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Underrepresented in medicine individuals have historically been discouraged to consider surgical subspecialties and instead encouraged toward primary care fields thus representing less than 2% of the workforce in these areas. In the last 15 years, the Rabb-Venable Excellence in Research program has worked with medical students, residents, and fellows in preparing them to become ophthalmologists, medical researchers, academicians, or private practice. While the Rabb-Venable program centers on expanding the number of ophthalmologists, pipeline programs exist to enhance the representation of URM individuals in other medical specialties to decrease health disparities.

This chapter discusses the Rabb-Venable program, funded by the National Institutes of Health and the sponsorship of the National Medical Association (NMA), has combined a research competition at the annual meeting of the NMA. The Rabb-Venable program is geared toward increasing the number of (URM) in the field of ophthalmology and increasing the number of URM participants in academic medicine. The program has a twofold mission of supporting the development of the clinical specialty of ophthalmology and creating physician researchers through leadership, academic excellence, professionalism, service, and mentorship. Exploration of the different types of eye diseases that disproportionally affect minority groups are identified. In addition the medical students who have been part of the program and are eligible to apply have had an 84% rate of matching in ophthalmology.

This case was based on both primary and secondary data. In-depth semidirected interviews were conducted in 2021–2022 after receiving the institutional research board approval. The interviews took an approximate time ranging from 90 to 120 min. They were recorded and transcribed. A thematic analysis was undertaken to identify the most relevant themes for the case. The secondary sources used included various websites, scholarly and trade journals, as well as specific databases, such as Statista.

The case exposes students in multiple disciplines to the challenges created by the COVID-19 crisis at Yale School of Medicine (YSM). It describes its remarkable effects on organizational and community members as they struggled to reimagine more inclusive and supportive spaces. As one of the most severe crises humanity has ever witnessed, COVID-19 exacerbated the existing struggles of the underrepresented communities, creating a double pandemic. It has also amplified inequities among marginalized groups including black, indigenous and people of color; women; immigrants; lesbian, gay, bisexual, transgender, queer/questioning; people with different abilities; working parents; single parents; religious minorities; and people with low income. When COVID-19 hit in 2020, Yale University School of Medicine (YSM), like other pioneering schools in the field of health care, doubled their efforts to face both the public health crisis and the substantial social turmoil (racial tensions after the death of George Floyd, food insecurity, vaccine resistance, social inequalities, etc.). Professor Marietta Vazquez, MD, who was the first Latina to be named Associate Dean for Medical Students Diversity at YSM, launched with Dr Latimore (Chief Diversity Officer) and her other colleagues many strategic initiatives aiming at improving the diversity, equity and inclusion of organizational and community members.

The case is an invitation to graduate students and students in executive education programs to reflect on the grand challenges leaders faced at YSM as well as in other institutions across the nation and the globe. It is also a call to reimagine ways leaders can accelerate the pace of change in their organizational ecosystems.

This case was written for use in graduate-level courses, including executive education dealing with Diversity, Equity, Inclusion and Belonging, Leadership and Change, Health-Care Equity/Policy, Health Sciences, Human Resource Management, Organizational Behavior, Crisis Management, Sustainability, Business and Society, Social Issues in Management, Strategy, etc. Faculty members can easily adapt the case to fit the content of the course they teach, the students’ context as well as the specific learning outcomes to be achieved.

As medical schools become increasingly diverse, there is a growing demand for schools to support their equity-seeking students. At the University of Toronto, the diversity mentorship program (DMP) is a new program created to support equity-seeking and diverse medical students in first- and second-year through didactic lectures, networking opportunities and mentorship from senior clinicians. This article aims to share participant perspectives on how diversity-focused mentorship benefits them, perceived barriers and insights for other institutions developing a similar program.

Using a mixed methods design, students and mentors completed semi-structured surveys to assess broad perceptions of their mentorship experiences. Focus groups were conducted with both groups to gain deeper understandings of participants' experiences. The authors performed thematic analysis to identify qualities of successful experiences and barriers to participation.

