Working for Systemic Change in Medicine

Like so many millions throughout the world, I was appalled and sickened by the killing of George Floyd. It was a vile act that made the scourge of racism in this country evident to all people of conscience. In its aftermath, thousands have raised their voices to demand accountability and change in the many institutions of this nation that intentionally or unintentionally perpetuate racism and societal injustice.

Harvard Medical School has not been immune to these calls and is acting to effect changes that will set us on a course to challenge and eradicate racism in our community and our profession. We hope that our changes will aggregate with those of others to bring real healing to our nation.

In June, Dean for Medical Education Edward Hundert, MD ’84, commissioned the Program in Medical Education’s Task Force to Address Racism and named Andrea Reid, MD ’88, associate dean for student and multicultural affairs for PME and director of the Office of Recruitment and Multicultural Affairs, and Fidencio Saldaña, MD ’01, dean for students, as co-chairs. Charged with making an in-depth internal analysis of all aspects of PME, the group has formed subcommittees now working to identify where racism lives in the PME experience, incorporate anti-racism education into the curriculum, develop concrete action plans to combat racism in PME, and, most importantly, develop a monitoring and reporting structure to address racist actions in real time going forward. We expect draft recommendations in February 2021.

Members of these groups are committed to revealing hard truths and making bold recommendations. It is my hope that their work will complement moves to analyze and develop antiracism recommendations for other parts of our community, including staff development, faculty diversity, and the graduate student experience. Our approach to this review exemplifies how we achieve continuous quality improvement across HMS: Whether in research, education, or clinic, we engage in critical inquiry, investigation, and analysis, followed by definitive action. That’s how science advances, and it’s how medicine and medical education change.

All of us must work for systemic change. Those of us who do not navigate daily life as a person of color must be aware and mindful of the emotional and physiological toll that overt and covert racism takes on our colleagues, trainees, students, and patients. It is essential to learn how to become the best ally possible. We all know that the changes we need to make to express our better angels cannot be defined only in rules, recommendations, or laws. They must be lived.

The work ahead will be challenging. The road to even the smallest milestone is steep and often will require us to extend one another a helping hand. We are beginning this work at HMS—and we know there will be no end. We are members of a profession that has continually bettered itself by looking inward, by striving to see things anew, and by making changes so that we might always fulfill our pledge to not only do no harm but also to improve health and well-being for all.