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Presidential Commission on Race and Diversity

Transcript of Town Hall Meeting, January 18, 2016

            Burgett:          All right, everyone, we’re ready to get started.  It’s 6 o’clock and we’re ready to get started; we want to keep this moving in a timely sort of fashion. To open, let me introduce Dr. Linda Chaudron, who is a member of the President’s Race and diversity Commission to get us underway.

            Chaudron:     Welcome and thank you all for coming out on this lovely night. This is Rochester in January if you didn’t know that.  Very excited to have you all here and have you come out to talk tonight about issues of race and diversity. That is really our charge tonight; it’s to hear from you. It’s not for us to talk but for you to talk, and give us your insights, your thoughts your ideas of how we can continually improve.

Before we go there, I am going to say just a couple things here. I was given the distinction to do the ground rules – oops, that’s not it.  I don’t know what that was; that was not mine.  [laughter in background]  Okay, now we’re going to have a quiz after the case study – no.  What we have seen work, this is the second of three of these town halls at the Medical Center.  There was one a couple weeks ago, there’s tonight, there’s one at the School of Nursing tomorrow, and there have been other town halls across the university.  What we’d like to do, because we’d like to hear from you, to try to keep your comments somewhat concise, if possible.  Talk about your own experiences, your own ideas, things you’d like to see. If you have examples from other places that have worked, please give us any ideas.  And, if you are wanting to provide more information or you don’t want to speak up, this is audiotaped and will be transcribed and put on the Presidential Commission website.  So if you don’t want to speak up, you’re welcome to not speak into the mic, but please do give us your comments.  Each of you have this around the room; you can put your information on there if you want or leave it completely anonymous but we have gotten great information from these.

We have also provided you with the website contact; you can also send an email to anyone from the Commission or the Commission directly with any comments.  And, I think that’s the list of to-do’s I was supposed to say tonight.

Then I wanted to give you the four questions that really are forming our charge as a commission that we are talking about across the university.  That is:  What is the state of our campus climate for everyone? What programs have you seen strengthen our climate?  What on our campus is not as consistent with the healthiest campus climate we want to have?  And – I think this is most important – what are your recommendations?  What do you think could be helpful to you as students, faculty, staff, trainees who are all part of this wonderful organization?

With that, I’m going to let those who are leading the commission take it from here.  There are microphones everywhere – there’s one here, one over there, one there.  When you get up to speak, please do speak into the microphone because it is being taped and transcribed.  Thank you.

Burgett:          Thank you, Linda.  My colleague Rich Feldman, Dean of the College, and I co-chair the Commission that was commissioned by President Seligman in response to an event that happened in – that happened last year with an anonymous social media site called Yik Yak, with which some of you may be familiar.  Yik Yak is a site that enables anyone who is so inclined to post whatever they would like to post and it is all anonymous.  Some of the unpleasantness and even more than unpleasantness, even deleterious and even violent posts that appeared on that site directed not only at a student group that is African-American but at an individual caused enormous concern and alarm for us.  First order of priority at the university is safety for all concerned.  We have been working very, very hard in our relationship with Yik Yak in response to the protests that the Minority Student Advisory Committee - MSAB, the BSU and the Douglas Leadership House presented the president with a series of demands about this issue and about climate issues as well.

So we’ve been working very hard on our relationships with Yik Yak to understand better what the situation with that social media site is all about as we prepare our recommendations for the president with respect to Yik Yak.  But this is a much larger issue that goes to the quality of the environment at the University generally.  As Linda has pointed out, we are having these town hall meetings throughout the university. 

I’d like to ask my colleague Rich Feldman if he would say a few words about what we have done to this point because we’ve been working very, very fast – and we think it is important to move as quickly as we have, but I’d ask him to just say a few words about the sorts of things we have been doing and what we’re expecting in the coming days and weeks ahead.

Feldman:       Thanks, Paul. I will just speak briefly about some of what we’ve done already, and then we want to spend as much time as we can this evening hearing from you.  The Commission has had, I think, half a dozen meetings already; we’ve talked about a variety of issues.  Many of the issues that prompted the students in the College’s demands are being addressed separately.  The Commission’s role is to take a much broader look at what’s happening around the university and to host these kinds of forums to give all of you a chance to speak.

One of the things we’ve done is collect information about – we’ve done an inventory of all the different kinds of programs and activities there are around the university that are designed to be supportive of diversity and of students.  That’s being pulled together now and we think once we have that, we will be in a much better place to understand what's already happening, and I think one of the things that’s falling into place for me is seeing there’s lots of different things happening in all the different schools and all the different parts of the university.  It’s beginning to look like there may be some opportunities for real collaboration and things that could be done more on a university wide basis in a way that would be supportive of our community.

We will see what works individually in the schools and what works more broadly around the university.  And I think we’re also looking at data, student data, demographic data, what the student profile is, what the graduation rates and persistence rates are among the different groups, just to get an understanding of what’s working and what’s not.  All of that will come out.  We will issue an interim report around the end of this month and then a final report at the end of the academic year.

Our initial focus is on issues facing students; we will later on look more at some issues related to staff and faculty.  I think with that, those are the key points.

Burgett:          Let me just identify the members of the Commission who are here:  Dr. Anne Nofziger, who is here; Dr. Vivian Lewis, who is here; you know Dr. Chaudron, who is here; where is Guylda?  Guylda, who is here.  Tony Kinslow, who is associate VP for HR is here.  Who am I missing?  Just so you know there are members of the commission who are present. 

