diversity and inclusion in healthcare essay

Diversity and Inclusion in Healthcare Essay

Ensuring and promoting diversity and equity in healthcare is critical and impactful in today’s world. Following national standards on culturally and linguistically appropriate services (CLAS) includes providing a comfortable environment for employees and patients with different backgrounds. The healthcare office should maintain diversity and inclusion across ethnic, racial, gender, religious, sexual, and other dimensions.

In particular, integrating workers from racial and ethnic minorities is essential in overcoming disparities in the workplace and receiving health care (Goode & Landefeld). To do this, both leadership and the workforce must be skilled in maintaining a respectful and inclusive environment. It is also vital that the administrators and leaders of the healthcare organization understand and provide development and growth opportunities for the staff. Their commitment and education are key to creating a comfortable and diversed climate in the clinic setting. Training, communication skills development, and cultural education are essential for running a healthcare office.

A crucial element of CLAS is the provision of free language assistance to both office workers and patients. Their competence and engagement will be of great help to patients and contribute to the positive standing of the office. An essential element is the printing and distribution of resources in different languages about the services of the health office. This makes the company’s principles and conditions clear and accessible for its non-English-speaking staff and visitors. Moreover, all individuals should be informed about their state of health and have the right to explain themselves in the language they understand the best.

Culturally and linguistically appropriate practices and policies should article part of company etiquette. By encouraging inclusiveness and diversity, healthcare providers empower people and give them the opportunity to access the appropriate healthcare, as well as to improve their quality of life.

Goode, C. A. & Landefeld, T. (2018). The Lack of Diversity in Healthcare: Causes, Consequences, and Solutions. Journal of Best Practices in Health Professions Diversity, 11( 2), 73–95.

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Home — Essay Samples — Social Issues — Diversity — Culture And Diversity In Healthcare

Culture and Diversity in Healthcare

Categories: Cultural Competence Diversity

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Published: Mar 19, 2024

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The influence of culture, promoting cultural competence, the importance of diversity, challenges and initiatives.

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Why Diversity, Equity, and Inclusion Matter for Patient Safety

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Meghan B. Lane-Fall; Why Diversity, Equity, and Inclusion Matter for Patient Safety. ASA Monitor 2021; 85:42 doi: https://doi.org/10.1097/01.ASM.0000798588.38346.fc

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The recent focus on diversity, equity, and inclusion (DEI) has highlighted many of the ways that individuals and organizations in health care are fallible; for example, by making decisions informed by social group membership instead of factors more germane to such decisions. We make patient care safer in part by introducing routinization and standardization and by engineering systems that are resilient in the face of human fallibility. It may seem, then, that the steps we take to ensure safety would obviate DEI concerns. In reality, we encounter DEI issues in much of the safety work that we do as members of the anesthesia and perioperative care team. Confronting and learning from these issues can make us better clinicians and team members.

As a leader in DEI, I find it helpful to ground conversations in this space with operational definitions of terms often used imprecisely. Diversity is a characteristic of groups (i.e., a single person cannot be “diverse”) that indicates a range of lived experience ( Acad Med 2015;90:1675-83 ). I think of characteristics that shape peoples' perspectives on the world, work, problem solving, and relationships to other people. In the U.S., conversations about diversity often center on race, ethnicity, and gender identity, but many additional aspects of experience are relevant to safe patient care, including age, languages spoken, physical mobility, body size, handedness, and visual acuity, to name just a few. Equity is about fairness and includes both opportunity and addressing barriers (Organizational Behavior, Theory, and Design in Health Care. 3rd edition, 2021). This might manifest as avoiding dissimilar treatment for similar behaviors, such as women and men being treated differently for speaking directly or raising their voice. I think of inclusion as a sense of belonging, which requires an organizational culture that welcomes differing perspectives. Inclusion does not mean that consensus needs to be achieved in all decisions, but an inclusive culture is one with strong psychological safety and the ability to take “interpersonal risks” like speaking one's mind without a fear of ridicule, retribution, or censure ( Annual Review of Organizational Psychology and Organizational Behavior 2014;1:23-43 ). Importantly, the organizational benefits of diversity depend critically on inclusion (Organizational Behavior, Theory, and Design in Health Care. 3rd edition, 2021).

“In reality, we encounter DEI issues in much of the safety work that we do as members of the anesthesia and perioperative care team. Confronting and learning from these issues can make us better clinicians and team members.”

What does this have to do with safety? Let's think about our clinical environment as work systems, as engineers do. In one human factors model, we think about the work system as having five basic components: the care team, tools and technologies, the physical environment, organizational conditions , and the tasks we perform ( Appl Ergon 2020;84:103033 ). I submit that DEI is relevant to all five of these components. Many recent articles have focused on the value of diverse and inclusive care teams. Here I focus on the perhaps less obvious intersections between DEI and the remaining four parts of the work system. A unifying theme across these work system elements is that diversity, equity, and inclusion are necessary to build and maintain systems that are responsive to different team members under a broad range of clinical conditions.

In considering tools and technologies , the concepts of usability and bias are relevant to DEI. Human factors engineers are trained to consider the needs of diverse groups in designing products like machines or software to be usable. Buttons, for example, should be operable by people regardless of dexterity, and user interfaces should be visible by people of different heights. Teams with diversity in these and other characteristics are poised to identify and ameliorate potential safety threats that can be encountered during clinical care. Diverse teams may also help identify or focus attention on bias in technologies, such as pulse oximetry and artificial intelligence ( APSF Newsletter 2021;36 ; BMJ 2020;368:m363 ).

Similar to tools and technologies, the physical environment in health care must be designed to accommodate a diverse workforce. Characteristics such as height, girth, reach, strength, dexterity, mobility, and sensory acuity all influence the way that we interact with our environment and may influence our ability to perform as expected in routine and emergent clinical scenarios (Handbook of Human Factors and Ergonomics in Health Care and Patient Safety. 2nd edition, 2011).

Organizational conditions and tasks are where I think equity and inclusion are most relevant. Our safety measures are developed and executed by people working in complex sociotechnical systems. For these systems to operate at peak performance, team members need to be confident that they will be treated equitably and that their perspectives will be considered in the design, evaluation, and optimization of the systems in which they work. In short, they need to perceive psychological safety. In their review of published research in health care and industry, Edmondson and Lei found that psychological safety was positively associated with organizational learning and organizational performance and that it may mitigate factors like conflict that can undermine performance ( Annual Review of Organizational Psychology and Organizational Behavior 2014;1:23-43 ). Psychological safety is promoted by inviting input, listening to team members, and celebrating failures ( asamonitor.pub/3zSykTj ). It is undermined by explicit or implicit actions that exclude or alienate team members. Microaggressions (also called “subtle acts of exclusion”) experienced by marginalized groups could therefore compromise psychological safety and team functioning ( asamonitor.pub/2YArTH0 ).

As seen in other aspects of health care, like biomedical research and medical education, attention to DEI can broaden our perspectives and allow us to meet the challenges posed by shifting patient populations, innovations in care, and organizational constraints. In highlighting DEI issues relevant to our work system in anesthesia, I believe that applying this lens to safety can help us design better, more resilient, and safer teams and health care systems.

Meghan B. Lane-Fall, MD, MSHP, FCCM. Vice President and Member, Board of Directors, Anesthesia Patient Safety Foundation, and David E. Longnecker Associate Professor and Vice Chair of Inclusion, Diversity, and Equity, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

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Medical School Diversity Essay: Complete Guide

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Admissions committees want to ensure their campus is as varied as possible, so they require additional diversity essays for medical schools.

Medical schools strive to draw candidates from diverse backgrounds so that each student can bring something unique to the school.

The diversity essay allows you to talk about your ethnicity or other distinctive characteristics and how those characteristics will benefit the campus community.

This article will give you a thorough understanding of a medical school diversity essay and the best tips on making a compelling one.

What is a Diversity Essay for Medical School?

Many secondary admissions require a diversity essay. If a diversity essay is suggested, you should still view it as a requirement because contributing additional, compelling materials increases your chances of getting accepted.

Sending extra resources will enable the admissions committees to understand your distinctive background better since they matriculate well-rounded, diversified, and experienced individuals. A recurrent element across purpose and vision statements on medical school websites is diversity.

This is due to the necessity for healthcare professionals who can relate to and treat a variety of patient populations in the medical industry.

Some institutions even have unique diversity declarations demonstrating their unwavering dedication to enrolling a diverse student body, including students of every color, religion, sexual orientation, identity, and experience in education and the workforce.

To further promote the advantages of diversity in medicine, admissions committees give unconventional applicants with non-science backgrounds substantial consideration and admit them.

What Counts as Diversity?

Put your worries aside if you are concerned that because you do not identify with a historically underrepresented group, you do not qualify as a diverse applicant.

Diversity in the context of med school applications does not mean that only members of racial or ethnic minorities should be admitted.

Yes, minority applicants are diverse and are urged to submit applications to medical school, but diversity does not stop there.

Instead, diversity is viewed broadly to embrace a variety of areas. In addition, everyone is diverse because each person may draw on their own particular experiences and backgrounds, which is advantageous in the healthcare industry.

Candidates might be diverse due to a variety of distinct qualities and traits:

Career switchers
Returning older students
Non-traditional candidates
Returning parents to the workforce
Candidates with military experience
Candidates who did not major in science
Candidates from challenging socioeconomic backgrounds
Candidates who persevere in the face of enormous difficulties
Historically underrepresented groups (including those based on race, ethnicity, gender, and gender identity as well as language, sexual orientation, and more )

You will have many examples to pick from if you widen your idea of diversity to include your learning experiences and worldviews.

8 Tips for Answering Medical School Diversity Essays

Diversity essays for medical schools give candidates with diverse backgrounds, unusual families, unorthodox educations, or other different experiences a chance to describe how their distinctiveness would enrich the campus community.

Your diversity essay is your chance to show the medical school you are applying to what you have to offer. Hence, it is a must that you ensure that you stand out among the other candidates.

Below are the best tips when writing your diversity essay for medical school.

