A magazine for friends of the Warren Alpert Medical School of Brown University.

Diagnosing Racism

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Brown’s medical school program addresses roots of bias in health care.
This article appeared in Diversity in Action magazine.

Providing quality care to a diverse patient population is a priority at Brown University’s Warren Alpert Medical School. Its Office of Diversity and Multicultural Affairs sponsors several programs, including Brown Advocates for Social Change and Equity (BASCE), a yearlong fellowship for medical students, residents and faculty members that started in 2017.

The program consists of a lecture series, projects and mentorship aimed at addressing structural racism in the health care system. One of the fellowships is a paid position filled by a medical student who takes a year off from school to focus exclusively on running the program. Ry Garcia-Sampson was the Diversity Fellow with the Office of Diversity and Multicultural Affairs last year when Garcia-Sampson created BASCE and its curriculum.

“I created the BASCE program based on a proposal from Bryan Leyva, who graduated from the medical school in 2018. The vision was to provide training to those who want to make antiracism work a central part of their careers in medicine,” says Garcia-Sampson.

Fellows meet monthly for two to three hours to discuss various aspects of structural racism, including racial bias in scientific research, how race is discussed in medical schools, and how education and research set the foundation for how people learn and practice medicine. “By providing resources to leaders and mentors in this area, we hope to build the capacity of the medical school, and, more broadly, the health care system in Rhode Island, to do this work,” Garcia-Sampson says.

Growing up in a rural border town in Texas, Garcia-Sampson learned at an early age how disparities in health care can affect individuals in a community. “When I was young, my mother had several organ transplants. I had a lot of exposure to the medical field from that standpoint and saw how discrimination made it difficult for some people to navigate the health care system. In part, it was what inspired me to become a physician.”

For the project component of the BASCE program, each fellow is given a $500 stipend plus any other type of support they need. Anne Murray, MD, a BASCE fellow who participated during its first year, was excited about the chance to apply her fellowship experience to her role at Providence Community Health Centers, where she provides clinical care as an obstetrician/gynecologist.

“When I heard about this fellowship, it was the right moment for me,” says Murray, who also is a clinical assistant professor of obstetrics and gynecology at Brown. “I had been frustrated politically by the racial discourse in our country today and wondering what I could do to change things. It was a combination of what I wanted to do professionally and what I wanted to do from my heart.”

For her project, Murray wanted to expand on the work that the health centers’ own diversity and inclusion committee was doing. “The committee was doing a good job,” she says, “but I wanted to provide health center staff with more training on cultural differences among patients and on how to identify the biases that we ourselves bring into the examination room.”

With the blessing of the facility’s leadership, Murray hosted an all-staff workshop on everyday bias in health care professionals. The center has more than 300 employees, including medical doctors, dentists, nurse practitioners, midwives, administrative personnel, health aides and nurses. “I introduced the workshop to the staff at the beginning of the program. I think it was important for me as a doctor and as a white woman to speak out and say why the workshop was important,” Murray says. “Everyone enjoyed the program, and since then, more people of color than before have joined the center’s diversity and inclusion committee, as well as staff members at all levels, not just administration.”

In the future, a BASCE fellow plans to come to the health center to conduct a workshop on microaggression for the nurses, she adds.

“I think BASCE is a brilliant concept,” Murray says. “It’s a good way to create bridges instead of allowing people to feel isolated as they fight their own little battles.”

Now that BASCE is in its second year, Garcia-Sampson is back in school applying for residencies, as well as collaborating with the new diversity fellow, med student Radhika Rajan, as she takes the year off to run the program. Together, they are in the process of creating an annotated bibliography of research they have done on structural racism that they hope to make available to a broad group of people.

For Garcia-Sampson, leading BASCE was a good learning experience. “I had great mentors in the process of creating the curriculum, and I have connected with amazing people who are doing this work here in Rhode Island and across the country. I’m really proud of what I and all the fellows were able to accomplish.”

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