While we are called the Presidential Commission on Race and Diversity, our focus has been on race initially, but we have the term ‘diversity’ because we recognize this is a much larger issue – that race is a focal point for us right now, but diversity more broadly defined is something we need to be concerned about also.

With that, let’s start hearing from whomever is going to be the brave first person to speak to us, from whom we can hear.  I know there are people here who have things on their minds that they want to say.  Sure.

Seligman:      I’ve attended a few of the town hall meetings and it’s very hard to start a conversation, but let me offer a few thoughts that may make it easier.  The way you improve an institution is by being honest about its challenges and problems, by listening – listening is the most important thing those of us in academic administration do. This is a broader issue than the University of Rochester, Yik Yak, and a student march in November; it is a national issue, it is one which is affecting our culture as long as we’ve been a nation – indeed longer.  It is where I will tell you that I and everyone I know at this university is committed to creating first, an institution as Paul has said, that is safe for everyone, that welcomes everyone.  And I became aware over the last few months – in part because of conversations with Vivian Lewis, that there were staff and faculty who didn’t feel that way, and I’ve become aware since the death of Jeffrey (Bordeaux) five years ago how hard this institution is for some individuals who feel marginalized.

We are basically saying it’s time to put these issues on the front burner.  I’m asking you to help us, that’s really why we’re here.  I’ll keep going to these sessions – I’m looking forward to the reports from the Commission, but this is an instance where there’s nothing anyone should say with the slightest trepidation or fear.  This is not the kind of situation where anything bad can happen; this is the situation where you can make a difference.

You have stories, you have experiences, you can share them with us. You have ideas.  And one of the great parts about being at a university is everybody’s really smart and, typically, if you’re comfortable speaking, as ways of coming forward.  So more than anything else, I’m asking you to tell us what you like, tell us how we can improve.  We’ll stay for an hour and a half tonight and we’ll keep going on this process as long as it takes to get things better.

Burgett:          I think we have someone here.  We have a couple.  Amber?

[background conversation]

Amber:           Hello, everyone. I am a former medical student here at the University of Rochester and I’m currently a second-year resident.  The thing that I think that’s been most encouraging about the University of Rochester is its investment in diversity.  Coming here as a medical student, knowing that U of R is known for having a very diverse student body was very attractive to me. The concern I had was the transition from having a very diverse medical student population to then having a diverse resident population. I feel that may be the reason why a lot of people do not stay; it’s because it isn’t diverse and you don’t see us, or you may not interact with a diverse resident population.

In addition that translates over to having faculty members too – not having as many minority faculty who can mentor us and help us understand the culture of academic medicine; I feel like that is the lack and where there is a disconnect.  So I am glad this is happening; I am actually jealous because I wish this was happening when I was a medical student, but I think those areas of disconnect are the areas that need to be addressed.

[applause]

Burgett:          Thank you.

Female:          Hi. I’m a 1976 graduate of the University of Rochester and the climate, unfortunately, when I was there, remains the same today.  I appreciate the effort but I have to echo what Ashley just said – Amber, I’m sorry – about not having the mentorship.  There aren’t enough minority faculty.  I know that there’s an effort throughout many departments to recruit faculty. I don’t know if it’s the weather in Rochester, I don’t know if it’s not having other minority faculty that will mentor them – I think white faculty can have empathy, they can empathize, but they can’t really tell me how to function as a professional, as a black professional, in a community that is primarily white.

I know there have been efforts to try to arrange articulation agreements with historically black colleges to try to get more minority faculty, but it just hasn’t filled.  I don’t know if – I’m not at the higher levels, so I don’t know if the problem is the fact that the old boy network is still alive and well in the sense that if there’s an opening and a faculty member knows somebody that knows somebody that went to school with them, that person moves to the top of the list.  I appreciate this effort. I appreciate having this kind of forum so we can be able to say what needs to be done, but it just saddens me that my life here in the university, my time here – I’m going to be here almost 30 years; I graduated in ’76 and it’s gotten a little bit better but it should be so much further ahead given the status of this university, given the initiatives, given the drive that is here.  We just should be doing better at this.

[applause]

Clayton:                     My name is Clayton; I’m a second year medical student and my point is very similar to Amber’s.  I have two people that I would consider mentors and both are older, white males and in talking to them, it sounds like they – other people that they mentor are exclusively or nearly exclusively white males. My perception is that there’s a triangular distribution when it comes to black faculty; there are many more younger than there are older and I think having a retired faculty makes it easier for them to take on mentorship because they don’t have other responsibilities. It’s also my perception that the black faculty that are serving as mentors are over-burdened – they have so many more people that they’re attempting to mentor.  I wonder, is there any formal recognition of the value of mentoring or any incentives that are being pursued to try to make that more of an explicit encouragement?

[applause]

Chaudron:     I think that’s a really good question. There’s been some great recent articles about the tax on people from under-represented groups in academia, in terms of what you just said – there’s many people who come to them.   I think that’s true for many of our staff members as well – they often end up with many of our students coming to them because that’s who they see.

From a perspective of does mentorship count, do you get time for it, yes, it does, but I think one of our challenges is to capture the amount that’s happening.  One of the things we’ve done recently at the Medical School is to adapt our promotion criteria so that mentorship and teaching are things that are very explicitly in there and are things that can be identified by the faculty member as something they want as part of their criteria.  Does it get exactly to what you’re saying?  No, but it’s a piece of it, so hopefully that helps answer that a bit. I don’t know, Vivian, if you want to say anything?