Decide What Makes You Unique

Before you even start writing, develop a list of the characteristics in your background that set you apart.

Consider your schooling, employment history, extracurricular activities, upbringing, family life, and other facets of your path to medical school.

The purpose of brainstorming is to stimulate your creative thinking.

Do not worry about spelling, grammar, or sentence structure at this time. Your objective is to write down as many thoughts as you can so that you can start to develop a narrative for your diversity essay using one to three examples.

Focus on Your Story

This is a crucial aspect since many applicants who do not belong to a particular socioeconomic or ethnic group feel they cannot bring variety to a potential medical school class.

Unfortunately, this is a typical misunderstanding. Diversity is not only about your skin tone or the religion your ancestors practiced.

Did you grow up in a non-traditional environment?

This could involve losing a family member, having a brother or other family member who is ill or disabled, growing up in a home with only one parent, starting work at an early age, or many other things. There are a ton of different things that could be a part of your variety.

Do not Hold Back

Do not be reluctant to share your experiences. Simple or uninteresting anecdotes will not stand out. What specific information about yourself can you include to support your arguments?

Clearly state how the encounter affected you.

What did you discover?

How has the experience helped you grow in terms of your character?

How did you utilize what you learned and acquired skills to further your medical education and, ultimately, your career?

In addition, keep in mind that your experience can come up during the interview. Therefore, any information you include in your application is fair for questioning throughout the interview process.

Never write about an experience that you will not be able to discuss in person. It is beneficial to be honest and vulnerable. Still, it is equally important that you keep your cool throughout the interview.

Make Sure Your Story Has a Potential Contribution to the Community

Occasionally, candidates focus so much on their differences that they lose sight that being unique is a means, not an end, to an objective.

These distinctions and distinctive traits/experiences must have a purpose. They must assist in demonstrating your merit for a place at the roundtable discussion for medical schools.

Being a two-time offender or a habitual absence from school are two examples of unusual qualities and experiences for a medical school applicant . Will they aid you in entering?

Most likely not, and for apparent motives. Concentrating on another subject for your medical school diversity essay might be best.

The idea is straightforward. Once you have determined your unique traits, your primary responsibility is to explain how that distinctiveness will enable you to offer something extraordinary both in and outside school.

Enter your text here...

Keep Developing Your Narrative

The coherent story you weave throughout your primary application about who you are and why you want to be a doctor is crucial to a successful application.

Nothing different applies to the second application. The diversity essay allows you to develop the story you started in your main application.

The diversity essay must flow naturally with the remainder of your secondary application. Each application component should support your narrative and offer further background information on how you came to be where you are.

Do Not Repeat Yourself

Make sure you are expanding on any experiences, moments, or lessons you have already addressed if you will bring them up again. You must include more background if you use the same examples in your secondaries.

Do not say the same thing twice in your secondary. Your initial application is already available to the admissions committee. Repeating the same tales will not give the admission committee any new information about you. The secondary chapters offer you the chance to develop your plot further.

Have Enough Evidence of What You Are Writing

Even if diversity may be an elusive idea or characteristic, it needs concrete proof. Therefore, diversity essays for med school are not comprehensive without a clear explanation of how your "diversity" relates to your experiences.

You cannot, for instance, blatantly claim that your history as an immigrant son or daughter and first-generation college student gives you some important insight into the concerns of immigrant populations.

You still need to provide evidence, even though it makes sense that you would be more knowledgeable than people from wealthy, non-immigrant families. Clearly state the links.

Therefore, the ideal strategy is not to overemphasize how significant your minority identity is if you do choose to focus on ethnic, cultural, or religious diversity.

Instead, a compelling essay might concentrate on your commitment to diversity and social justice issues or your efforts to address the health disparities between minorities and non-minorities. It could also be your encounters that show a concrete proof of your cross-cultural competence in patient or client interactions.

These three subjects are not exhaustive but could serve as an excellent starting point.

Proofread and Double-Check Your Diversity Essay

Spend some time going over a few crucial details in your article again. Ensure the element or elements you emphasize have real personal significance for you. Then, reread your essay one last time to ensure you genuinely respond to the question.

The diversity essay is multifaceted. For example, one school might require you only to list any noteworthy aspects of your background.

At the same time, another would want you to explain how those aspects will improve their curriculum or influence your future line of work.

Additionally, make sure you relate your attributes to medicine, particularly to the institution you are applying to.

Medical School Diversity Essay Sample Prompts

The leading schools' diversity essay prompts are provided below to give you an idea of what is anticipated. Remember that each of these prompts has a consistent theme.

Specifically, medical schools are interested in your broad diversity and how it will benefit the institution's purpose, vision, and student body.

Larner College of Med – University of Vermont

The Larner College of Medicine understands that diversity embraces all of a person's experiences and goes beyond their self-identified or unidentified identities. Consider a period when you gained knowledge from a person or organization that is different from yourself.

Mayo Med School – Mayo Clinic

Our individual inflections, which make up our diversity, distinguish us from one another or bind us together. Describe how your personal and professional activities reflect your relationship to your own variety and the diversity of others.

Stanford University School of Medicine

The diversity of an entering class is viewed by the admissions committee as a crucial component in advancing the school's educational purpose. The Committee on Admissions encourages you to address any distinctive, personally significant, and/or challenging aspects of your background.

These aspects may include how well you were educated as a child, your gender, your sexual orientation, any physical disabilities, and life or employment experiences.

Please explain how these influences have shaped your aspirations and training for a future in medicine and how they might enable you to make a distinctive contribution to the Stanford learning environment.

University of Chicago Pritzker School of Medicine

The Pritzker Sch of Medicine at the University of Chicago is committed to encouraging diverse students with an extraordinary promise to become leaders and innovators in science and medicine for the benefit of humanity. This is done in an environment of multidisciplinary scholarship and discovery.

Our essential objective and educational ethos are expressed in our mission statement. In particular, it emphasizes how important diversity is to us since we believe that variety in the student body is vital to academic performance. Please submit an essay outlining how you would further Pritzker's goal and promote diversity there.

Wake Forest School of Medicine

We want to develop doctors who can relate to various patient populations, even though they may not have a common background. Tell us about a situation that helped you to see the world more broadly or to understand people who are different from you better and what you took away from it.

Medical School Diversity Essay Samples

The diversity essay questions you are given by various institutions may differ, meaning that the terminology and what is being asked of you will be unique to each institution.

To prepare yourself, reading a few samples is a good idea.

While the general substance of each prompt will not fluctuate significantly depending on the school, you might want to change the organization or sequencing of the content for various prompts.

Here are some of the best samples of medical school diversity essays.

Prompt: Diversity can take many different shapes. How do you think you could add to the class's diversity?

I feel fortunate to have a solid sense of my roots. Being in Italy frequently throughout my life has allowed me to see how this culture's ideologies differ from those of the United States.

Italian society is frequently tarnished by the myth that its people are idle or unwilling to put forth the effort. People will, in my opinion, see a community where love and camaraderie are more critical than monetary possessions if they view the world objectively.

As a result, there is a considerable emphasis on other people's health and wellness. There is always time for family dinner, a coffee with a friend, or a mind-clearing walk in the evening.

Growing up, my family always ensured everyone had access to food and conversation. I adhere to this concept and see working in the healthcare industry as a chance to assist people in leading fulfilling lives and seeking their own happiness.

Healthcare experts have continuously allowed my loved ones to live independently and be there throughout my life. They have provided me with a service and a gift, and I want to spend the rest of my life sharing that gift with others. My passion for studying medicine and my holistic way of living have been influenced by my culture, background, and experiences in life.

In addition to being a physician in training, I will bring these qualities of empathy and holistic care to my role as a classmate who supports others through medical school challenges.

Prompt: Without restricting the discussion to your identity, please elaborate on how you see yourself supporting the fundamental principles of inclusion and diversity at our school of medicine and the medical field.

When I think about diversity, the first thing that springs to me is "a difference of opinion." As a member of the debate club and a student with a budding interest in classical philosophy, I've come to understand the importance of having a variety of viewpoints. I think advancement is basically impossible without the ability to question our assumptions and expectations about the world and ourselves.

My responsibility as a volunteer scribe at a mobile clinic was to document the specifics of patient examinations. We saw primarily middle-aged or older people. One patient, Paul, showed up at the mobile clinic with a nasty cut on his foot that he claimed was caused by catching his foot on an old rolled-up fence behind his barn. He was skeptical when we suggested he get a tetanus injection. He expressed why he didn't think immunizations were effective.

It was crucial to avoid conflict. We emphasized that while maintaining his autonomy was our first goal, he was likely to contract tetanus, which is potentially fatal. We explained to him that the tetanus vaccine has contributed to a 95% reduction in tetanus cases since about 1950. The patient thought for a bit, then agreed to the vaccination and thanked us for our assistance before leaving. I want to provide the University of Maryland School of Medicine with what I've learned through polite, open communication.

Prompt: What diverse characteristics and experiences could you offer the community of medical schools?

Our training for the Peace Corps taught us a metaphor for our work. Our new neighborhood could be compared to a square if America, our country of origin, were a circle. Volunteers like me formed triangles. The purpose? We could see both as legitimate modes of existence since we were a part of both.

The majority of us have several identities. I also practice living in the center by driving a boat across an island chain. The translator assumes a crucial role in Ann Patchett's Bel Canto, one of my favorite books, which tells the tale of foreign ambassadors who are taken hostage during a banquet. He is the one who must communicate, interpret, and give voice to the blank spaces between characters.

I have had many opportunities to translate for my siblings, parents, Belizean villagers, and others in my health advocacy work. I am the oldest child, a former Peace Corps volunteer, and a member of a mixed-race family.

My "triangular" persona enables me to take an alternative perspective on issues. The medical school is a hub for creative thinking and an entrepreneurial community. I wish to take part in the translation of differences and support of evidence-based solutions to health issues.

I believe that to fulfill my duty, I must be willing to try to comprehend others. My capacity to stand in two places, ears and heart open, enable dialogue, and give my perspective from a place of collaborative appreciation, will be my most outstanding contribution to the medical school community. In a silo, growth cannot take place. It starts with acknowledging the significance of all identities while learning from and working with others.

