The Icahn School of Medicine at Mount Sinai will enroll 11 partner medical schools in its Anti-Racist Transformation (ART) in Medical Education initiative, which seeks to use a formal change management process developed at Mount Sinai to address deeply entrenched racism and bias. The initiative has received generous support from the Josiah Macy Jr. Foundation.
"While racism permeates clinical practice and biomedical research, the shadow that it casts on medical education is even more profound and egregious; it is through medical education that racism and bias are perpetuated across multiple generations," says David Muller, MD, FACP, Dean for Medical Education, Icahn Mount Sinai, and a Principal Investigator of the initiative. "We developed our model in the belief that racism can only be mitigated through a formal change management process that is life-long and requires vigilance and openness to course correction."
Icahn Mount Sinai's project to dismantle racism in medical education gets underway immediately and will last about three years. The goal of the initiative is to transform culture and build capacity at each of these schools, in an effort to establish anti-racism as an organizing principle in medical education. The initiative includes a virtual learning platform designed to engage students, staff, and faculty in virtual experiential learning, assessments, outcome and performance monitoring sessions, and coaching. The ART in Medical Education project replicates and adapts a framework developed by Mount Sinai faculty and students.
Icahn Mount Sinai received a total of 48 submissions, which a selection committee evaluated to gauge vision, commitment, administrative capacity, institutional alignment, and diversity of institutions (geography, public/private, new/established schools). Its selection committee was purposeful in selecting a broad spectrum of schools:
College of Medicine, University of Saskatchewan
Columbia University Vagelos College of Physicians and Surgeons
David Geffen School of Medicine at the University of California, Los Angeles
Duke University School of Medicine
East Carolina University Brody School of Medicine
The George Washington University School of Medicine & Health Sciences
The Ohio State University College of Medicine
University of Arizona College of Medicine – Phoenix
University of Minnesota Medical School
University of Missouri-Columbia School of Medicine
University of the Incarnate Word School of Osteopathic Medicine
Step one of the project will involve co-creating "a brave learning environment," where dialogue is open and direct, within established boundaries that ensure a framework that is open and honest, while feeling safe at the same time. While co-creating these brave spaces, Icahn Mount Sinai is working with working groups of students, faculty, and staff at each of the 11 schools to assess readiness to change at both the individual and institutional levels. This assessment of readiness will involve taking a close look at the factors that contribute to the school's overall ability to change, those who will help the school prepare for change, and the motivation of individuals involved with the change.
To change the way physicians are trained in medical school, Icahn Mount Sinai began implementing its anti-racism strategy several years ago. One of the first milestones in this process was the publication of a paper titled "Addressing and Undoing Racism and Bias in the Medical School Learning and Work Environment" in Academic Medicine in December 2020. The paper, coauthored by Leona Hess, PhD, MSW, Senior Director of the Strategy and Equity Education Program, and Ann-Gel S. Palermo, DrPH, MPH, Senior Associate Dean for Diversity, Equity, and Inclusion, sparked engagement within the Mount Sinai community while also engaging the interest of other medical schools.
"We're thrilled to share the lessons we've learned and the approach that was developed by our faculty in close partnership with students and staff. It takes this all-in, team approach to effect meaningful change and has been an eye-opening experience for us," says Dr. Muller.
"ART in Med Ed is not the linear, task- and output-oriented approach that is traditionally seen in academic medicine. It relies on deep personal and communal reflection, the courage to ask the really hard questions, and the patience to course-correct in a very dynamic manner in an effort to achieve equity and racial justice," says Dr. Muller.
Dr. Hess, a co-investigator of ART in Med Ed, joined Icahn Mount Sinai in 2018 to lead a transformational process to dismantle racism among leaders, faculty, and students. Dr. Hess emphasizes that Icahn Mount Sinai has done its own hard work to grasp a new understanding of change. "As we were reviewing applications we were specifically looking for schools where leadership and students alike would embrace a change process that is life-long and involving deep, difficult conversations in an environment that fosters a welcoming and creative community exchange of ideas, where we are all learning from each other," says Dr. Hess.
"In our evaluation of schools, we looked for schools with strong student support, because without support from the ground up and the top down, sustained change is not possible," says co-investigator Jennifer Dias, a rising third-year medical student, who has taken a scholarly year to design, implement and manage the project under the direction of Drs. Muller and Hess.