Lewis:             Sure.  Mentoring is a big interest of mine and a – something we need to think about, not just in the School of Medicine but across the entire university. I have data from both quantitative and qualitative sources that say that faculty – all faculty in general feel like they don’t get enough mentoring, and those who are doing the mentoring feel like they don’t get credit for it.   I’ve started some conversations with the Faculty Senate about how can we incorporate recognition of that, those sorts of duties into our promotion criteria at the more senior levels. That is university wide, not just at the Medical Center, where I think they’re ahead of the curve and recognize this takes time and effort and should be recognized.

Chaudron:     We also have mentorship awards and a faculty diversity award that was recently established so there is recognition of that as something that is a huge contribution to our community and our students.

Charity:          Hi, my name is Charity and I’m a third-year Med-Peds resident and this question is for some of the medical students.  At the last town hall meeting, there was a medical student that was talking about some of the minority students are getting lower scores during their clerkships compared to their white counterparts and even though they’re equally qualified.  I want to hear from you – are you all seeing the grading is unfair?  Are there numbers to show this is happening on an objective level? Are you seeing students who are equally qualified get lower scores?   No one’s noticed anything?

Chaudron:     Dr. Lambert is here. 

Alan:               Hi, my name is Alan (Aguilar) and I’m a fourth-year medical student here at the U of R, originally from deep South Louisiana, so racism and diversity and bias is something that is not new to me; granted, it was a big surprise coming up here.  I did not expect to experience the level of bias and racism that I did when I came here, starting out, I would say, within the first month of being here – having to really vie for respect of my peers, vie for the respect and recognition of faculty members, and as you mentioned, as you go up in your training, when you get on to the floors in your third year, you’re still vying for the same respect and recognition.  Because the grading system is so subjective, it’s really – it almost seems it’s who you can get along with the most, who’s the nicest person to you, who you have the most in common with. 

Not many residents or faculty members may feel they have that much in common with me or they may feel that they wouldn’t even want to try to figure that out. At least that’s far too many times been my experience.  Granted, I don’t have the data on that, that’s not something that would be released to me, but from talking to my classmates that does seem to be the trend.  You work just as hard or twice as hard or be just as competent or more competent, but so often you know you’re going to get a pass.  And unfortunately, sometimes you’ll just be happy for that pass.

I feel like that doesn’t stop there – I feel that goes along with teaching.  The amount of teaching that you’ll get from faculty and residents is different. I notice a clear difference in the amount of teaching and education I get on the floors when I’m by myself and when a peer, another medical student that is white, is with me.  Then it’s time to teach, it’s time to learn, it’s time to do all these activities and calculate all these formulas, but not so much when I’m by myself.

As much as I would like to convince myself it has nothing to do with race and culture and diversity, I think when it slaps you across your face enough times, you can’t help but pay attention to it.

[applause]

Burgett:          We’ll hear from Dr. Lambert and then I’ll comment.

Lambert:         I’ll address the grade issue that came up.  We don’t have grade distribution by demographic characteristics – we look at some things like sites where people go, we look at gender sometimes and things like that.  There are, as Alan adeptly vocalized, great issues of subjectivity in clerkship evaluations.  If you knew the question right three times, people think you’re brilliant; if you didn’t know it once, they think you’re the stupidest to walk on the face of the planet.  That’s a challenge faced by a lot of medical schools and one of our goals is to help even the education of people who assess and evaluate students.

I’ve heard similar – in discussions I’ve had, I’ve heard similar types of experiences from non-black minority students as well.  That’s something that clearly concerns us and we have to figure out how we can best address that. I can say if you look at students who get certain accolades, such as AOA, there are minority students within that population.  But if there are other factors involved, we need to try and figure out and address them.  I probably don’t give you an answer, but that’s where we’re at with that.

Burgett:          Yes?

Female:          I would like to echo his statement too. I’m a third year Med-Peds resident, and you’re right, it’s very subjective the way those things are filled out, even within the same – because we kind of see the same med students, third and fourth year specifically, throughout the year.  And residents talk and there are comparisons between residents and there have been times I’ve thought a medical student was doing a really good job and then from a completely different person – and in theory, I’ve seen this person on the floor and they didn’t get dumb over the past two weeks, but suddenly they don’t care, they’re not working as hard, you tell them they’re allowed to go home but then you write in – and they go home, but then you write in their evaluation ‘didn’t show interest in my specialty’, as if it was a trick.  As if saying ‘go home’ was an ‘aha, I’m going to catch you in something.

I personally have seen that. I’ve talked about that with at least one medical student who had that happen, and to echo what Amber was saying previously, there’s a definite lack of mentorship.  Being Med-Peds, I straddle three residencies, really, and within those three residencies there is a distinct lack of diversity amongst all residents.  Charity and I are the only black people, not even females, within the entire Med-Peds residency. I don’t know one black faculty within Med-Peds residency, and then on the medicine side, it’s just as few.  On the Peds side, I think it’s fewer.  On the family medicine side, I can’t speak directly to that, but I think it’s just Amber too.

[applause]

Burgett:          Please.