Most mentors and mentees found the DMP helpful and identified five themes contributing to a positive mentorship experience: (1) accessibility, (2) program diversity focus with clear expectations, (3) career guidance, (4) exposure to different perspectives and (5) community and shared identity. Uncertainty on how to help less assertive mentees, mentorship pair discordance where mentees paired by race did not share racial identities and logistical challenges was identified as barriers to maintaining mentoring relationships.

To the authors’ knowledge, this is the first qualitative study exploring the feelings and impressions of participants in a mentorship program at a medical school addressing the needs of equity-seeking groups. By understanding the characteristics and value of diversity-focused mentorship, this will inform the creation of similar supportive programs across various professional fields at other schools.

Canada's population is becoming increasingly diverse and the recent recognition of the need for inclusivity and diversity has led to conversations in undergraduate and graduate medical programs across the country. The intended outcomes of these conversations around representation are actions that better prepare medical graduates to meet the needs related to caring for a diverse Canadian population. It is paramount that learners see this progress toward equity, inclusivity, and diversity reflected in the leadership of their medical training programs. Actions toward this goal may be more impactful from a new understanding of leadership. This chapter focuses on a postcolonial reimagining of leadership that expands qualities that are valued, resulting in a natural diversification and increased inclusion among medical leaders. The authors write from their personal viewpoints and provide suggestions on revisioning leadership and curriculum, throughout. It is hoped that a paradigm shift in the way leaders are identified, recognized, and supported will address current challenges in medical culture and subsequent socialization of learners that influence their professional identities and ideas about who and what makes good leaders.

The purpose of this paper is to build insight into how the local community impacts an organization’s ability to develop an inclusive culture. The paper introduces the concept of inclusion disconnects as incongruent experiences of inclusion between an organization and its community. Then, using the case of teaching hospitals, the paper empirically demonstrates how individuals and organizations experience and deal with inclusion disconnects across the boundaries of organization and community.

A multi-method qualitative study was conducted in hospitals located in the same city. Focus groups were conducted with 11 medical trainees from underrepresented backgrounds and semi-structured interviews were conducted with ten leaders involved with diversity efforts at two hospitals. Data analysis followed an iterative approach built from Miles and Huberman (1994).

The findings demonstrate how boundary conflicts arise from disconnected experiences of organizational and community inclusiveness. Such disconnects create challenges for leaders in retaining and supporting minority individuals, and for trainees in feeling like they could build a life within, and outside of, their organizations. Based on findings from the data, the paper offers insights into how organizations can build their capacity to address these challenges by engaging in boundary work across organizational and community domains.

Future research should build upon this work by further examining how inclusion disconnects between communities and organizations impact individuals and organizations.

The paper includes in-depth insight into how organizations can build their capacity to address such a deep-rooted challenge that comes from a less inclusive community.

This paper contributes to an understanding of how forces from the community outside an organization can shape internal efforts toward fostering inclusion and individuals’ experiences of inclusion.

The purpose of this case study is to describe one Southern United States of America (US), historically Black medical school's approach to adapting medical education training through learning communities (LCs) during the COVID-19 pandemic.

The COVID-19 pandemic created a wide variety of problems for higher education. Classes moved quickly from in-person to virtual instruction with little time for training; faculty and students had to adapt to new learning platforms, learning styles, study techniques and technological challenges. Emotions ran high due to constant change, transitions and numerous unknowns. The LC structure embedded in the curriculum of this US medical school aided in the navigation of these challenges.

Of the 95 MD1–MD4 respondents combined who responded to the COVID-19 LC survey, 67% rated the LC sessions good/outstanding, 20% average, 7% poor/fair and 5% N/A. When asked if LCs had helped them during the pandemic, overall, 66% said “yes” and 34% said “no.” When asked how LCs have helped during the pandemic, themes emerged related to safety, adapting to feelings of isolation/mental health/emotional support, and academic progress.

The small LC group structure created a sense of security for receiving academic help, emotional support, a network of assistance resources and a place to process COVID-19 losses and insecurities. Receptivity to utilizing the LC structure for support may relate to the medical students' commitment to addressing health disparities, serving the underserved and embracing a medical school culture that values community.