Additional FAQs – Medical School Diversity Essay

Do all medical schools require a diversity essay, why is diversity good in medical school, you're no longer alone on your journey to becoming a physician.

The Importance of Diversity and Inclusion in the Healthcare Workforce

Affiliation.

1 Obesity Medicine Physician Scientist, Massachusetts General Hospital and Harvard Medical School, Division of Neuroendocrine and Pediatric Endocrinology, Affiliated Faculty, Mongan Institute of Health Policy Associate, Disparities Solutions Center, United States. Electronic address: [email protected].
PMID: 32336480
PMCID: PMC7387183
DOI: 10.1016/j.jnma.2020.03.014

Background: Diversity and inclusion are terms that have been used widely in a variety of contexts, but these concepts have only been intertwined into the discussion in healthcare in the recent past. It is important to have a healthcare workforce which represents the tapestry of our communities as it relates to race/ethnicity, gender, sexual orientation, immigration status, physical disability status, and socioeconomic level to render the best possible care to our diverse patient populations.

Methods: We explore efforts by the Liaison Committee on Medical Education (LCME), the Institute of Medicine (IOM), and other medical organizations to improve diversity and inclusion in medicine.

Conclusion: Finally, we report on best practices, frameworks, and strategies which have been utilized to improve diversity and inclusion in healthcare.

Keywords: Diversity; Healthcare; Inclusion; Workforce.

Cultural Diversity*
Delivery of Health Care / organization & administration
Health Personnel*
Health Workforce*
Societies, Medical
United States

Grants and funding

L30 DK118710/DK/NIDDK NIH HHS/United States
P30 DK040561/DK/NIDDK NIH HHS/United States

6 Medical School Diversity Essay Examples (Ranked Best to Worst!)

Most medical school diversity essay prompts give little away when it comes to helping you with ideas on what to write. Without seeing examples? It’s incredibly difficult to know where to get started!

As a medical student with an undergrad in English, I thought I’d run my eye over some of the web’s popular medical school diversity essay examples.

Ranking these six examples from best to worst, I’ll give a critique of each along the way.

All with the hope of better helping you craft your own diversity essays with a bit more ease and expertise!

Ready to get started? Let’s go.

Want some quick writing tips first? Check out this article; How To Write An Awesome Diversity Essay In Medical School (5 Quick Tips) .

I’ll be ranking each of these from, what I feel, is the worst to best.

Note : It’s not my intention to be disparaging (having any one of these examples is a huge plus), but rather entertaining. I hope it’ll be fun figuring out what I’d look for if I was part of a Med School Admissions Team!

Medical School Diversity Essay Examples

Make sure you click through the links on each of these essays. Not only does this help give credit to other people’s work, but you’ll also benefit from their own explanations and critique!

6. Diverse Backgrounds – Chronicles of a Medical Student

My father gave me two things when I was young: early exposure to diverse people and a strong desire to learn to work cross-culturally. But the most important thing he taught me was to be a life-long learner through interaction with people from diverse backgrounds. Our house was always a second home for international students studying at nearby universities. I can remember playing Jenga with Russian engineering students or seeing our kitchen taken over by Korean music students. During college, I continued to learn to relate to people from many backgrounds through an internship to Southeast Asia in 2006. I found that humility and a genuine desire to learn about someone’s culture opened doors to relationships that would have remained closed. If students fail to interact with people of different cultures, preferring to cluster where they are comfortable, the benefit of a diverse campus is lost. My cross-cultural experiences have prepared me to learn to embrace ethnic and cultural diversity. – Chronicles of a Medical Student

This is by no means a bad essay – and there’s a lot of personal relevance that shines through – it’s just that it misses the mark a little when it comes to drawing parallels between the past and the future.

Although the student shows they’ve had a range of experiences that’s brought them into contact with diverse peoples and cultures, it doesn’t really answer how this lends itself to medicine.

Personally, I find myself wanting to know more about how these experiences have shaped this person’s desire to become a doctor!

5. Connecting Through Cultures – BeMo

I am extremely fortunate to have a strong connection to my roots. Spending time in Italy throughout my life has allowed me to see how the ideology of this culture differs from that in the United States. The Italian society is often marred by the stereotype that they are lazy, or not willing to work. I believe that if one truly sees the society from an objective lens, they will see a society that derives their happiness less from material objects and more from love and companionship. Resultantly, there is a monumental emphasis placed on the health and well-being of others. There is always time for a family meal, a coffee with a friend, or an evening walk to clear one’s mind. Growing up my family always made sure everyone had enough to eat, and someone to talk to. I believe in this ideology and view the healthcare field as the opportunity to help others live a full, and fruitful life pursuing their own happiness. Throughout my life, healthcare professionals have consistently given my loved ones the ability to live autonomously and be present in my life. It is a service and a gift that they have given me and a gift I wish to spend my life giving others. My culture, upbringing, and life experiences have fostered my desire to purse medicine and my holistic approach to life. I will bring these elements of empathy and holistic care not only as a training physician, but as a fellow classmate who is there for others through the rigors of medical school. – BeMo

There’s a lot to like about this essay, especially the way they talk about a different culture (Italy) and how it fuels that desire to become a physician.

Where I feel it could be lacking is in drawing upon specific experiences (extracurriculars) diverse enough to pair well with an application.

They perhaps waste the second paragraph a little by repeating a similar sentiment; “a desire to pursue medicine and a holistic approach to life.”

It’s maybe just a bit too unspecific and uncreative.

4. Sharing Passions – Shemassian Consulting

There are many things a girl could be self-conscious about growing up, such as facial hair, body odor, or weight gain. Growing up with a few extra pounds than my peers, I was usually chosen last for team sports and struggled to run a 10-minute mile during P.E. classes. As I started to despise school athletics, I turned towards other hobbies, such as cooking and Armenian dance, which helped me start anew with a healthier lifestyle. Since then, I have channeled my passions for nutrition and exercise into my volunteering activities, such as leading culinary workshops for low-income residents of Los Angeles, organizing community farmer’s markets, or conducting dance sessions with elderly patients. I appreciate not only being able to bring together a range of people, varying in age, socioeconomic status, and ethnicity, but also helping instill a sense of confidence and excitement that comes with making better lifestyle decisions. I have enjoyed encouraging kids in the inner city to combat similar issues of weight gain and low self-esteem through after-school gardening and physical activity lessons. Now, I hope to share my love for culinary nutrition and fitness with fellow medical students at UCLA. As students, we can become better physicians by passing on health and nutrition information to future patients, improving quality of life for ourselves and others. – Shemassian Consulting

This is an example of just how creative you can get when it comes to essay writing – especially when you might not consider yourself “typically diverse” too!

The experiences of this applicant are ones that most of us, growing up in the West, are familiar with. Yet they expertly turn these “standard problems” into something personal that communicates to the reader why they got involved with volunteering and community projects in the first place (i.e. not just because med school admissions teams told them they had to!)

Even if the bottom line is a little generic; “passing on health and nutrition information to future patients”; it’s that honesty at the beginning that makes it seem like a genuine essay.

The way it addresses the school specifically is another nice touch.

3. Multiple Identities – Motivate MD

In Peace Corps training, we learned a metaphor for our service. If our home, America, was a circle, our new community could be described as a square. We, as volunteers, were triangles. The point? We were part of each; not quite one, nor the other, but able to recognize both as valid ways of being. Most of us have multiple identities. I also bring practice of inhabiting the middle; the boat in a channel between islands. In one of my favorite novels, Ann Patchett’s Bel Canto, the story of international diplomats held hostage at a party, the translator plays a central role. It is he who must interpret and communicate; give voice to space between characters. As a Returned Peace Corps Volunteer, oldest child, and part of a mixed-race family, I’ve had many opportunities to translate; on behalf of my siblings (to my parents), my parents (to my siblings), Belizean villagers, & others in my health advocacy work. My “triangular” identity helps me approach problems differently. _______Medical School is a place for visionary thinking; a community of innovators. I want to be part of curiosity-driven inquiry; translating differences & supporting evidence based solutions to health problems. I see my role as one that can only be attempted through willingness to understand others. My greatest contribution to the medical school community at _________will be my ability to stand in two places, ears & heart open, facilitating dialogue & sharing my perspective from a place of collaborative appreciation. Growth cannot occur in a silo. It begins in learning from & with other people, recognizing the value of all identities. – Motivate MD

This is a really awesome example that’s formatted perfectly.

Compact, punchy, and making great use of metaphor, this does so many right things when it comes to putting together a strong diversity essay.

What I like most about it is the way it plays on the cultural background of the applicant to explain how they will contribute to the school’s community moving forward.

This is a really important thing to consider!

But what’s also neat is the way they link reading and literature to their own cross-cultural role. That’s a nice creative flourish.