Catherine Thomas:  Good evening.  Thank you for the opportunity to share. This is my day off so excuse my – but I was determined to make it; the weather’s very bad out, but I wanted to echo what this young man had said. I’ve had the opportunity to share under Dr. (Kodjo) – she teaches a class on cultural diversity – and last year I had two students of color in the group of 12.  It broke my heart to hear their stories and their experiences being students of color and how they would be treated by physicians and by the patients.  What really stood out for me is that, as myself being a patient here, I’ve been told a number of times this is a teaching university, this is a teaching hospital, virtually saying ‘There’s no choice in having a student come in.’

So when I hear the stories of these young African-American men and women, I think about ‘What’s the message that these physicians are being told? Not to give them the same opportunities to learn as others?’  That’s something I wanted to share and I think that has to come out.  It has to be a whole cultural shift in this whole teaching dynamic because it’s not just the other teaching – they’re here to learn as well.

[applause]

Chante Calais-Morgan:      I’m Chante Calais-Morgan. I’m a fourth year medical student.  Actually, I just have a question regarding teaching in terms of the faculty who will be over different rotations, as far as diversity – what’s the extent that they get?  I’ve had times whenever, often times in a clerkship, we’ll get evaluated by the clerkship director or by different physicians that we’ve worked with, and I’ve had instances where one of the physicians has said to me directly – not just evaluating what the different people have said about me, but I guess from her own perspective deciding that she should tell me ‘I know being that you’re a black student, I know that you’ve probably experienced racism’ – and I feel like that is not part of the evaluation process.  I feel like I was singled out in a sense because I am a black student – I should, you know, perform in a different way or the fact that other people are looking at me in that sense.  I think that’s a problem when we’re being evaluated and the first thing the evaluator is saying is because you’re a student of color, people will look at you in a different light…

When a faculty member sees me in that light and feels she has to express this to me, I feel like it represents her view of other minority students and how they’re viewed.  I just wonder about the training these faculty members have prior to being involved in teaching and these different types of rotations.

[applause]

Burgett:          We’ve had a question asked; perhaps David or - ?

Colleen Fogarty:      Is it Chante?  Did I get your name right?  Thank you.  I appreciate that you brought that up and I think that is a real dilemma because as a white woman faculty, I want to be sure that I’m acknowledging people’s experiences that might be hard and I would never want to put you in the position of assuming that if I said that, I assumed something.  For me, it’s really helpful to hear this because at times, I feel like I’m in a no-win situation.

Before you spoke, what I was going to suggest is that I think I completely appreciate – I don’t appreciate; I’m sad about your experiences, I appreciate that you shared them.  I think that some of the bias that is around is probably intentional and explicit and there’s a whole lot that’s implicit.  I kind of feel, to Pat’s point, 40 years down the road, we really have to start dealing with implicit bias, and I don’t know the right answer. I don’t know an evidence-based way to do it, but it seems to me that small mixed group, six to 12 people, taking the IAT together and talking about what that feels like and sharing real stories might be helpful.  I don’t ever want to be that faculty that makes you feel so bad.

On the other hand, being able to acknowledge, have you had this stuff happen, can we talk about that, and can I be supportive with that?  So how do I be, as a faculty who’s a white woman – it’s a question I ask myself most of the time.

[applause]

Female:          I think by the very fact that you’re asking yourself that question at all is a step in the right direction.  I think not a lot of people, not even in a malicious way, don’t think to ask themselves that question because they can’t understand the experience somebody else could possibly have. Even just being aware that things are different on another side is really important and maybe that’s part of the training that needs to happen – to recognize.  I know we have that third mandatory session that the staff had to do where there was some diversity training, I think – socio-economics of our patients but not necessarily inter-professionally, but that was towards the patients because, again, super diverse amongst the patient population we see.

[background conversation]

[student speaking in background – away from mic]

Charity:          Okay, I was looking up different papers and I found a guy named John Dovidio from Yale; he studies implicit bias.  He has all these different lectures and he’s been doing this for years.  One thing he’s found is that implicit bias has changed over the years.  A lot of people are no longer explicitly biased because it’s socially not okay to just be outwardly racist, but implicit bias hasn’t changed.  They studied this 10 to 20 years ago, and implicit bias is the same as it was 20 years ago because people don’t know it exists.

I think your question is really good – we should – we’re in an era now where we’re moving past explicit bias; no one, most people aren’t outwardly racist but people need to first know that there is implicit bias in almost 80 percent of white people.  No one wants to be racist – no one wants to be biased and no one wants to treat you that way, but if they knew better, his evidence – and he studied this in the military, where people, when they realized they had implicit bias, they actually, the way they promoted minorities changed.  He said he approached some of the people in the military and said your African-American counterparts or your minority counterparts, your female counterparts are as equally qualified as the whites, so I should see no difference in the proportion of promotions because of this.

After he approached them, the way people were promoted was much different than it had been years ago.  His evidence showed that actually just telling, just exposing what implicit bias is and training people, actually does make a difference.  Maybe if we can find a way to teach or – I was even - if the guy can come from (grand rounds) and explain his research, because it’s really, really good stuff that may make a difference in our institution.

[applause]

Burgett:          Dr. Lambert, did you get that name?

Lambert:         I was going to share, and I am right now, based on a student initiative and work by Dr. Naumburg, we actually have planned for the second year a small group series of sessions during lunch time that will be required of students to go over issues of implicit bias – just to understand it and then other situations, other anonymous ‘How would you respond?’ situations not only if you are experiencing it but if you see it, what can you do.

People need tools, just like you need a tool when a patient says to you ‘What would you do if you had this disease?’ you have a tool – you have things that you pull from; you need ways to understand how to respond in the setting that’s appropriate and that conveys your thoughts.

