How a Med School Partnered to Build Health Equity Education

January 06, 2022 - Medical schools across the country are playing a long game, increasingly investing in recruiting students of color with the intent of creating a medical workforce that better reflects the nation’s diversity and, ultimately, promoting principles of health equity.

But Morehouse School of Medicine, an HBCU medical school established in 1975, has been doing that work since its founding, according to Erica Hart Sutton, MD, the associate dean for Academic Programs and Affiliations at the school. Health equity is at the heart of Morehouse’s medical education curriculum and serves as one of the school’s main draws for aspiring medical professionals.

“Every day, every member of this team is really pushing the message furthering the work advancing, what is known and done in the space of health equity,” Hart Sutton told PatientEngagementHIT in an interview. “Over the last year and a half, when the social justice movement has really started to garner national attention, we felt poised, we felt ready, and we felt appreciative that there were more ears and more voices behind this idea and behind this work.”

Morehouse has used that momentum to partner with leading health system CommonSpirit Health to form the More in Common Alliance, a collaboration set to expand medical school rotations and residency slots in traditionally underserved neighborhoods and communities. The partnership will also give medical students in Seattle, Tennessee, Kentucky, and Southern California access to Morehouse’s extensive health equity curriculum.

Ultimately, the More in Common Alliance should help build out a medical workforce that better reflects the nation’s diversity, which according to Hart Sutton will improve the quality of care delivered to traditionally underserved populations, like Black and Brown populations.

“Diverse providers provide high quality care for diverse patients,” Hart Sutton explained. “They provide high quality parent care for all patients, but really improving the breadth, the heterogeneity, the contributions of scientists, healthcare providers, all of those things make for a stronger healthcare system. They make for a stronger scientific workforce in which differing opinions, viewpoints, and solutions to problems are valued included.”

Numerous studies have corroborated that. In November 2020, researchers wrote in JAMA Network Open that patient experience improved when patients visited doctors who were the same race as them.

Just about 86 percent of physicians in a concordant patient-provider racial dyad received top marks in the “likelihood to recommend” satisfaction domain, researchers found, compared to only 82 percent of physicians in a discordant patient-provider racial dyad. Racial concordance proved more important to patients of color, the study added.

About a year later, researchers from Drexel University’s Dornsife School of Public Health found that Latina moms who take their kids to a pediatrician of the same race are more likely to report receiving family-centered care. Family-centered care is important for supporting shared decision-making, family caregiver education, and clinical outcomes.

But to make that racial concordance more prevalent, most experts agree the medical industry needs to build a more diverse workforce, something the More in Common Alliance has its sights set on.

The partnership will put medical students and medical residents right in the communities who need them most.

“Creating this diverse workforce happens in communities and counties everywhere in the country,” Hart Sutton said. “One of the major goals behind the More in Common Alliance is to take that work that we do in health equity, and to distribute it broadly across the United States, in those hospitals held by our partner CommonSpirit Health.”

The medical school and health system have already taken the first steps to establishing those training opportunities, sending in four medical students and one physician assistant student participate in clinical rotation at one of CommonSpirit’s Tennessee facilities.

“One of the things that we did right away to prove to ourselves, the country, the world that we would execute on this broad mission, is to start establishing medical student rotation sites at CommonSpirit’s hospitals,” Hart Sutton stated.

Moving into this year, the partnership will grow and create opportunities for medical students in Seattle, Washington, and Lexington, Kentucky.

And on the residency side, Hart Sutton said the More in Common Alliance has aimed high.

“The overall goal is to have 10 new residency programs,” she reported. “We're focusing our efforts on programs related to family medicine, to surgical specialties, really to general surgery as well.”

Program leaders also want to build out programs in hospital-based provider services, like inpatient internal medicine or emergency medicine and other specialties that don’t have a large ambulatory component.

This plan should play long-term dividends, Hart Sutton predicted.

“We're looking to start those in areas where there are large numbers of underserved patients or underserved community,” she explained. “We know that having a residency program at a hospital tends to greatly attract those trainees into staying in that area, so that is our strategy around the residency program part.”

But the efforts to build a diversified medical workforce will move beyond training and clinical opportunities; the More in Common Alliance has a plan to ensure health equity curricula supplement practical experience. Through the partnership, medical students in Seattle, Tennessee, Kentucky ,and Southern California will begin accessing Morehouse School of Medicine’s health equity curriculum as part of their studies. 

That health equity curriculum is one of Morehouse’s crowning jewels, Hart Sutton said, noting that it’s a significant draw for many of its learners.

“That curricula is built by several faculty members, through the department of community health and preventative medicine, where they primarily hold their appointment,” she noted. “It's really built on principles of health equity and public health.”

This program is the culmination of decades of hard work from Morehouse School of Medicine, Hart Sutton said, which since its inception has been at the forefronts of building medical education rooted in health equity. The past year and a half and its focus on social justice and particularly social justice in healthcare has felt like the moment the Morehouse had been primed for.

It’s also one that can’t be squandered.

“The trap to avoid is to let it trail off,” Hart Sutton advised. “The trap to avoid is to turn our attention to a new shiny object, when there is still so much to be accomplished in the space of justice, equity, diversity, and inclusion.”

“And what do we really need to keep going?” she posited. “We need to build sustainable processes into all of the processes that we've started. If you're engaged in an effort, if you're interested in starting an effort, or you're partnering with someone in an effort, think sustainability, and ask how we can make this a part of what we continue to do every day, and not just what we're doing right now.”