were listening to second year medical student tell them about differences but also making them realize that it’s relevant. What you bring to the table is actually relevant to your growth as a medical student. It was a wonderful way to open their eyes. That’s the first week.

Continuing the conversation

Since orientation, and in collaboration with the Office of Student Affairs, we have continued the dialogue on diversity in our learning communities and other settings. Our biggest resource has been the students themselves. I established a Multicultural Fellows Council, which is made up of representatives from all of the diversity organizations (broadly defined) here, such as the Asian American Association, Student National Medical Association, the Latin American Association, the Hillel group, Christian Medical and Dental Association, etc… What has been amazing to see is the level of collaboration among student groups as a result of students serving on the Council. For example, the students recently launched an inaugural, medicine and faith conference. The Hillel group, the Muslim group, and the Christian Medical Dental Association group came together for an interfaith conversation about how faith beliefs interdigitate with health beliefs and practices. They plan to have a follow up discussion with hospital chaplains about how religious beliefs weigh into patients’ decision-making about end-of-life care.  I’m very excited about that. This collaboration came about because students  were sitting across each other in the same room. One of the goals of convening the Council was to bring these groups together so that they could realize that they are all working on different parts of the same elephant- Jumbo if you will (she laughs). As they collaborate with each other, students are getting to know each other in the process. That is an example of making sure there is deliberate learning occurring among students.

Supporting faculty engagement and development

We recently introduced intramural faculty grants called IDEAS Grants – Innovations in Diversity Education Awards. (For more information, go to http://www.tufts.edu/med/about/faculty/educationalgrants/innovationsdiversityawardsoverview/index.html ) 

We invited faculty members to think about innovative ways to teach diversity with a focus in three areas: addressing health care disparities, how to attract and advance diversity in the institution using evidence – based approaches, and cultural competency education – how do we train medical and public health professionals in a way that really allows them to communicate across cultures. The charge is to develop curriculum, programs or an intervention that addresses any of these three areas. We have received some superb grant applications. Some of the proposals we received are aimed at the classroom, at first or second year students, while others  focus on second and third year students who are completing clerkships in our affiliated hospitals  Other proposals are aimed at examining the best ways to engage our local community as partners as we develop opportunities for our students to learn about diverse cultures.  In short, we are encouraging our faculty to generate creative  and innovative ways to teach the skills needed for cross-cultural communication and practice into the classroom and the hospital setting. We anticipate these seed grants will support  faculty to approach diversity in a scholarly manner. These efforts will hopefully help their own career advancement.

Getting the conversation going at the faculty level is mirroring what is happening among students.  The IDEAs grant application strongly encourage faculty collaboration with students. As faculty focus on how to better teach students and residents, we both faculty and students will engage in conversations that will converge.
 

Creating a “pipeline”

We also have a number of programs, described as “pipeline” programs related to diversity. Through a number of summer programs we bring high school, college and post bac students to Tufts to participate in enrichment programs  aimed at strengthening their academic backgrounds. Our hope is students participating in these types of programs will increase the chances of getting to the next level of education. These programs are all aimed at, ultimately increasing diversity in the biomedical science workforce. Although we take all students, there is an enriched sample of under-represented minority students. For these programs to be successful, we need faculty mentors. Unfortunately, we do not have enough underrepresented minority faculty to do race concordant matching, but those faculty who volunteer to serve as mentors in these programs are among those who care most deeply about working with students and supporting their development. In in the end, that is what matters, not the color of  a mentor’s skin. Of course, I would love to have more underrepresented minority faculty also participate as mentors in our program. There is something empowering about a student walking down Tufts’  corridors and seeing somebody who looks like them. This is the basis of my firm belief that in order to support our mission of maintaining a vibrant community of excellence at Tufts we must engage in continued and sustained efforts to recruit and support a diverse faculty.

Dr. Joyce Sackey is the Dean for Multicultural Affairs and Global Health at Tufts University School of Medicine (TUSM). She is originally from Ghana, and came to New England on her own at the age of 18 to study at Dartmouth College. This independent, focused and determined streak is a theme in her life. She followed on to medical school at Dartmouth before completing her residency at Beth Israel Deaconess where she became chief resident, and practiced primary care medicine. Prior to joining TUSM she was an assistant professor of medicine at Harvard Medical School and served as Associate Master in one of the academic societies at HMS. She has been able to pursue her passions as a medical educator and leader in addressing global health issues. She is co-founder of the Foundation for African Relief (FAR), a Massachusetts-based non-profit organization and directed the BIDMC-based AIDS Collaborative Project and its Visiting Scholar’s Exchange Program. The program has contributed to the fight against AIDS in Ghana and Sudan by training African physicians in the forefront of providing clinical care to people living with HIV/AIDS.

Find more from the Faculty Spotlight interview series at the spotlight’s archive here.