Chaudron:     I just want to say at the Medical Center we’ve been thinking about this for a while in terms of looking at a variety of research as well as educational opportunities out there.  There’s a lot right now around implicit bias education and what’s the best mechanisms to do that; it’s one thing to take the IAT – which, for those of you who don’t know, is the Implicit Association Test, which is – Google it, do one and you’ll be amazed what your biases are.  I know I am every time I take it.

There’s a lot of different opportunities for being educated, but you need time to process it as well because it’s a challenge sometimes to reflect on yourself, right? It’s easier to teach about our patients rather than ourselves in the inter-professional component but we are looking at that and determining what we should do across the board, so appreciate that. It was one of the recommendations from the medical students that I think was number one, actually.  It was on our radar and it has moved up the radar.

Ria:                 Hi, my name’s Ria and I’m a second year medical student. I’m really happy this conversation is happening. I have a general question, whoever can field it. I think that in order to – acknowledging implicit bias is so important, but in doing that, I think we need to use vocabulary that a lot of people are uncomfortable with. We need to acknowledge that racism and sexism are very much institutionalized, and have been.  My question is, what specifically are we waiting for? At what point will be okay with saying it and mainstreaming it?

Female:          I think you just did. I’m not sure – can you articulate a little bit more what you’d like to hear?

Ria:                 Right. I was wondering at what point will this conversation be happening at a lecture hall where everyone is present and not just people who are interested in it.

Female:          Got it.  Thank you.

[applause]

Seligman:      I will tell you the answer will be soon.  The world is changing; I know when I showed up 10 years ago we didn’t have a special opportunities fund, we didn’t have an office of diversity and development, there wasn’t a commitment to hiring more, to focusing on other mechanisms to help, there wasn’t the connections with the city that we were able to establish, and those were initial things we focused on.

What you’re describing and so many others are describing are real issues and they’re harder.  They’re harder because you go to people’s hearts and minds.  Whether you think of it in terms of implicit bias, micro-aggressions, whether you think of it in terms of the frustration so many of us have with the legal system orchestrated by a legal system that basically says we can’t talk about Affirmative Action, we can’t talk about a whole lot of things.  We’re limited to a very crimped vocabulary focusing on diversity as a plus factor.

The reality is I can’t overstate how many of us want to hear and listen and continuously improve.  What you’re describing is an echo for me of a conversation I had 25 years ago when I was a law professor at the University of Michigan.  I used to eat lunch with a wonderful man named Wade McCree.  He was an African-American who’d been solicitor general of the United States, the highest position for a litigating lawyer in the country, a judge in the 6th Circuit, and an unbelievably wonderful guy.

By sheer coincidence we used to sit down for bag lunches at the round table at the Michigan law school day after day, and he told me stories. He told me what it was like to grow up near Detroit, what it was like to run for office and the only way he could win was by exploiting the fact that his name sounded Irish, so he got elected a judge on the theme ‘when Irish eyes are smiling’.  He is someone who is the fairest, most decent person I ever knew, and he is someone tons of students would come and speak to.

More than anything else, what he talked to me about was in his life time, the life expectancy of African-Americans in this country was significantly less than whites, although often they had the same health systems available to them.  He talked about hypertension, always looking over your shoulder – he talked about a world which I hope is dissipating, but has not fully dissipated.  That was explicit bias – that was tough stuff.

But there were always reminders.  In effect, if you want to build the universities or the cities or the world, we have to be honest about these kinds of issues, be willing to address them and start with what a famous management consultant described as ‘talking about the big, hairy truths’ – not hiding from them, not pretending they’re not there.

There are a lot of good people in this room who’ve spoken in the Medical Center, in the medical school, and they’re trying, but we’re all learning.  When you say ‘When will this be part of the mandatory curriculum?’, I think you heard Professor Lambert that it’s coming.  In reality, there are other things that will be coming as well.  You can help us so much just by being candid, whether in words or if you don’t want to speak, write to us.  I’m not going to make any false promises to you – we’re not going to solve everything instantly; that’s not the way the world works, but we’re determined to move forward and to keep looking forward.

Anne Nofziger:         Thank you for that question.  Since I don’t see hands up, I had said I was going to try not to talk this time, but I’m going to talk anyway. I think when the current medical curriculum was created, one of the ideas was that by having a diversity theme and a committee of people who would be responsible for looking at every element of every part of the curriculum for where we should be teaching about diversity and where we should be including more diverse patients as examples to learn from, etcetera, etcetera.  The idea was that was going to be a way.

We could talk for a long time about how that works – that’s some really good people who really tried to help us with that.  One of the things I was thinking about after the last town hall meeting and I’m thinking about it again, is that really well intentioned people sometimes feel very concerned that they’re not going to do it justice and they’re not going to do it well.  My good friend Dr. (Fogerty) down there was partly talking about the same thing; that’s really not an excuse not to do it, but it is a thing that sometimes prevents us from just diving in and saying ‘Okay, guys, how much of the problem that this patient faces is related to her race?  How much is related to her education?’

Because we’re afraid we’re not going to be able to do a good job with your questions, but I guess my suggestion would be I think we would be – I would encourage you to ask the questions in a bold way anyhow, and be kind to us when we try and when we flounder a little bit.  I think in these conversations that are really difficult and sensitive, we all have to be generous to each other because I do think it’s true that most people are trying to do it well and do a good job, and there’s so many reasons that we don’t necessarily nail it.

