Introspection to Improve Pipelines and Graduate Programs at University of Utah Health

Although attrition represents a methodological challenge for evaluating our program,1 we agree that student factors are but a small part of the challenge, and will heed the call for introspection. Attrition of students from the program reflects many of the structural and institutional barriers to which Drs Amaechi, Foster, Robles, and Campbell refer in their letter.2 We recognize and affirm that our underrepresented in medicine (URM) students are not deficient in any way and are an essential asset to our institution.³ Opportunities to address institutional deficiencies in serving URM students are abundant, and we will focus this letter on what we can do to address them at the University of Utah.

Health Sciences Learning, Engagement, Achievement, and Progress (HS-LEAP) programming has for many years taught students how systemic racism, White/male privilege, and sexism are detrimental to education and society. HS-LEAP leaders, in addition to preparing students, use their influence to move admissions processes in HS-LEAP and in our graduate programs towards equity. Today, our PhD and physician assistant programs4 no longer use the Graduate Record Examination (GRE), making their admissions processes more equitable. Holistic admissions principles are being used in our MD program. However, like most health sciences centers, our institution has a long way to go to approach equity in admissions and retention. As we succeed in recruiting URM students, our institutional culture must intentionally evolve to welcome these students, value their journeys, and incorporate their individual assets into the tapestry of our health sciences educational programs. Centering the URM student experience requires provision of places in the physical landscape and the curriculum where they can feel seen. Explicit discussions on how systemic racism and privilege systems affect the learning and delivery of educational material will need to be incorporated into multiple programs. The culture change in academic health sciences is in its infancy, but we will nurture it to maturity. We are optimistic that these changes will address some of the institutional causes of attrition from HS-LEAP.

We unite with like-minded scholars across the country in the call for sustained antiracism and antisexism efforts to become pervasive in our institutions. Equity, diversity, and inclusion offices throughout the University of Utah coordinate efforts to center equity for our learners and become a place where all can experience equality of outcomes, regardless of individual circumstances. We will also advocate for making the changes to the institution of academic medicine enumerated in your letter. While it is a long journey, we are prepared for it and will invite your collaboration as we work to undo centuries of systemic racism.