Medical Community Advocates for Representation, Equity and Social Justice (MedCARES)

Our Internal Medicine Residency Program completes an annual self-assessment and identifies areas for further exploration and improvement. We set goals for these individual areas and create working groups comprised of faculty and residents.  

As part of these efforts, we created the Implicit Bias Improvement Group in 2019 under the mentorship of one of the Associate Program Directors, Bi Awosika M.D. 

With the heightened unraveling of structural racism within the summer of 2020, the group led residency-wide town halls dedicated to challenging long standing structural racism within our institution. Residents and faculty provided a listening ear and shared insights and personal experiences regarding injustices while supporting each other.  Subsequent efforts from this group have led to various initiatives including the implementation of an implicit bias academic half day and a departmental health equity rounds.  

In the summer of 2021, we rebranded this group as MedCARES: Medical Community Advocates for Representation, Equity, and Social Justice to better encompass our vision.

Our group has now expanded to include interprofessional members across other departments. Our current global aim has evolved towards exploring and addressing social inequities as healthcare providers to provide optimal care to our patients, while fostering and supporting diversity and inclusion within the residency program.  

We continue to expand our efforts and hope you will join us. Following the lead from an article entitled Diversity Is Not Enough: Advancing a Framework for Antiracism in Medical Education, we have created the following framework:

See – We know that we cannot change what we do not see. Therefore, we aim to see at the individual and institutional levels.  

Next steps:  

• Training in mindfulness and self-awareness 
• Implicit bias training - Academic Half Day 

• Facilitated discussions of racial disparities in learning environment – Sharing Communities 
• Use MMI format to highlight racism 

Name – We recognize that naming the experiences “confirms specificity, clarity, and importance.” This allows us to “understand, rectify, and move forward.” We recognize “that we are all vulnerable to perpetuating racism and responsible for rectifying it.”  

Next steps: 

• Apply framework of disclosing errors to this context -> acknowledge, disclose, apologize, and learn 

• Build common vocabulary 
• Build reporting structure 

Understand – We will explore underpinnings and consequences with rigor of science.  

Next steps: 

• Leverage narrative and data to deepen collective knowledge and understanding of racism 

• Evaluate bias and disparities in patient care, interactions, curriculum, and evaluations 
• Education about national and local Cincinnati context and history 

Act – “Once we see, name and understand... we must act.” We must make changes in “pedagogy, policy and culture” that are grounded in equity.  

Next steps: 

• Include DEI topics in all aspects of training – Academic Half Day, Scoop, Noon report 

• Establish and disseminate intention and transparency in recruitment 
• Intentionality of policies 
• Develop standards and training around areas where bias is most prevalent such as patient and trainee hand-off 
• Leadership training to build safe learning environments including in retreats for residents, development of chief residents, and faculty development 

Additionally, we have started developing safe sharing space which we have named Sharing Communities, offering further opportunity to continue dialogue and grow in our understanding of one another. Continued longstanding goals for sustainable change include expanding recruitment efforts, building leadership training, and implementing a new framework of see, name, understand, and act, learning to address and combat racism within the framework of our residency program and beyond.