The other thing, I’ve been reading a lot about this too – as many of us have – and have kind of encountered this concept of ‘stereotype threat’, which is when you know that you might be perceived through a lens of stereotype, it impacts your performance, it makes it harder to do a good job. I just want – I feel like as a teacher, that’s a real challenge but I think we have to be area of that and thinking about that as we try to do this better.

Kendrick:       Hi, I’m Kendrick; I’m a fourth year medical student at the University of Rochester.  I appreciate everything that’s been going on, all these efforts to bring these issues to the table.  Sort of just to piggyback, I have a question; I know that it seems there’s been just a – some way to make sure things are done correctly, but I have somewhat of a fear that in order to do it correctly, it’s going to make the majority uncomfortable. Is the university willing to make the majority uncomfortable to address the needs of the minority?

[applause]

Burgett:          I often like to say my most impressive growth over a lifetime has been in response to discomfort.

Feldman:       Just very briefly, I can speak more about the undergraduate experience and what goes on in the college, but yes is the answer to your question.  I think an essential part of an undergraduate education includes being made uncomfortable sometimes.

Burgett:          Amen.

Feldman:       That’s where growth comes, that’s where challenges happen, and so yes, I think what we need to accomplish there – and I suspect this is true throughout the university, finding ways to enable those kinds of conversations and uncomfortable conversations to occur, but do it in a respectful and open way.  But yes, I think we are and I think we have to be willing to make people face hard issues and not – I think too often people can feel comfortable and think ‘Everything’s okay’ and they have to face the facts.

Colleen:         Hi, I’m Colleen Schneider; I’m a third year MD/PhD student and I just wanted to speak to your question about what’s stopping us. I’ve been thinking about this recently too and I think we can’t have a conversation about racism without including the concept of shame because oftentimes people get called ‘racist’ – I don’t think it’s about being racist but having racist ideas or ideologies or stereotypes; it’s not about the person themselves.  So I think we need to move from labeling people as racist to labeling those ideas as racist.

I just wanted to share a quote I think speaks especially well to this from Brené Brown – she’s a shame and vulnerability researcher.  She says ‘Shame corrodes the very part of us that believes we are capable of change’.  I think that we have to move away from shame and make sure we’re acknowledging when we do feel shame and bring that into the light in order to continue that conversation and go into the more uncomfortable realms of making a difference.  If we just feel shame, we’re not going to want to do anything and we’ll become defensive.

[applause]

Burgett:          Yes?

Michelle:        Hi, my name is Michelle.  I’m a second year medical student.

Burgett:          Stand up so we can see you.

Michelle:        Okay.  There are a couple of things said today that resonate with me and made me think. I think it was Alan – I hope I got your name right – who said perhaps some people don’t take the time to learn about someone who might seem different from them and I – it got me thinking what are we doing for our students to get to learn about our peers in a different way.  If we’re cultivating future doctors and future faculty members, how do we not inadvertently perpetuate the things medical students are experiencing now by breeding doctors and future faculty members who are more culturally competent and sensitive?  There are a lot of things in our curriculum that are put in place to create that, like bio-psycho-social learning objectives and PBL, the AD lunches that I think will be fruitful discussion, like standardized patients.

Although in those places, sometimes when someone suggests a learning objective in PBL that’s about race or about something that’s not going to be on the test, the rest of the group says ‘No, we should probably not do that, right?’  Or, I don’t know with standardized patients that my group has had a conversation about race necessarily. Similarly with extracurricular activities, there should be opportunities to go out into the community and learn about people who are different from us, things like URWell and street medicine. Again, in those environments I don’t hear a lot of conversations about race necessarily in those settings and what can we be doing to create that more.

I see that a lot is being done; I’m just wondering if it’s enough so that we are creating students who are – I’m not quite sure what the word is – culturally competent, culturally sensitive.   Not necessarily minority students who are experiencing that and get it, but for those who don’t.  Thank you.

[applause]

Female:          I just want to empower all the medical students here to know you have the power to make it part of the curriculum as a part of the medical education pathway. That was what I talked about.  I talked about diversity. I know you all – they probably remember because that’s when I was here, but you have the power to do it and incorporate it.  Even though I was there in PBL nobody wanted to do the person from – like different places.  No one wants to do those types of things but I feel like, as a medical student and also as a resident, it’s our job to teach people how to approach different circumstances.  And I would also like to add – and I just thought about this because as a medical student, I remember sitting in here thinking about this – in regards to when we do have courses – I forget the name of the courses, but in the second year when you learn the name of the pathology, it would be nice to have a variation of different things.

So if we’re learning about psoriasis in a Caucasian person, then if we learn what it looks like in a minority patient because a lot of the times, I’ve just learned it in residency because I was exposed to that.  I know that would be a difficult set of things to find, but I think in regards to – in regards to making a physician who is open to different things, I feel you have to expose it not only in the cultural lecture; it should be infused into every lecture so we’re learning how to think differently in every way through medicine.

[applause]

Valerie:          Hi, everyone. My name is Valerie. I’m a second year SMD students from the biostatistics department.  We have a lot of people from different countries in our department and some people might not even be aware of the race problem in the United States.  For example, I’m coming from Ukraine and we have mostly white people.  To find people of color, go wonder.  I think bringing the awareness of the problem for not just residents and citizens of the United States but also for international students may be a good point because some people might not even think there is a problem or there is an issue.  Thank you.

[applause]

Burgett:          Yes?

