The Census Bureau lists Vermont among the 10 whitest states in the nation, yet in this small, picturesque New England state, the University of Vermont College of Medicine is intentionally helping diversify the region’s physician workforce.
“It seems there is always work to do when addressing diversity and inclusive excellence, especially in a very homogeneous state such as Vermont,” says Margaret Tandoh, a trauma surgeon at the University of Vermont (UVM) Medical Center and associate dean of diversity and inclusion for the College of Medicine. “We have made tremendous progress as an institution over the past decade, with [student] recruitment, professional development, and more visible support of diversity and inclusion efforts.”
There is good reason behind UVM’s efforts to get more minority medical students in the pipeline. The university is located in the city of Burlington, which is statistically different from much of the rest of the state. In recent decades, many ethnic groups — from such countries as Bosnia, Somalia, Nigeria, Ethiopia, and Vietnam — have settled in the city, creating a growing demand for a diverse physician workforce.
Thanks to an uptrend in minority enrollment over the past decade, UVM College of Medicine is well-positioned to prepare future physicians to care for patients from these ethnic populations.
Of the current 408 students enrolled in the college, minorities make up 34 percent, up nearly 40 percent from a decade ago and nearly double the national average.
Tandoh attributes such positive results to a “robust, five-year diversity strategic action plan” that touches every aspect of the college — from recruitment and hiring to professional development. For its diversity efforts, INSIGHT Into Diversity magazine awarded UVM its Higher Education Excellence in Diversity (HEED) Award in 2014.
“I’m proud of the fact that we’ve created and implemented a five-year diversity and inclusion plan that is mission-driven and has the full support of the College of Medicine administration,” Tandoh says.
UVM College of Medicine also boasts a mission focused on ensuring that its students gain hands-on experience working with diverse populations in Vermont.
Through public health projects — completed as part of a required course — UVM medical students are not only engaging with diverse populations, but are also tackling health disparities in the surrounding communities of Chittenden County. For example, they have established a program to work with the state’s migrant farm workers, a largely hidden population. The required course, titled Public Health Projects, was implemented in 2004 under a partnership between UVM and United Way.
“Students get to see people in the context of their daily lives. They see the many things that influence people’s health, including their education, income, what their neighborhood is like, and if they have nutritious food in their family,” says Jan Carney, associate dean of public health for the College of Medicine. “It gives them a sense of the real world and the problems people face around health.”
Alejandro Velez, a second-year medical student at UVM, along with fellow student Jessica Huang, helped establish a public health project — supported by the Albert Schweitzer Fellowship — to distribute bilingual healthcare information to migrant, Latino dairy-farm workers.
“The Office of Diversity and Inclusion has been instrumental in the success of this project, and they have supported us mostly in identifying interested volunteers and raising awareness about the demographics and the struggles of these farm workers,” says Velez, 24, who identifies as white and Hispanic/Latino.
The payoff is twofold. UVM medical students gain valuable real-world experience in public health, and nonprofit agencies get much needed research that they otherwise may not be able to afford.
“The projects are things the community wants to know about, but many agencies don’t have money to do the research,” says Laurie Dana, coordinator of volunteer mobilization for United Way of Chittenden County.
Student-Led Study Examines LGBTQ Medical Needs
Like Velez and Huang, Alison Alpert, a graduate of UVM College of Medicine, made good use of the opportunities available to her while enrolled there.
By the time Alpert came to UVM as a medical student, she had been working with the LGBTQ community for more than 10 years to reduce health disparities, particularly with LGBTQ people of color. Around the same time, there were a number of suicides involving people in the LGBTQ community, including someone she had known in New York.
“I talked to my mentor about how we could do something to reduce harm to the LGBTQ community within the context of the medical school,” she says. “We realized it all comes down to competency. If you don’t know what people don’t know, you can’t find the gaps in knowledge.”
This led to a study in 2013 and 2014 of the negative and positive experiences of people in the LGBTQ community, as well as the development of a list of competencies for healthcare providers. According to Alpert’s study, previous competency guidelines had been made without formal surveys of members of the LGBTQ community.
The study consisted of six focus groups, with 47 lesbian, gay, bisexual, transgender, queer, and intersex people over the age of 16 from Burlington, Washington, D.C., New York City, and Oakland, Calif. When asked to give feedback on other competency guidelines, those surveyed still found gaps, Alpert says.
Because the results of Alpert’s study and list of competencies for physicians are not yet published, she is reticent to talk about the findings, but she hopes to see medical schools training physicians to be more patient-centered when treating people in the LGBTQ community.
“It’s really important [for professors] to think about the examples they use in class,” Alpert says, when referring to clinical vignettes. “Patients in the vignettes are assumed to be white and straight. LGBTQ people are only mentioned when you talk about HIV, and black people are mentioned when you talk about sickle cell anemia. This does a lot to reinforce the idea that LGBTQ people are ‘other.’”
Alpert is now a first-year resident at Cambridge Health Alliance in Massachusetts. In her own work, Alpert says she asks open-ended questions to give patients the opportunity to “say what they need to say,” rather than making assumptions about their medical background.
“I will say that at UVM, I was just really impressed and moved by the authentic collaborations among marginalized groups on campus,” Alpert says. “I felt like a lot of professors who are not in the LGBTQ community had my back around LGBTQ issues, and a lot of my peers in the LGBTQ community had the backs of people of color.”
Casting the Widest Net to Find the Best
Charles Irvin, associate dean of faculty affairs, professor of medicine, and director of the Vermont Lung Center at UVM’s College of Medicine, says that increasing faculty diversity at the school has been “slow but sure.”
“We’re doing really well with diversity at the leadership level,” he says. “The dean [Frederick Morin] is a first-generation student, and he is visibly behind our diversity and inclusion efforts.”
Since 2012 — when the College of Medicine’s Dean’s Advisory Committee on Diversity and Inclusion was established — Irvin says there has been a significant increase in the number of diverse faculty members, including three minority faculty members he recently helped hire.
“We begin the process with carefully worded advertisements and communications,” he says. “I review the makeup of the search committee to ensure its members represent the diverse academic community we seek to establish and retain. About 25 percent of my time with each of these search committees is focused on discussing diversity and inclusion objectives, and I review each interview request to ensure the candidate meets our mission criteria.”
Seven percent of the college’s full-time faculty meet its broad definition of diversity, which is a higher percentage than the overall diversity of Vermont.
“We’d like to be 15 percent minority in the next five to 10 years, and I think we can do it because we’re committed to [increasing diversity] for the right reasons,” Irvin says. “We’re not interested in tokenism. We cast the widest net so we can find the best people, and I think we do really well with that.”
Irvin says the most effective method he has found for recruiting a diverse mix of faculty members is a simple telephone call to a friend or colleague.
“If they aren’t interested in the position, they probably know someone who is,” he says. “And once you get them into Burlington, the town sells itself.”●
Tannette Johnson-Elie is a contributing writer for INSIGHT Into Diversity. Rebecca Prinster is a senior staff writer for INSIGHT Into Diversity.