2. Diversity Through Faith – University of Pittsburgh School of Medicine

In the sweating discomfort of the summertime heat, I walked through Philadelphia International Airport with several overweight bags, tired eyes, and a bad case of Shigella. Approaching Customs, I noticed the intensity and seriousness on the faces of the customs officers whose responsibility were to check passports and question passengers. As I moved closer to the front of the line, I noticed someone reading a foreign newspaper. The man was reading about the Middle Eastern conflict, a clash fueled by religious intolerance. What a sharp contrast to Ghana, I thought. I had just spent three weeks in Ghana. While there I worked, studied their religions, ate their food, traveled and contracted malaria. Despite all of Ghana’s economic hardships, the blending of Christianity, Islam, and traditional religion did not affect the health of the country. When I reached the front of the line, the customs officer glanced at my backpack and with authoritative curiosity asked me, “What are you studying?” I responded in a fatigued, yet polite voice, “Religious studies with a pre-med track.” Surprised, the officer replied rhetorically, “Science and religion, interesting, how does that work?” This was not the first time I had encountered the bewildered facial expression or this doubtful rhetorical question. I took a moment to think and process the question and answered, “With balance.” Throughout my young life I have made an effort to be well-rounded, improve in all facets of my personal life, and find a balance between my personal interests and my social responsibility. In my quest to understand where I fit into society, I used service to provide a link between science and my faith. Science and religion are fundamentally different; science is governed by the ability to provide evidence to prove the truth while religion’s truth is grounded on the concept of faith. Physicians are constantly balancing the reality of a person’s humanity and the illness in which they are caring for. The physicians I have found to be most memorable and effective were those who were equally as sensitive and perceptive of my spirits as they were of my symptoms. Therefore, my desire to become a physician has always been validated, not contradicted by my belief system. In serving, a person must sacrifice and give altruistically. When one serves they sacrifice their self for others benefit. Being a servant is characterized by leading by example and striving to be an advocate for equity. As a seventh grade math and science teacher in the Philadelphia public school system, everyday is about sacrifice and service. I sacrifice my time before, during and after-school; tutoring, mentoring and coaching my students. I serve with vigor and purpose so that my students can have opportunities that many students from similar backgrounds do not have. However, without a balance my effectiveness as a teacher is compromised. In February, I was hospitalized twice for a series of asthma attacks. Although I had been diagnosed with asthma, I had not had an attack since I was in middle school. Consequently, the physicians attributed my attacks to high stress, lack of sleep, and poor eating habits. It had become clear to me that my unrelenting drive to provide my students with a sound math and science education without properly balancing teaching and my personal life negatively impacted my ability to serve my students. I believe this experience taught me a lesson that will prove to be invaluable as a physician. Establishing an equilibrium between my service and my personal life as a physician will allow me to remain connected to the human experience; thus enabling me to serve my patients with more compassion and effectiveness. Throughout my travels and experiences I have seen the unfortunate consequences of not having equitable, quality health care both domestically and abroad. While many take having good health for granted, the financial, emotional, mental, and physical effects illnesses have on individuals and families can have a profound affect on them and the greater society. Illness marks a point in many people’s lives where they are most vulnerable, thus making a patient’s faith and health care providers vital to their healing process. My pursuit to blend the roles of science and religion formulate my firm belief that health care providers are caretakers of God’s children and have a responsibility to all of humanity. Nevertheless, I realize my effectiveness and success as a physician will be predicated mostly on my ability to harmonize my ambition with my purpose. Therefore, I will always answer bewildered looks with the assurance that my faith and my abilities will allow me to serve my patients and achieve what I have always strived for and firmly believe in, balance. – University of Pittsburgh School of Medicine

First things first, you’re incredibly unlikely to get the chance to write this much for a diversity essay.

Most of the prompts you’ll see from med schools are in the 500 words range. As evidenced in the following article…

Related : Medical School Diversity Essay Prompts (21 Examples)

What I love about this example here however is the narrative. This essay really paints a picture. And has an awesome hook in its opening about the writer experiencing shigellosis!

Other things it does excellently include discussing diverse experiences (teaching, preaching, illness, etc.) and showing a firm understanding of the roles doctors play across societies and cultures.

It shows real passion and drive, as well as someone struggling on a more personal level to make sense of their own journey.

I imagine this would stand out well from the crowd.

1. Exploring Narratives – Morgan (The Crimson)

I started writing in 8th grade when a friend showed me her poetry about self-discovery and finding a voice. I was captivated by the way she used language to bring her experiences to life. We began writing together in our free time, trying to better understand ourselves by putting a pen to paper and attempting to paint a picture with words. I felt my style shift over time as I grappled with challenges that seemed to defy language. My poems became unstructured narratives, where I would use stories of events happening around me to convey my thoughts and emotions. In one of my earliest pieces, I wrote about a local boy’s suicide to try to better understand my visceral response. I discussed my frustration with the teenage social hierarchy, reflecting upon my social interactions while exploring the harms of peer pressure. In college, as I continued to experiment with this narrative form, I discovered medical narratives. I have read everything from Manheimer’s Bellevue to Gawande’s Checklist and from Nuland’s observations about the way we die to Kalanithi’s struggle with his own decline. I even experimented with this approach recently, writing a piece about my grandfather’s emphysema. Writing allowed me to move beyond the content of our relationship and attempt to investigate the ways time and youth distort our memories of the ones we love. I have augmented these narrative excursions with a clinical bioethics internship. In working with an interdisciplinary team of ethics consultants, I have learned by doing by participating in care team meetings, synthesizing discussions and paths forward in patient charts, and contributing to an ongoing legislative debate addressing the challenges of end-of-life care. I have also seen the ways ineffective intra-team communication and inter-personal conflicts of beliefs can compromise patient care. By assessing these difficult situations from all relevant perspectives and working to integrate the knowledge I’ve gained from exploring narratives, I have begun to reflect upon the impact the humanities can have on medical care. In a world that has become increasingly data-driven, where patients can so easily devolve into lists of numbers and be forced into algorithmic boxes in search of an exact diagnosis, my synergistic narrative and bioethical backgrounds have taught me the importance of considering the many dimensions of the human condition. I am driven to become a physician who deeply considers a patient’s goal of care and goals of life. I want to learn to build and lead patient care teams that are oriented toward fulfilling these goals, creating an environment where family and clinician conflict can be addressed efficiently and respectfully. Above all, I look forward to using these approaches to keep the person beneath my patients in focus at each stage of my medical training, as I begin the task of translating complex basic science into excellent clinical care – Morgan, Harvard Med Matriculant; The Crimson

You can see why this student successfully made it into Harvard Med!

Again, they tell a story. They hook us in curiously with a statement that we want to know the answer to. And we continue reading while the greater narrative unfurls.

What this example does perfectly is interweaving the personal with the playful while showing a diversity of thought (writing about a local boy’s suicide etc) and a commitment to expanding her perspective.

Showing (not telling) how this pastime has enriched her staple extracurriculars (internships, research, clinical experience, etc.), it shows real thought as to the future of medicine and exactly where this future physician wants to take it.

The level of detail and specificity shows that she’s really thought about how she wants to develop her career based on her existing clinical experience.

This is the type of diversity essay I’d aspire to write!

Final Thoughts

Hopefully, in ranking these examples and discussing their finer points, you have some better ideas about how you might want to approach writing your own diversity essays.

While it’s impossible to really comment on the appropriateness of each example, namely because we don’t know the exact prompt, they still give plenty of food for thought.

Just remember to follow your own prompts where possible, and make sure to go over your school’s mission statements to help tailor your own essays.

I’m pretty confident you can write essays as effective as these!

How To Conclude Your Medical School Personal Statement

Born and raised in the UK, Will went into medicine late (31) after a career in journalism. He’s into football (soccer), learned Spanish after 5 years in Spain, and has had his work published all over the web. Read more .

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How to write the perfect diversity essay for medical school.

diversity and inclusion in healthcare essay

Reviewed by:

Akhil Katakam

Third-Year Medical Student, Lewis Katz School of Medicine at Temple University

Reviewed: 5/19/23

Wondering how to write the perfect diversity essay for medical school? Stick around to find out our top tips!

The medical school admissions process is becoming increasingly holistic. Admissions committees look at more than just your GPA and extracurricular activities to decide your candidacy.

There is a significant need to diversify the medical field, so various other selection factors play an important role in your success. Many medical schools require secondary essays as part of their application materials to help them assess candidates’ strengths, desirable qualities, experiences, and insights.

Some schools require the medical school diversity essay, so it’s essential to understand the ins and outs of what makes a compelling essay stand out. This blog will review the definition of diversity in the context of medical school applications and provide examples of prompts from top schools.

You will also learn how to write a diversity essay, including tips on what to include and the proper format to follow. Lastly, we’ll provide an example that tells an interesting story and connects a candidate’s diversity with a medical school’s mission and vision.

Get The Ultimate Guide on Writing an Unforgettable Personal Statement

What is a Diversity Essay for Medical School?

A diversity essay is required or recommended for many medical school secondary applications . In the cases that the diversity essay is recommended, you should still consider it as a requirement, as submitting additional, strong materials maximize your chances of acceptance.

Admissions committees matriculate well-rounded, diverse, and experienced candidates , so sending more materials will help them gain a better overview of your unique background.

If you look at medical school websites, there is a common theme among mission and vision statements: diversity. This is because the medical field needs to diversify health care practitioners who can empathize with and effectively treat various types of patient populations.

Some schools even have separate diversity statements that show their ongoing commitment to matriculate a diverse student body, representing every race, religion, sexual orientation, identity, educational/professional background, and more.

In fact, admissions committees are even seriously considering and matriculating non-traditional applicants from non-science backgrounds to further serve the benefits of diversity in medicine.

Infographic outlining the factors that make candidates diverse and how to write a diversity essay.

What Counts as Diversity?

If you’re worried that you don’t count as a diverse candidate because you don’t belong to a historically underrepresented group, cast your concerns aside. Diversity in the context of diversity essays for medical school is not a code word to only matriculate ethnic or racial minorities.

Yes, candidates from minority groups are diverse and are encouraged to apply to medical school, but diversity doesn’t end there. Rather, diversity is broadly defined to include many categories. Everyone is diverse because everyone has their own unique experiences and backgrounds to draw from, which is valuable in healthcare.

There are many distinguishing factors and characteristics that can make candidates diverse:

Non-traditional applicants (2 or more gap years before med school)
Candidates who are non-science majors
Career changers
Candidates with a disability
Historically underrepresented groups (racial, ethnic, gender and gender identity, linguistic, sexual orientation, religion, and more)
Older returning students
Applicants with military service
Parents returning to the workforce
Candidates who overcome extreme challenges and adversity
Applicants with a difficult socioeconomic background

If you broaden your understanding of diversity to include your unique learning experiences and worldviews, you will have a plethora of examples to choose from to write a powerful diversity essay.

Examples of Diversity Essay Prompts

The following are previous diversity essay prompts from top medical schools to give you an idea of what a diversity essay prompt looks like . You’ll notice there is a similar thread in all of these prompts: medical schools want to know about your diversity in broadly defined terms, and most importantly, how it will enhance the school’s mission, vision, and student body.