Aguilar:          Yeah, Alan Aguilar again, fourth year medical student.  A second ago we talked about – as Kendrick put, being uncomfortable. I feel like we as minorities, we already feel uncomfortable.  We’re comfortable uncomfortable.  {chuckles}

[laughter]

But more so, what are the consequences going to be?  Are we saying that we’re – are we that open to being uncomfortable that there will be consequences to these situations?  Like for instance, when bias is taught, when I sit in lecture halls and the lecturer, the person who is leading the lecture, the person who the rest of the medical students in the classroom is supposed to be emulating is making jokes about black females and black hair, and the rest of the class laughs.  And then she says ‘Now that I’ve entertained you, I’ll go on with what I was supposed to do.’  Or, saying that black patients won’t understand the word ‘diabetes’; they’ll say ‘sugar’ so you should know that.  Or showing slides making fun of Barack Obama, the only black president that we’ve had by showing slides of him and 40-ounce malt liquor bottles.  At that point, I’m supposed to sit in that class as a black student, African-American male and still be able to learn.  So that’s a detriment to my education that I pay a lot of money for.  Since we’re on the topic of being uncomfortable, what are the consequences going to be?  What I’ve seen when I bring these issues up to people in authority, which I might add when I look around, most of those people don’t look like me, they don’t feel they can relate to me, so when I bring these issues up, what I see is maybe a slap on the wrist at most.

Are there any thoughts as to what the consequences are going to be to some of these actions?

[applause]

Burgett:          It goes to the issue of power.  Perhaps the power relationships are a critical element in all of this.  Dean Taubman?

Taubman:      So I think the short answer is, there has to be consequences.  I think in terms of the whole process, one of the things we need to understand is what should the consequences be, and particularly as an educational institution, obviously the first approach is to try and educate – that’s what we do.  I think that – but any discussion of how we move forward has to include accountability.  I think you’ve really hit the nail on the head, but it’s also a very, very difficult question.  And I think it’s something we need to do a lot of thought about and come up with an answer that is also consistent with what we are as an academic institution – that our first approach is to teach, not to punish.  

Lambert:         I think it would be good for me to address some of your examples, Alan.  In those settings, when the school is made aware, there is an education that goes on with the faculty member. One of the things we don’t do is we don’t go back to a group and say necessarily ‘Hey, this happened.  This is what we did.’  But we close the loop on the individuals who tell us about it. In those instances where we’ve gone back to a group and said ‘Hey, this person came in and used a word about disability’ – this is one that happened more recently and someone’s perception about the word ‘disability’ versus not using that word to describe someone’s impairment – ends up sometimes backfiring and we get a bigger backlash.  ‘You’ve used up my education time to tell me something that I already know was crazy that went on and shouldn’t have happened.’

I think it’s really important that people understand the only way, which is why we’re here today, we get better is if we hear about things and we have protection mechanisms so people aren’t hung out to dry.  But that’s the only way we get better, and when the school knows about these things, the school does everything it can to respond.  Are we going to fire a faculty member because they say something like that?  No.  Are there circumstances where the institution would terminate a faculty member because of some things?  Sure.  But again, the only way we can get better is if we hear about these things.

Kinslow:         I just wanted to share with you all, considering the day that it is, that I appreciate the people who spoke up today and their courage for doing so.  As Dr. King said, on some positions, cowardice asks the question, ‘Is it safe?’, expediency asks the question ‘Is it politic?’, and vanity comes along and asks the question, ‘Is it popular?’  But conscience asks the question, ‘Is it right?’  There comes a time when one must take a position that is neither safe nor politic nor popular, but he must do so because conscience tells him that it’s right.

I think that us being here together tonight is a good start to working from the level of conscience and trying to get it right. I know that all of us who are listening to you are going to put forth a lot of effort to getting it right.

[applause]

Female:          I would just like to advocate that whatever the medical school does with the residents that pushes, it takes care of these unhealthy attitudes, these actions, that it be shared with other areas in the Medical Center.  We have other students that are going through the same thing and they’re not paying as much as you guys are paying for your education, but they’re still experiencing the same thing and why should we recreate the wheel? If we find something that works and is usable, then let’s share it.  I think we struggle in our areas with recruiting, retention, hiring faculty – minority faculty – and I’ll just make the plug, please take the word ‘qualified minority’ off the books.  It’s really, really offensive. If I have a four-year degree from this institution or any accredited institution, I’m qualified for any job I apply for.

[applause]

Female:          I just wanted to talk a little bit about what Kendrick and then Alan spoke about and Dean Lambert, about being uncomfortable.  Alan mentioned that we’re comfortable being uncomfortable, and I think to a certain extent, that has become a problem.  You get so comfortable with the fact that you’re the minority, that people have these biases that are not always intentional – and it’s easy for us as students to talk amongst ourselves.  And oftentimes, Alan has mentioned lecturers have said offensive things and it’s hard to engage in the lecture, it’s hard to appreciate the material that is being brought forth, and oftentimes you shut down.  This helps us know that people are willing to listen to our concerns because oftentimes, you think that no one is listening to you after you’ve expressed your concerns a few times and then you tend to shut down and close up and then talk to other minority students experiencing the same things.  You do become comfortable being uncomfortable, and that creates its own problem, I think.

