1. Shifting Paradigms: Implementing Sullivan Commission Recommendations to Increase Diversity at the University of Virginia School of MedicineAuthors: R.J. Canterbury MD, L. Thomas JD, M. Moxley MD, G. Marzani-Nissen MD, J. Densmore MD PhDSenior Leadership Innovators: Arthur Garson, Jr. MD MPH– Executive Vice President and Provost, University of VirginiaSteven DeKosky MD – Vice President and Dean of UVA School of MedicineSharon Hostler MD – Vice Provost for Faculty Development, University of Virginia and Senior Associate Dean, University of Virginia, School of MedicineR.J. Canterbury MD – Senior Associate Dean for Education, School of MedicineM. Norman Oliver MD MA - Associate Dean for Diversity, School of MedicineW. El-Amin MD – Assistant Dean for Diversity, School of Medicine (2007-2010) Presenters: G. Marzani-Nissen MD – Office of Admissions, UVA School of MedicineM. Moxley MD- Office for Diversity, UVA School of Medicine Marcella Willis- 4th year medical student, UVA School of Medicine

2. Sullivan Commission Background In 2004, The Sullivan Commission produced a monograph entitled: Missing Persons: Minorities in the Health Professions. A Report of the Sullivan Commission on Diversity in the Health Care Workforce. Among other issues, it noted the disparity of individuals who were underrepresented in medicine (URM) Increased diversity in the medical workforce has numerous benefits, including a healthier nation. It has been demonstrated that health care providers need to be sensitive to variety in patient ethnicity, socioeconomic status, sexual orientation, and life experiences in order for patients to have successful outcomes.

3. Vision and Implementation Process In 2004, The Dean and Senior Leadership for the School of Medicine, committed to diversity, envisioned a process by which students, traditionally underrepresented in medicine, could be more fully represented in the medical school class. R.J. Canterbury, MD embraced this mission and formalized a process of outreach and recruitment through the Office of Admissions in the School of Medicine. A cultural shift took place, which included increased membership of students and faculty under-represented in medicine and implementation of a day-long retreat for all Admissions members. This retreat included a focus on holistic approaches to student applications and included presentations on diversity, including lesbian, gay, bisexual and transgender issues. Contemporaneously, a proactive Admissions Office, Assistant Dean for Medical Education and Office for Diversity created pipelines and mentoring initiatives within the greater university as well as in the community. Active recruitment of students in historically black colleges and at pre-medical conferences also increased. Coordination with student groups such as the Daniel Hale Williams Society Student National Medical Association (SNMA) and the National Network of Latin American Medical Students during recruitment activities was enhanced. Students in other organizations such as qMD (an LGBT group) became active in outreach.

4. Diversity and Academic Outcomes • During 2003-2010, the percentage of students underrepresented in medicine who matriculated into the UVA School of Medicine more than tripled from 5.7% to 21%. • Using data from the University of Virginia, School of Medicine Office of Admissions, URM matriculants (African American, Hispanic, Native American, and Alaskan/Hawaiian American), were determined as a percentage of the entering classes during 2003-2010. • Average USMLE Step 1 and Step 2 scores increased or remained stable over this time frame. Pass rates for these exams remained stable. • Increased diversity in the medical school has been accomplished in the face of stagnant national percentages of applicants and matriculants underrepresented in medicine.

5. Outcomes: Diversity and USMLE Results UVA School of Medicine 2003-2010

6. National Data adapted from Table 28: Total U.S. Medical School Enrollment by Race and Ethnicity within Sex, 2002-2010 (2009) Association of American Medical Colleges

7. Examples of Specific Strategies Changing Admissions Committee – 27 members representing medical students, multiple medical and surgical disciplines and a broad swath of diversity in all forms. Term limits for members Focus on Role of Diversity – Targeted Recruitment of an Assistant Dean of Medical Education - Wendi El-Amin, M.D. • Recruited to develop and implement programs and recruitment activities that increase the number of qualified underrepresented minorities who matriculate at the University of Virginia School of Medicine • Dr. El-Amin – working closely with R.J. Canterbury, MD accomplished the following:

8. Dr. El-Amin – working closely with R.J. Canterbury as mentor accomplished the following • Met with Daniel Hale Williams Pre-Medical Society. Interviewed seniors about premed support. Distributed a survey to members of the Society to do a needs assessment. • Created a template for “Toolkit for Success” to be utilized by undergraduate students. • Presented at UVA Summer Medical and Dental Education Program. • Created community service opportunities for minority undergraduate students. • Served as a mentor for UVA Summer Medical and Dental Education Program. • Presented at Hampton University to Premed Society • Secured Research summer positions for two Virginia Nebraska Alliance interns from Hampton University. • Participated in second look weekend at UVA. • Presented to minority second look participants mock POM class. • Worked with SNMA students and Office of Diversity to explore pipeline initiatives. • Identified mentors for Daniel Hale Williams Society

9. Office of Admissions/Office for Diversity – some keys to success • Warm environment, approachable people • Importance of human connection – nurturing • Accessibility to accomplished mentors • Visibility of mentors representing diverse backgrounds • Creation of and establishment of pipelines in high schools and colleges (e.g. medical science clubs) • Active recruitment at health fairs and student fairs • Close connections with SNMA, Daniel Hale Williams Society, LGBT communities • Holistic review of applications, diversity (in the broadest sense) on Admissions Committee • Term limits on Admissions Committee membership • Strong and unyielding support from administration • Yearly training on diversity and cross-cultural sensitivity and training

10. References • Missing Persons: Minorities In The Health Professions. A Report of The Sullivan Commission on Diversity in the Work Force. The Sullivan Commission (2004) • Association of American Medical Colleges (AAMC) website: www.aamc.org