Prompt: Stanford University School of Medicine

“ The Committee on Admissions regards the diversity (broadly defined) of an entering class as an important factor in serving the educational mission of the school. The Committee on Admissions strongly encourages you to share unique, personally important and/or challenging factors in your background which may include such discussions as the quality of your early education, gender, sexual orientation, any physical challenges, and life or work experiences. Please describe how these factors have influenced your goals and preparation for a career in medicine and may help you to uniquely contribute to the Stanford learning environment.”

Prompt: Wake Forest School of Medicine

“We seek to train physicians who can connect with diverse patient populations with whom they may not share a similar background. Tell us about an experience that has broadened your own worldview or enhanced your ability to understand those unlike yourself and what you learned from it.”

Prompt: Larner College of Medicine at the University of Vermont

“The Larner College of Medicine at the University of Vermont recognizes that diversity extends beyond chosen and unchosen identities and encompasses the entirety of an individual’s experiences. Reflect on a time you learned something from someone or a group of people who are unlike yourself.”

Prompt: Columbia Vagelos College of Physicians and Surgeons

“Columbia Vagelos College of Physicians and Surgeons values diversity in all its forms. How will your background and experiences contribute to this important focus of our institution and inform your future role as a physician?”

Prompt :University of Chicago Pritzker School of Medicine

“At the University of Chicago, in an atmosphere of interdisciplinary scholarship and discovery, the Pritzker School of Medicine is dedicated to inspiring diverse students of exceptional promise to become leaders and innovators in science and medicine for the betterment of humanity. Our mission statement is an expression of our core purpose and educational philosophy. In particular, it highlights the value we place on diversity since we regard the diversity of entering class as essential for educational excellence. Please write an essay on how you would enhance diversity at Pritzker and advance the Pritzker mission.”

Use our tool to discover every U.S. medical school’s secondary essay prompts!

How to Write a Diversity Essay

If you’re having trouble figuring out how to write a diversity essay, take the following steps:

1. Identify What Makes You Unique

First, before you even begin to write, brainstorm the things in your background that make you unique. In particular, think about your education, work experience, extracurricular activities, upbringing, family life, and other aspects of your journey to medical school.

Brainstorming ideas is meant to get your creative juices flowing. At this point, don’t worry about grammar, spelling, or sentence structure. Your goal is to get as many ideas on paper as possible so that you can begin to craft a story that uses one to three examples for your diversity essay.

You can ask yourself the following questions to get started:

Who are you at your core, at your best self?
What experiences have defined you?
How do you identify yourself, and how does this differ from society’s expectations of your identity?
How have you overcome challenges, adversity, or rejection?
Where did you grow up, and what was it like to live there? How do your geographic roots inform your worldview?
What was your family life like?
Have you faced a disability, injury, or illness? What did you learn, and how did you overcome these challenges?
Are you a part of any teams, groups, or organizations? How have they contributed to your interpersonal skills?

Remember, admissions committees are interested in your story. You should never falsify information in your essays. Write what you know!

2. Pick 1-3 Meaningful Experiences to Potentially Write About

A compelling diversity essay consists of one or a few meaningful experiences instead of overloading the essay with brief mentions of too many examples. You should prioritize quality over quantity and weave a story that’s memorable to the admissions committee.

You should also be mindful of character limits. Every school has different requirements, so be sure you achieve the minimum character count and stay within the upper limits.

3. Outline the Structure of Your Diversity Essay

No matter the length of your secondary essays , you should always structure it with the following:

An introduction that hooks the reader.
A body that details your experience(s).
A conclusion that concisely ties everything together with the school’s mission.

The introduction should begin to tell your main story. It should introduce your main talking points so that the reader knows what to expect in the essay. Strong introductions often have a hook, which can appear as the beginning of an interesting and evocative anecdote.

The body of your diversity essay should delve into your unique experience through reflective storytelling . Here is where you will go into compelling details about your examples. The body will also demonstrate how your diversity will be an asset to the school and your peers and colleagues.

It’s also important to show rather than tell. For example, rather than list all of the personal characteristics that make you diverse, use imagery and storytelling to show these personal characteristics in action.

Finally, the conclusion should neatly tie in your meaningful and diverse experiences to the pursuit of medicine. Your last sentences should leave the reader with a strong impression of why your diversity will be an asset to the school.

4. Write the First Draft

Draw from your notes and outlines to write the first draft. Excellent writing involves an evolution of multiple drafts, so don’t be discouraged if the first draft isn’t perfect.

You’re not striving for perfection here—you’re still in the beginning stages, so you should prioritize fully addressing the essay prompt with strong examples from your diverse background. Polishing your first draft can come later.

5. Revise and Edit Your Diversity Essay

Go over your draft with a critical eye. Ensure that all prompt components are thoroughly answered, check for spelling and grammatical mistakes, and proofread for proper syntax and sentence structure.

Look at the flow of your essay. The transitions from introduction, to the body, to the conclusion should be seamless and make sense. If you’re writing about a few experiences, ensure that they make sequential and logical sense. The transitions should feel natural, not jarring or out of place.

Have someone else look at your essay to offer objective feedback. This can be a trusted friend, family member, instructor, employer, peer, or mentor. Be open to constructive criticism and revise any areas that need improvement or further clarification/elaboration.

Diversity Essay Examples

The following diversity essay examples both tell compelling and memorable stories. As you read, consider how the essay transports you to another location and invites you to view medicine and health care from a unique perspective.

Note how the essay ties into the school’s mission, vision, and goals for diversifying health care. Finally, consider the overall structure of the essay: there is a tangible introduction, body, and conclusion.

“Being South Asian, I have firsthand knowledge of what it means not to access basic health care. As a child, my mother took me to Pakistan every year, where I spent summers with my grandfather, a top pediatrician in the nation. He had a free clinic attached to his home in Faisalabad, and his practice was so renowned and respected that people from all over the country would travel great distances to have my grandfather treat their children. Pakistan is a third-world country where a significant part of the population remains illiterate and uneducated due to the lack of resources and opportunities. This population is the most vulnerable, with extremely high numbers of infectious disease and mortality rates. Yet, it is entirely underserved. With the lack of hospitals, clinics, and doctor’s offices in rural Pakistan, parents of ailing children must travel great distances and wait in long lines to receive proper health care. Every summer at my grandfather’s clinic, from ages five to 17, my job was to open the doors to long lines of tired, hungry, and thirsty parents with their sick children. I would pass out bottled water and pieces of fruit. I would record names, where the patients came from, and the reasons for their visits. I would scurry back inside with the information for my grandfather to assess, and then he’d send me running back out again to let the next family inside. I learned in my formative years how to communicate with diverse patient populations with special needs and a lack of basic necessities. I learned to listen to every family’s unique reasons for their visit, and some of their desperation and pleading for the lives of their children will stay with me forever. When I get into medical school, I hope to share the story of how Gulzarah carried her dehydrated daughter for 12 miles in the Pakistani summer heat without rest (thanks to my grandfather, she later made a full recovery). I want to tell my peers that doctors like my grandfather are not only healers in biology but healers in the spirit by the way he made up heroic songs for the children and sang the fear out of their hearts. I want to show my peers that patients are unique individuals who have suffered and sacrificed to trust us with their health care, so we must honor their trust by providing quality treatment and empathy. My formative experiences in pediatrics contributed to my globally conscious mindset, and I look forward to sharing these diverse insights in my medical career.”

Example 2: University of Pittsburgh School of Medicine

“‘911 operator, what’s your emergency?’ ‘My friend has just been shot and he is not moving!’ ‘Is he breathing?’ ‘I don't think so!’ ‘Are you hurt?’ ‘No.’ ‘Stay there, the paramedics are on their way.’ ‍ On April 10th 2003, at approximately 11pm, my best friend Kevin and I, intending to see a movie, headed out my front door. We never made it to see a horror movie; but our night was nothing close to mundane, when we became innocent victims to gang crossfire. As we descended my front door stairs two gunshots were fired and one person fell to the floor. Kevin was shot! I vividly recall holding him in my arms, and while he lost blood I almost lost my mind. All I wanted was to help, but there was nothing I could do. At 1am that morning Kevin's family and I sat in the emergency waiting room at Brookdale Hospital in Brooklyn, hoping and praying that the chief surgeon would bring us good news. While this event started me on my quest to become a medical doctor, at that moment all I could envision was a life of despondency. ‍ According to author Jennifer Holloway, ‘tragedy is a substance which can ignite the soul.’ When Kevin’s surgeon walked through the door of the emergency waiting room he did not have to say a word. Kevin’s family cried hysterically. I, on the other hand, could not cry. As fast as despondency had filled my heart, it was now gone; I was consumed by anger, frustration and motivation to change my life’s direction. The death of my best friend compelled me to pursue a career in medicine. This, I hope, will enable me to help save the lives that others try to take. ‍ In the fall of this event, I took my first biology and chemistry courses. By the end of the year I excelled as the top student in biology, received the Inorganic Chemistry Achievement Award and was encouraged to become a tutor in general biology and chemistry. ‍ Tutoring was a captivating experience for me. Questions raised by students challenged my understanding of scientific concepts and their application in patient care. To further develop my knowledge of medicine, I volunteered in the emergency department at Albert Einstein Hospital, in Bronx, NY. While shadowing doctors, I was introduced to triaging, patient diet monitoring and transitioning from diagnosis to treatment. This exposed me to some of the immense responsibilities of a doctor, but my 5 experience helping in the cancer ward was where I learned the necessity of humanity in a physician and how it can be used to treat patients. Peering through a window I saw Cynthia, a seven-year-old girl diagnosed with terminal cancer, laughing uncontrollably after watching her doctor make funny faces. For a moment not only did Cynthia forget that she was dying, but her smile expressed joy and the beauty of being alive. This taught me that a physician, in addition to being knowledgeable and courageous, should show compassion to patients. It also became clear to me that a patient’s emotional comfort is as important as their physical health, and are both factors that a physician considers while providing patient care. ‍ Although focused on medicine, I was introduced to research through the Louis Stokes Alliance for Minority Participation in Science. Here, I learned organic synthesis techniques, while working on a project to elucidate the chemical mechanisms of oxygen protein binding and its relationships to anemia. I also received the United Negro College Fund/Merck Science Initiative Research Scholarship that allowed me to experience cutting edge research in Medicinal Chemistry, with a number of world-class scientists. At Merck Research Labs, I learned the fundamentals of synthesizing novel compounds for drug discovery, and we focused on treatments for cardiac atrial fibrillation. This internship changed my view of medication and their origins, and left me with a deep appreciation of the challenges of medicinal research. I also now understand that medical doctors and research scientists have similar responsibilities: to solve current and future health issues that we face. ‍ Despite the tragedy that brought me to the hospital on April 10th 2003, the smells, the residents and the organized chaos of the emergency room have become an integral part of a new chapter in my life. On the day that my friend lost his life I found my soul in medicine. Today as I move forward on the journey to become a physician I never lose sight of the ultimate goal; to turn the dying face of a best friend into the smiling glow of a patient, just like Cynthia’s. A patient’s sickness can be a result of many things. But with the right medications, a physician’s compassion and some luck, sickness can be overcome, and the patient helped. In time and with hard work it will be my privilege to possess the responsibilities of a physician in caring for life.”