Having these types of forums where we can discuss that, in a sense, we’re all uncomfortable with the race issue, I think that’s a big reason why these forums are often – not many people attend or it’s people’s choice to attend. We don’t have big instances where people come and talk about these issues because everyone is uncomfortable talking about race – it’s like the elephant in the room.  Everyone knows it’s there but it’s hard to talk about.  I think having these instances where people can open up and share their experiences and, as a black student, these conversations are nothing new to the minority students – we’re all often talking about these issues, trying to figure out solutions, and a lot of times we don’t feel like we have allies is the problem so trying to figure out a way where we can have something like this and people can feel comfortable talking about the issues and trying to have them addressed.

Oftentimes we’ll think ‘Okay, that’s just how it is’ and you don’t necessarily go to the administration with these issues because it’s such a common – I’m also from the deep South so this is nothing new for me either. Over your lifetime when things happen so frequently you get so used to it.  I think we need to stop being comfortable being uncomfortable.  That’s an issue.  All of us are uncomfortable in this room, I think, when we talk about race and we talk about the issues, and some of us can’t believe some of the things that are happening even now, in 2016.

On the floors, we experience a lot of different issues – being mistaken for the person taking out the garbage when you’re in scrubs, or you have to be the diet tech with the white coat – you can’t be a medical student.  It’s that kind of issue we’re facing every day and just bringing light to this is very important.  I’m grateful we have the opportunity and also I want to say lastly, we can’t do it alone as a minority race; it has to be something that impacts all of you.  I appreciate every race and culture being here and represented tonight because it has to be an issue everyone thinks is important enough to make a change.  Thank you all.

[applause]

Female:          The only reason why I want to comment is that my heart – I got nauseous when you talked about what goes on in class because one thing me and Amber talked about is that how that affects you on the floors.  If there are situations where you’re not learning, I can’t be in med school again but if there are situations where you’re not learning what you’re supposed to learn – and in my head, I assume that you’ve learned what you’re supposed to learn before you get to the floors and I assume other people are too, it’s really difficult to hear that you can’t even engage in your medical school classes and then be expected to perform at the level of a third or fourth year medical student on the floor. I think we can all agree that that’s probably one of the more disgusting things we’ve heard this evening, and I think Chante is completely right; it is amazing how everybody in this room came together for this discussion.  I’ve had palpitations all evening and that’s fine; we’re supposed to feel these feelings and rise above them because this conversation is very important.

[applause]

Taubman:                  I would like to comment on your statement that it really – we shouldn’t be an island.  It really has to – every part of the medical center has to embrace it.  I think you’re absolutely right.  I think one of the reasons, in fact, we essentially created Linda’s position is the feeling that we – if we’re going to tackle this problem seriously, we have to tackle it in all parts of the medical center, whether it’s the medical students, the residents, the faculty, the staff – it’s everything. In fact, one of the things we are creating, Linda’s creating, is a permanent advisory body which will include members of every constituency to do exactly what you say, which is if we’ve got something right, let’s make sure we get it spread throughout the medical center.  If we’ve got a problem, let’s make sure we can address it in the medical center.

But I also feel, in terms of enhancing diversity, it’s a continuum.  Our best shot at increasing the diversity of the faculty is increasing the diversity of our residency program.  And it’s the fastest one because it’s got the shortest turnover, and we know that a substantial part of our residents wind up as faculty.  If we’re going to tackle this, you’re absolutely right; it’s by doing this as a system, not putting the pressure or the onus on any one part.

[period of silence]

Female:          People look energized but a little bit tired. 

Seligman:      I want to thank all of you who’ve spoken today.  I think you’ve heard a number of comments that we’re going to take into account, take seriously.  I thought what Tony said – Tony Kinslow, our vice president for human relations – about conscience is absolutely the right thing. We have to do the right thing; we shouldn’t be running a university if we’re not determined to do it.  I thought what Mark Taubman just said about this being a systemic is correct, but in one small sense he is understated because it’s the whole university, not just the medical center.  The reason I asked Paul and Rich and the other people on the Commission on Race and Diversity to work as hard and to listen as hard as they’re doing now is we’re determined to make some progress.

We’re never going to be able to erase every evil thought, every evil human being, but we can do everything we can to encourage the best behavior, to hold people accountable when they work in our system, to focus on steps we can take forward and that’s what this is really about.  When I described race relations as a challenge for this country since it was formed, if not earlier, I understated it.  The way Gunnar Myrdal put it, ‘It’s the American tragedy.’

Our challenge right now, look at this room.  Look at the diversity, look at the races represented here; this is the future.  We’re not going to live in a lily white world, an all-male world.  That’s long ago.  We’re in transition. We’re moving in the right direction.  Put all the political vicissitudes you want aside; the reality is people of good heart and commitment and determination like those in this room are going to be part of the solution.  Thank you for coming out.  I look forward to progress the Medical Center will make on its own, I look forward to the recommendations of the Commission and will tell you that it will receive very sympathetic response from me and from the board of the University of Rochester. 

[applause]

Burgett:          I will just say, on behalf of Rich – my co-chair – Feldman, we want to piggyback on what the president just said and thank all of you.  While this session is at an end, we urge you, as you have additional thoughts, not to hesitate to check out our website.  Rich and I receive emails at racecommission@rochester.edu, which we always respond to.  We are happy to hear from you after this session is over.  This session is taped, as you know, and the transcript of the tape will be uploaded to the website. It takes a little while for that to happen, but again, on behalf of Rich and myself, we want to thank you for taking time out of a very, very busy schedule to join us this evening.

[applause]

           

[END OF RECORDING]