Movement in Diversity: Using data for equity, diversity and inclusion in the Department of Medicine

Mar 7, 2019
Author: 
Drs. Ayelet Kuper and Larry Robinson

"This is what a doctor looks like" buttonsThe Department of Medicine is seen as a leader within the Faculty of Medicine and beyond for our focus on equity, diversity and inclusion (EDI) - for faculty members, trainees and patients. There is increasing evidence for a strong link between this focus and achieving excellence in multiple domains. For example, EDI has been shown to lead to:

  • better health outcomes,[i]
  • better learning environments,[ii] and
  • more research productivity.[iii]

EDI is among the values and principles guiding the Department of Medicine. More recently, EDI has become part of the new Academic Strategic Plan for the Faculty of Medicine under the focus of ‘Excellence through Equity.’ It has also been identified as a priority for many of the hospitals in the Toronto Academic Health Sciences Network.

As part of our commitment to EDI, the DoM has begun to analyze our own demographics over time. Supported by the Mentorship, Equity, and Diversity (MED) Committee, we have started by leveraging the demographic data that already exists within the University of Toronto’s FOCUS (human resources) database. This has allowed us to create yearly snapshots of the gender make-up of the department as a whole, its hospital sites and its divisions. We have also been able to look at hiring, promotion and academic job description by gender. (Note that the FOCUS database reports self-declared gender and that the Department of Medicine interprets the words "female" and "male" as fully inclusive of all self-identified trans and cis women and men, respectively.)

The gender-related data from July 2017 and July 2018 were recently shared with departmental leaders, including Department Division Directors and Physicians-in-Chiefs, to help them strategize within their own sites and/or divisions about ways to move towards improved gender equity. Leaders are regularly encouraged to share their reflections and strategies in this area at the department’s Executive Committee meetings. They will be receiving these data annually, allowing the divisions, sites and department as a whole to track and reflect on progress in this area.

In keeping with best practices in equity-related work, the department is also committed to freely sharing the aggregate gender data with all those people being “counted” – which, in this case, means all faculty members in the Department of Medicine. Interested faculty members can receive a copy of the aggregate data, dubbed the ‘DoM Diversity Dashboard,’ by emailing Lilian Belknap, Administrative Coordinator, Events and Mentorship, Equity and Diversity, at dom.events@utoronto.ca. New data will be available from her annually each July.

Gender is, of course, only one element of diversity, and achieving gender-related equity and inclusion is only one step in ensuring an equitable, inclusive department. There are many other aspects of people’s identities that may unfairly lead to inequitable hiring, promotion, pay and day-to-day treatment more broadly. As it is our goal to ensure that we are not discriminating on the bases of these aspects of identity, which in our society include (but are not limited to) race, religion, Indigeneity, self-identification as LGBTQ2S+ and disability, we are looking for ways to track our department’s diversity and inclusion efforts with respect to those as well.

The FOCUS database does not contain information about any of these aspects of identity other than gender. However, given the growing consensus of the necessity of data for holding organizations and institutions accountable for EDI, the department is committed to working with and supporting faculty members from underrepresented and structurally marginalized groups to help generate data about themselves.

Based on previous input from a variety of stakeholders, we are starting by working with black, Muslim and LGBTQ2S+ faculty members to develop one or more processes by which they are comfortable generating some form of aggregate data about themselves and their colleagues. This process will include working with members of different groups as they determine who can own their data, how it can be shared and with whom.

We welcome Department of Medicine faculty members who self-identify as members of one or more of those groups to contact us via Lilian (dom.events@utoronto.ca) if they’d like to be part of that development process.

 

[i] Institute of Medicine. 2004. In the Nation's Compelling Interest: Ensuring Diversity in the Health-Care Workforce. Washington, DC: The National Academies Press. https://doi.org/10.17226/10885

The Sullivan Commission. 2004. Missing persons: Minorities in the health professions: A report of the Sullivan Commission on diversity in the healthcare workforce. Durham, NC: Sullivan Commission on Diversity in the Healthcare Workforce. https://www.aacnnursing.org/Portals/42/News/Sullivan-Report.pdf

[ii] Association of American Medical Colleges. 2016. Assessing Institutional Culture and Climate. Washington, DC: AAMC. https://store.aamc.org/assessing-institutional-culture-and-climate-pdf.html

Karani R, Varpio L, Win M, Horsley T, Chenault J, Miller KH, O’Brien B. 2017. Racism and Bias in Health Professions Education: How Educators, Faculty Developers, and Researchers Can Make a Difference. Academic Medicine 92 (11S): S1–S6. https://doi.org/10.1097/ACM.0000000000001928

[iii] Nielsen MW, Alegria S, Börjeson L, Etzkowitz H, Falk-Krzesinski HJ, Joshi A, Leahey E, Smith-Doerr L, Williams Woolley A, and Schiebinger L. 2017. Gender diversity leads to better science. PNAS 114 (8): 1740-1742. https://doi.org/10.1073/pnas.1700616114

Powell K. 2018. News Feature: These labs are remarkably diverse — here’s why they’re winning at science. Nature 558: 19-22. https://doi.org/10.1038/d41586-018-05316-5

Johnson, SK. 2017. What 11 CEOs Have Learned About Championing Diversity. Harvard Business Review. 17 August. https://hbr.org/2017/08/what-11-ceos-have-learned-about-championing-diversity

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