FAQs: Med School Diversity Essays

Here are our answers to some of the most frequently asked questions about how to write a diversity essay for medical school.

1. I’m Not an Underrepresented Minority, so How Can I Write a Diversity Essay for Medical School?

Diversity in the context of medical school secondary essays is not limited to race, sexual orientation, socioeconomic status, or other historically underrepresented groups. Think of diversity in broader terms that include your unique experiences and insights, and write about how your diverse skill sets will enhance the school and the student body.

2. How Can I Write a Diversity Essay that Stands Out from Other Candidates?

Brainstorm unique experiences that you have had and narrow down one or two main experiences to weave compelling stories with a clear introduction, body, and conclusion. You should prioritize the quality of your experiences and elaborate upon them rather than pack too many bullet points in a limited space.

3. I’m Not a Strong Writer, How Can I Improve My Diversity Essay for Medical School?

Writing is not a linear process, and even bestselling authors need skilled editors. Start small with outlines and notes, then flesh out the essay with details. Write multiple drafts. When you’re happy with a draft, ask friends, family, peers, colleagues, instructors, or mentors for objective feedback. You can also consult with our team of experts to help you.

4. Why Do Some Medical Schools Require Diversity Essays?

Medical schools want to diversify the field and accept candidates with unique backgrounds and skill sets. These students will go on to be leaders in health care, so a holistic admissions process ensures that the world’s future doctors represent diverse groups, perspectives, talents, and skill sets.

5. Where Can I Find More Prompts and Examples of Diversity Essays?

Browse the medical school’s website and read their application procedures. You can also contact the school’s admissions committee helpline for more information.

6. What Should I Avoid in my Medical School Diversity Essay?

Avoid spelling and grammar errors, an unprofessional or casual tone/language, controversial or offensive statements, embellishing stories, and negative outlooks. If your diversity essay addresses facing adversity, make sure to focus on a growth mindset, what you learned, and the positive outcomes of that experience.

7. How Long Should a Diversity Essay Be?

Every school has its own character limits and requirements for secondary essays. Be sure to follow the recommended application guidelines and secondary essay requirements, including the school’s specific diversity prompt. You can use the same stories for each diversity essay but repurpose them to answer different prompts.

8. How Important is a Diversity Essay for Med Schools?

Essays are generally considered a highly important piece of your med school application as they allow you the most room to express who you are and stand out from others. So, writing a thoughtful, compelling diversity essay can seriously improve your chances of acceptance - making them an important piece of your overall application.

Final Thoughts

The diversity essay for medical school is an important component of many secondary applications. Medical schools are increasingly relying on a holistic review of candidates to diversify medicine to better serve global patient populations.

To write an effective diversity essay, think about the unique characteristics and experiences that make you unique. Remember that diversity is broadly defined, so don’t limit yourself to only certain categories.

Pick one to three of the strongest examples that showcase your diversity in the best light. Answer the prompt fully and include every aspect of the prompt. Remember to tell a great story and tie in your experiences to the school’s goals of diversifying health care.

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By Taha Shaltu, PharmD Candidate, Class of 2026

[Editor’s note: this was a winning essay for the Walgreens Diversity Scholarship Award]

Diversity and inclusion in healthcare are crucial components for providing appropriate and optimal care to patients of different cultures. Diversity encompasses differences in race, ethnicity, gender, sexual orientation, religion, language, socioeconomic status, and more. Inclusion involves creating an environment where these differences are respected, valued, and integrated into all aspects of care delivery. To me, diversity and inclusion mean recognizing and embracing the unique backgrounds and needs of every individual, regardless of their cultural background. In providing care to patients from diverse cultures, understanding fundamental cultural ideas, language, and religious beliefs is essential. Making assumptions about patients based on their culture can lead to misunderstandings and suboptimal care. Building trust through respectful communication and actively listening to patients’ concerns fosters a therapeutic relationship that is essential for effective care delivery. Moreover, educating patients about medications and treatment options in a culturally sensitive manner ensures that they are informed and empowered to participate in their healthcare decisions. Demonstrating a commitment to diversity and inclusion on campus can take various forms. This may include participating in multicultural events, advocating for inclusive policies, and actively engaging with diverse student groups. By promoting dialogue and understanding among peers, we can create a more inclusive environment that celebrates diversity and values the contributions of individuals from all backgrounds.

Representing an underrepresented group in pharmacy positively impacts the profession, the community, and patient care in several ways. First, diversity in the pharmacy profession promotes innovation and creativity by bringing together individuals with different perspectives and experiences. This diversity of thought enables pharmacists to develop more effective strategies for addressing the unique healthcare needs of diverse patient populations. Additionally, pharmacists from underrepresented groups serve as role models and mentors for aspiring healthcare professionals who may identify with similar backgrounds. By increasing representation within the profession, we inspire future generations to pursue careers in pharmacy, thereby fostering greater diversity in healthcare overall. From a community perspective, pharmacists who reflect the diversity of the population they serve are better equipped to understand and address the cultural and linguistic barriers that may affect patient care. This leads to improved patient satisfaction, adherence to treatment plans, and health outcomes. embracing diversity and inclusion in pharmacy practice enhances the quality of care provided to patients from different cultural backgrounds. By valuing and respecting the unique perspectives and experiences of individuals, we can create a more equitable and patient-centered healthcare system.

In addition to English, I am fluent in Afaan Oromo, Amharic, and Swahili, stemming from my upbringing in Ethiopia. This multilingual proficiency significantly enhances my capacity as a pharmacist, enriching communication and fostering deeper connections with diverse patient demographics.

The ability to converse fluently in multiple languages transcends mere linguistic proficiency; it embodies cultural competence and empathy, essential components in delivering patient-centered care. In a profession where effective communication is paramount, my linguistic versatility enables me to bridge linguistic and cultural gaps, thereby facilitating clearer comprehension of medical instructions, medication regimens, and health education materials.

Moreover, my proficiency in Afaan Oromo, Amharic, and Swahili empowers me to cultivate trust and rapport with patients from Ethiopian and Swahili-speaking communities, fostering a sense of inclusivity and reassurance in healthcare settings. This inclusivity not only enhances patient satisfaction but also contributes to improved health outcomes by ensuring patients feel understood, respected, and supported throughout their healthcare journey.

In a broader context, my linguistic skills serve as a conduit for promoting health literacy and public health initiatives within ethnically diverse communities. By disseminating vital health information in languages accessible to various cultural groups, I actively participate in mitigating healthcare disparities and advancing health equity.

In essence, my fluency in multiple languages serves as a cornerstone in delivering comprehensive pharmaceutical care, fostering cultural competency, and nurturing a healthcare environment that prioritizes patient well-being, inclusivity, and empowerment.

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The ACC, American Society of Echocardiography, American Society of Nuclear Cardiology, Association of Black Cardiologists, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Magnetic Resonance, Society of Cardiovascular Computed Tomography, and The Society of Thoracic Surgeons are committed to advancing health equity regardless of race, gender, socioeconomic status or geography and to expanding our efforts to support diversity, equity and inclusion in the cardiovascular profession.

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v.6(5); 2022 May

Valuing Diversity and Inclusion in Health Care to Equip the Workforce: Survey Study and Pathway Analysis

Jiban khuntia.

1 Health Administration Research Consortium, Business School, University of Colorado, Denver, CO, United States

2 Business Department, University of Wisconsin Parkside, Kenosha, WI, United States

Wayne Cascio

Rulon stacey.

The COVID-19 pandemic, with all its virus variants, remains a serious situation. Health systems across the United States are trying their best to respond. On average, the health care workforce is relatively homogenous, even though it cares for a highly diverse array of patients. This perennial problem in the US health care workforce has only been accentuated during the COVID-19 pandemic. Medical workers should reflect on the variety of patients they care for and strive to understand their mindsets within the larger contexts of culture, gender, sexual orientation, religious beliefs, and socioeconomic realities. Along with talent and skills, diversity and inclusion (D&I) are essential for maintaining a workforce that can treat the myriad needs and populations that health systems serve. Developing hiring strategies that will help achieve greater workforce diversity remains a challenge for health system leaders.

The primary aims of this study were to: (1) explore the characteristics of US health systems and their associations with D&I practices and benefits, (2) examine the associations between D&I practices and three pathways to equip workforces, and (3) examine the associations between the three pathways to better equip workforces and business and service benefits. The three pathways are: (1) improving D&I among existing employees (IMPROVE), (2) using multiple channels to find and recruit the workforce (RECRUIT), and (3) collaborating with universities to find new talent and establish plans to train students (COLLABORATE).

During February to March 2021, 625 health systems in the United States were surveyed with the help of a consultant, 135 (21.6%) of whom responded. We assessed workforce talent- and diversity-relevant factors. We collected secondary data from the Agency for Healthcare Research and Quality Compendium of the US Health Systems, leading to a matched data set of 124 health systems for analysis. We first explored differences in diversity practices and benefits across the health systems. We then examined the relationships among diversity practices, pathways, and benefits.