Cultural competence is a continual process that is ever expanding. Cultural competence is defined as proficient knowledge, skill development, and the application of that knowledge and skills to demonstrate cultural awareness, understanding, sensitivity, and humility. The objective of a health science-related cultural competence seminar is to provide meaningful and in-depth discourse expounding upon cultural attitudes, expressions, and experiences that shape and direct interactions between patient and health providers, allied health professionals, medical and allied health students, and faculty. The current health care infrastructure is “ill-equipped to provide effective health care to underserved populations in the United States” (Roberts et al., 2015, p. 1408). As such, the Post Baccalaureate Seminar was developed to mitigate the gap between what students know upon entering medical studies versus what they need to know to provide culturally competent care, particularly in medically underserved areas. The Post Baccalaureate Seminar is a 15-week course given during the fall semester of the one-year program in preparation for matriculation into medical school. Students have required readings, small group didactics, and group activities which address professionalism, medical ethics and experimentation, informed consent, cross-cultural communication, Lesbian/Gay/Bisexual/Transgender/Questioning (LGBTQ + ) concerns, and other aspects of cultural diversity. The required texts were selected as a pedagogical strategy to introduce the constructs of valuing diversity in a holistic manner. Upon completion of the seminar, premedical students indicate increased knowledge and skills for displaying cultural awareness and a greater level of sensitivity for their medical studies.

The aim of this paper is to present a conceptual model on foreign-born health care workers from developing countries working in the US. The model covers their motivations for migration, the consequences in terms of the inequality and exclusion they may experience and the role of institutional responses at micro-, macro- and meso-level of intervention.

The paper is based on: (1) in-depth review of key literature studies on the foundation theories of international migration including sociology, economics, anthropology, psychology and human resource management, (2) analysis of theoretical approaches to medical migration across disciplines, (3) analysis of the international and national documentary sources of micro-, macro- and meso-level policies on migration and (4) analysis of evidence on best practices, solutions and aspirational changes across different levels of institutions.

(1) Migration of international medical graduates (IMGs) from developing countries to the US can be explained from a micro-, macro- and meso-level of analysis. (2) IMGs who identify as racial/ethnic minorities may experience unfair discrimination differently than their US-born counterparts. (3) Although political/legislative remedies have had some successes, proactive initiatives will be needed alongside enforcement strategies to achieve equity and inclusion. (4) While diversity management initiatives abound in organizations, those designed for the benefit of IMGs from developing countries are rare. (5) Professional identity groups and some nonprofits may challenge structural inequities, but these have not yet achieved economies of scale.

Although it is well-documented in the US health care literature how ethnic/racial minorities are unfairly disadvantaged in work and career, the studies are rarely disaggregated according to sub-groups (e.g. non-White IMGs and US-born MGs). The implication is that Black IMG immigrants have been overlooked by the predominant narratives of native-born, Black experiences. In placing the realities of native-born Blacks on the entire Black population in America, data have ignored and undermined the diverse histories, identities and experiences of this heterogeneous group.

An awareness of the challenges IMGs from developing countries face have implications for managerial decisions regarding recruitment and selection. Besides their medical qualifications, IMGs from developing countries offer employers additional qualities that are critical to success in health care delivery. Considering organizations traditionally favor White immigrants from Northern and Southern Europe, IMGs from developed countries migrate to the US under relatively easier circumstances. It is important to balance the scale in the decision-making process by including an evaluation of migration antecedents in comprehensive selection criteria.

The unfair discrimination faced by IMGs who identify as racial/ethnic minority are multilayered and will affect them in ways that are different compared to their US-born counterparts. In effect, researchers need to make this distinction in research on racial discrimination. Since IMGs are not all uniformly impacted by unfair discrimination, organization-wide audits should be in tune with issues that are of concerns to IMGs who identify as racial/ethnic minorities. Likewise, diversity management strategies should be more inclusive and should not ignore the intersectionality of race/ethnicity, nationality, country of qualification and gender.

Immigrant health care workers from developing countries are integral to the health care industry in the United States. They make up a significant proportion of all workers in the health care industry in the US. Although the literature is replete with studies on immigrant health care workers as a whole, research has rarely focused on immigrant health care workers from developing countries. The paper makes a valuable contribution in drawing attention to this underappreciated group, given their critical role in the ongoing pandemic and the need for the US health industry to retain their services to remain viable in the future.