Health system characteristics such as size, location, ownership, teaching, and revenue have varying associations with diversity practices and outcomes. D&I and talent strategies exhibited different associations with the three workforce pathways. Regarding the mediating effects, the IMPROVE pathway seems to be more effective than the RECRUIT and COLLABORATE pathways, enabling the diversity strategy to prompt business or service benefits. Moreover, these pathway effects go hand-in-hand with a talent strategy, indicating that both talent and diversity strategies need to be aligned to achieve the best results for a health system.

Conclusions

Diversity and talent plans can be aligned to realize multiple desired benefits for health systems. However, a one-size-fits-all approach is not a viable strategy for improving D&I. Health systems need to follow a multipronged approach based on their characteristics. To get D&I right, proactive plans and genuine efforts are essential.

Introduction

Health systems have been overwhelmed with COVID-19 patients [ 1 ]. Perennial shortages in the health care workforce have been exacerbated during the pandemic [ 2 ]. Stress, trauma, and burnout have tested the limits of health systems’ existing workforces [ 3 ], and health systems lack workforces to treat the diversity of COVID-19 patients [ 4 , 5 ].

In general, the workforce in medicine is relatively homogenous, despite serving diverse populations. The health care system faces significant challenges matching patients’ beliefs, attitudes, expectations, and care customization to an appropriately diverse workforce. In 2020, the US health care workforce reportedly comprised more than 50% white, approximately 20% Asian, 7% Black, and less than 1% Hispanic and Native American workers [ 6 ]. Two-thirds of physicians and surgeons are Christian, 14% are Jewish, and fewer than 15% represent other religions [ 7 ]. In addition, two-thirds are men, although this is changing as more women are admitted to medical schools [ 8 ]. In addition, dropouts among medical students in the first 2 years are high due to socioeconomic factors [ 9 ]. Assessment of sexual and gender diversity is also problematic, as disclosures risk discrimination claims [ 10 ], although schools attract unrepresented LGBTQ applicants [ 11 ]. In general, a lack of diversity in the health care workforce poses challenges for caring for diverse populations of patients, leading to variable and often detrimental access and quality issues [ 12 ]. Although the value of diversity has been well-established, unless health system leaders adopt explicit strategies to improve diversity and inclusion (D&I), they will not accomplish this goal. Moreover, it is not clear how health systems can best equip their workforces along with best practices to achieve a diverse workforce.

This study sought to assess efforts to improve D&I, as reported by chief executive officers (CEOs) of health systems across the United States. We argue that in addition to the talent and skills required for effective health care delivery, D&I needs to be part of the strategic agenda. Without this consideration, catering to the diverse needs of various populations will continue to present a challenge. This study thus explored the characteristics of US health systems and the perceived benefits of D&I. To achieve a diverse workforce in health care, health systems need to leverage different pathways. We examined factors that may shape those pathways to help balance talent and diversity. We also explored the associations between workforce pathways and both business and service benefits. Our approach will provide decision-makers with helpful practice and policy inputs [ 12 , 13 ].

Health Care Workforce Diversity

Health disparities are not homogeneous. Segments of populations are affected differently by different diseases. Accordingly, approaches and treatments may vary across these segments and thus require customized care [ 13 ]. Therefore, it stands to reason that a lack of diversity in the health care system can negatively affect patients. For instance, an Indian patient with traditional ethnic or religious values or a transgender patient may have needs unique to their circumstances and worldview. A diverse workforce in health systems should respectfully and knowledgeably approach and assist all patients with an appreciation of their values and needs [ 12 ]. Professionals from different cultures and backgrounds bring unique perspectives to share with colleagues and patients alike as they strive to better understand and respond to patients’ needs.

Alarmingly, when patients do not find providers, approaches, or treatments that echo or align with their beliefs, culture, or life circumstances, they are more prone to delay or avoid care. This problem is inherent in the current health care system. Patients from different cultures may perceive diseases and treatments differently. Greater diversity among health care workers will help reduce the barriers patients face when seeking care and contribute to better access and quality of care.

Prior research suggests that health care workforce diversity can improve creativity and decision-making while catering to multiple perspectives and contexts [ 14 , 15 ]. Specific to the COVID-19 context, research suggests that diversity-oriented leadership could improve employees’ knowledge-sharing, promote professional collaborations, and help reach marginalized and hard-to-reach communities [ 16 , 17 ]. For example, immigrant and refugee professionals represent essential resources that can provide linguistic and cultural services for their communities during and after the COVID-19 pandemic [ 18 ]. Greater diversity broadens traditional boundaries to improve care and patient satisfaction, and could prove helpful in managing stressful environments [ 4 , 5 ].

Employee engagement is also higher in organizations with diverse workforces [ 19 ]. As the populations served by doctors are becoming increasingly diverse, doctors need to adopt a more global mindset. Ensuring a diverse student body in medical schools will help future doctors broaden their perspectives and improve their understanding of D&I. Doctors from such schools will be better equipped to provide care in diverse environments [ 6 ].

Prior Work on the Value and Benefits of D&I

Valuing D&I in the workforce goes beyond the basic requirements of skills and capabilities. Prior research suggests seven categories of diverse attitudes and perceptions: (1) diversity sensitivity, (2) integrity with a difference, (3) interaction variations, (4) valuing differences, (5) team inclusion, (6) managing conflict over differences, and (7) embedding inclusion [ 20 ]. Diversity focuses on the makeup of a population or its demographics, while inclusion encompasses involvement, engagement, and integration into organizational processes [ 21 ]. It is vital to create a supportive environment that is diverse, respectful, and inclusive [ 20 ]. Such an environment eases the expression of dissenting opinions, is open to new problem-solving approaches, encourages innovative thinking, and more effectively avoids the dangers of groupthink, thereby opening doors for innovation and creativity-based organizational culture and business performance [ 22 ]. Diverse customers are often more loyal to diverse workforces and businesses [ 11 ]. Thus, through diversity, companies create organizational capabilities beyond their collective talents and skills, and can be more responsive to a comprehensive system of values and customers in a competitive marketplace [ 23 ]. To illustrate, a diverse and inclusive organization can potentially tap into the disposable income of African Americans in the United States, which reached US $1.2 trillion in 2018 [ 24 ], and the buying power of Asian Americans, which topped US $1 trillion in 2018 [ 25 ].

Although diversity has attracted substantial research attention, significant barriers and difficulties often accompany its implementation [ 26 ]. A workable approach begins with embedding inclusiveness in all aspects of an organization’s culture, starting with recruiting different races, genders, sexual orientations, national origins, and religions. It also requires a conscious shift toward a culture in which policies and procedures provide opportunities for all employees to excel [ 27 ].

Diversity goes beyond the traditional “black and white” [ 28 ]. In addition to addressing observable attributes of inclusiveness such as race, invisible attributes such as religion, values, and beliefs are also important features of organizational culture to promote inclusiveness actively [ 29 ]. For instance, gender differences in the professional workforce have decreased considerably. Women now represent 47% of the US workforce and 52% of all managerial and professional positions [ 30 ]. Technology-driven, gender-fair hiring processes in many organizations have contributed to this trend [ 31 ]. In addition to hiring more women to improve diversity, there is an increasing trend of better representation among racial and ethnic minorities, immigrants, and people with disabilities in the US labor market. A 2018 study by Accenture found that the US economy could grow up to US $25 billion if more people with disabilities were to join the labor force [ 32 ]. US regulations also require federal contractors to hire more workers with disabilities to avoid penalties [ 33 ]. There is a myth that hiring people with disabilities will cost more, which is a concern among organizations with low revenue levels. However, research has shown that more than 30% of the accommodations for workers with disabilities do not require additional expenditures, even after purchasing assistive technologies [ 34 , 35 ]. Nevertheless, valuing D&I must move beyond the surface or visible attributes to encompass different cultural and situational values and behaviors [ 36 ]. Ultimately, such efforts must become embedded within the organizations to be successful.

Firms outside of health care (eg, Apple, Google, IBM) recognize the benefits of diversity [ 37 ]. Research has shown that a discriminatory work environment can hinder an organization’s ability to build and equip the workforce it needs, leading to decreased productivity and performance. Conversely, proactively valuing D&I can attract the best talent and create an environment of belongingness and respect [ 36 ].

Health care workforce diversity needs to improve to successfully treat a greater variety of patients, from increasing care reach to improved satisfaction for racial and ethnic minority patients. Accessibility to underserved patients through a diverse workforce will bring health care closer to African American, Hispanic, and Native American communities [ 38 ]. Patients treated by physicians of their own racial or ethnic background are more likely to report receiving higher-quality care [ 39 ]. Improving access, care, quality, and reach all have significant implications for the long-term success of the health care sector in the United States.

Pathways to Equip the Workforce: Improve, Recruit, and Collaborate

What is the starting point toward greater workforce diversity? Undoubtedly, schools and universities are the formative platforms to inculcate D&I in young minds through examples, demonstrations, and practices [ 6 ]. Diverse classrooms broaden perspectives, promote active thinking, foster intellectual engagement, develop social skills, teach empathy, and improve racial understanding, all of which are essential for embracing diversity [ 40 ]. At the same time, organizations need to put more significant pressure on the education system to drive diversity. We consider three pathways to achieve this.

First, existing employees must acquire the necessary skill sets and diversity training. Programs such as “returnships,” in which experienced professionals take career breaks for training through professional and executive development programs, can help to promote and equip a more diverse workforce [ 41 ].

Second, technologies have made the recruitment process more efficient. Platforms such as LinkedIn and other social media avenues have become instrumental in finding talent. While health systems rely on traditional recruitment processes, using emerging channels to discover new talent could prove helpful.

Third, reaching out to and collaborating with universities can effectively expand the talent pool to recruit. This may start at the beginning of an education cycle, continue through projects and internships, and result in hiring from the collection of students engaged with the organization through these avenues.

For large health systems with diverse customers, a diverse base of employees is required. The revenue status of a health system can change its recognition of the direct link between diversity and performance. Major teaching health systems, as knowledge-based organizations, may have more proactive organizational cultures and reputations for openness, which will help them attract talent regardless of nationality or ethnic background. Macro factors such as increased mobility due to climate change and changing economic situations portend more women, more people of color, and more immigrant workers in the United States over the next 25 years [ 42 ]. To broaden recruitment to reflect the composition of society and the spread of business operations, organizations will need more women and people from different ethnic origins. In this context, understanding what health systems are doing to diversify their workforces remains an open question. In addition, due to social distancing policies implemented during the COVID-19 pandemic, digital transformations such as virtual teams and telehealth pose new challenges for collaboration. Diverse backgrounds among virtual collaborators, if managed well, can promote better learning to achieve more efficient outcomes [ 43 ]. Recognizing this potential will enhance remote working both during and after the COVID-19 pandemic.

The question remains as to which one or more of the three pathways mentioned above—improve, recruit, and collaborate—can effectively meet the challenges of D&I requirements. Identifying and assessing effective pathways will help instill appropriate plans in health systems. For example, explicitly valuing D&I will motivate organizations to develop long-term career plans to retain talent [ 44 ]. Organizations can better equip existing employees by developing internal training and education programs [ 20 ]. The critical element is an individual’s openness to change, which can be improved through training [ 45 ]. At the same time, it is also essential to recruit new employees, as having a diversity of work experience is a helpful way to refresh organizational culture. Finally, external collaboration with strategic partners benefits allying partners’ resources, including human resources [ 46 ]. This study further explores these three pathways to equip the workforce better—improving, recruiting, and collaborating—and their relative associations with business and service-oriented benefits.

The pathway model has been used in previous studies on diversity [ 47 ]. A common framework is diversity practices–pathways–performance [ 48 ]. Following this framework, we considered business and service benefits as the performance component. We examined the associations with three pathways: improving, recruiting, and collaborating. The two types of diversity practices are D&I strategy and talent strategy.

Data Collection

The effort to study the talent strategy in health systems is part of a broad project undertaken by the Health Administration Research Consortium at the Business School of the University of Colorado Denver. The idea of monitoring health systems emerged from observations and conversations with several chief executives of health systems during the COVID-19 pandemic. This research is part of the Health Systems’ Climate Study of 2021 conducted by the Health Administration Research Consortium [ 49 ]. The Climate Study aims to understand the current state of health systems in the United States following the COVID-19 pandemic. The objective was to collect and disseminate the insights of health systems’ CEOs to help inform policymakers, practitioners, and academic stakeholders as they collaborate to create ongoing strategies to help the industry respond to this pandemic and prepare for the next crisis.

A questionnaire was developed in December 2020 to collect data from health systems. We drew the survey items from prior literature, and questions were reworded to fit the health systems context. We sought input from knowledgeable researchers, consultants, and executives with the requisite expertise to design and evaluate the questions. The survey was pilot-tested, revised, and finalized in January 2021 with five top executives who are part of the Health Administration Program Advisory Board.

A contact list of CEOs was compiled from 624 health systems across the United States using multiple sources, contacts, professional connections, websites, and annual reports. The survey instrument was administered using a professional online survey platform, and was mapped to emails to the platform to create unique, trackable links for each health system. Email and phone solicitations were made in multiple rounds between January 25 and March 2, 2021. In addition, the authors called several CEOs and asked them to complete the survey instrument either online or in paper format. The researchers also requested CEOs who had participated in the survey to share the link with other CEO colleagues. A total of 148 responses were received, with a 24% response rate; however, 13 incomplete responses could not be used, leaving 135 usable responses. We address potential nonresponse bias in a later section.

The 135 health systems represented in this survey varied from 1 to 18 hospitals and from 176 to 75,000 employees. The annual revenue of the health systems in 2020 ranged from US $0.7 million to US $14 billion. The health systems represented US $300 billion in revenue and 1.1 million employees across the United States.

We then matched the survey data set with secondary data collected from the Agency for Healthcare Research and Quality compendium to construct a complete picture of the health systems. Our final sample included data from 124 health systems across the United States. We analyzed this combined data set, which yielded several important insights.

Variables and Measures

Table 1 describes the variables used in this study. The two constructs of health systems’ workforce strategy focus are D&I STRATEGY and TALENT STRATEGY. The two constructs of health systems’ benefits are BUSINESS BENEFIT and SERVICE BENEFIT. These variables were each measured using 7-point Likert scales. We also tested the internal-consistency reliability of these multi-item variables using Cronbach α. The four α values were close to or greater than the recommended acceptable threshold of .70 for exploratory research [ 50 ].

Description of variables, including survey questions and coding scheme.

a Responses reflect a 7-point Likert scale from 1=strongly disagree to 7=strongly agree.

b D&I: diversity and inclusion.

c AHRQ: Agency for Healthcare Research and Quality.

The three variables used to measure the pathways to equip the workforce by health systems were IMPROVE (ie, improve current talent), RECRUIT (ie, recruit new talent), and COLLABORATE (ie, collaborate with universities). This study’s other independent and control variables represented several categories: size, region, teaching status, revenue, and several other system characteristics. We coded these variables (see Table 1 ) to reflect the attributes of a health system.

The size variable measures the number of beds in a given health system (SIZE_B-SMALL, SIZE_B-MEDIUM, SIZE_B-LARGE). The region variable reflects the location of a health system (REGION-NE, REGION-MW, REGION-SOUTH, REGION-WEST). The teaching status variable assesses how a health system operates in association with a teaching program (TEACHING-NON, TEACHING-MINOR, TEACHING-MAJOR). The revenue variable measures the annual revenue of a health system (REVENUE-LOW, REVENUE-MEDIUM, REVENUE-HIGH). Finally, we included variables to capture the high discharge levels of the health systems (HIGH-DSH-HOSP), uncompensated care burden (HIGH-BURDEN-SYS and HIGH-BURDEN-HOSP), ownership status (OWNERSHIP), number of physicians (PHYSICIANS), and number of hospitals (HOSPITALS). Table 1 presents complete information about the variables in our study.

Sample Statistics

The descriptive statistics and pairwise correlations among the key variables used in this study are shown in Table 2 and Table 3 , respectively. As shown in Table 2 , health systems, on average, value a talent strategy for improving employees’ skills and capabilities more than a D&I strategy. The most popular pathway to equip a workforce is through collaboration with universities, followed by recruitment, and then by improving the current workforce.

Summary statistics of the variables (N=124).

a See Table 1 for variable descriptions.

Pairwise correlations among key variables (N=124).

b Values in italics indicate a significant correlation at P <.10.

In addition, to ensure there was no nonresponse bias, we compared the characteristics of responding and nonresponding health systems. As shown in Table 4 , the t test results for all comparisons indicated no significant difference between respondents and nonrespondents.

Characteristics of responding and nonresponding health systems.

a The numbers of physicians and hospitals are presented in this table in different categories for easy comparison across respondents and nonrespondents.

Statistical Analysis

We used ordered logit regressions to estimate (1) the relationship between specific hospital characteristics and workforce-strategy focus as well as diversity benefits, (2) the relationship between workforce-strategy focus and pathways to equip the workforce, and (3) the mediating effects of workforce choices on the relationship between workforce strategy focus and diversity-driven business and service outcomes. We used ordered logit regressions because the dependent variables are ordinal. This approach does not assume equal intervals between levels of the dependent variable. The ordered logit model is as follows:

where Y i * is the propensity of respondents to indicate higher levels of the dependent variables, X i is a set of explanatory variables, β a vector of parameters, and e i are disturbances (errors).

We do not observe Y i *; instead, we observe the ordinal dependent variable Y i . Depending on the values of thresholds or cut-off points τ m –1 and τ m , the probability distribution of Y i is as follows:

Ethical Considerations

An ethics review was not applicable for this study. The data used was received through a leading professional consulting firm that anonymizes and provides secondary firm-level data for research and analysis to draw insights.

Estimation Outcomes

The first two columns in Table 5 display the results from the ordered logit-model estimations that describe the relationship between contingent factors and health systems’ workforce strategy focus. The remaining two columns in Table 5 present the results on health systems’ diversity-enabled benefits.

Differences across health systems a .

a The results of the cut points are omitted for brevity.

b See Table 1 for variable descriptions.

c D&I: diversity and inclusion.

d Pseudo R 2 =0.0247 (n=124 observations).

e Pseudo R 2 =0.0298 (n=124 observations).

f Pseudo R 2 =0.0282 (n=124 observations).

g Pseudo R 2 =0.0401 (n=123 observations).

First, the results indicate that compared to small-sized health systems, medium-sized health systems are less likely to value diversity and inclusiveness in their D&I strategies ( P <.001). Conversely, large-sized health systems are more likely to value D&I strategies than small-sized health systems ( P =.002). There are some differences between health systems located in the Northeast and West, insofar as those in the West tend to focus more on diversity and inclusiveness ( P =.001).

Second, when the health system includes at least one high-discharge-patient-percentage hospital, it tends to value D&I more ( P <.001). The results also showed that high-revenue health systems seem to value D&I less than low-revenue health systems. In addition, health systems with a system-wide high uncompensated care burden tend to value D&I less.

These results differ from the estimation results of the contingent factors on valuing a talent-acquisition strategy ( Table 5 ). In terms of a workforce strategy focus, there seem to be no differences in health systems concerning size, ownership status, discharge, uncompensated care burden, and the number of physicians and hospitals. Region and revenue level yielded the most significant differences. The results indicate that health systems in the Northeast emphasize employees’ skills and capabilities more than those located in the South and West. In addition, compared to low-revenue health systems, medium- and high-revenue health systems tend to place less emphasize on a talent-acquisition strategy ( P <.001).

The last columns in Table 5 show the associations between health system characteristics and business and service benefits (while valuing D&I). The results of size and revenue were consistent for both types of benefits. For both business benefits ( P <.001) and service benefits ( P <.01), small-sized health systems tend to gain compared with medium- and large-sized health systems. Further, high-revenue health systems are more likely to gain both types of benefits than low-revenue systems ( P <.001).

We also found some differences between these two benefits across health systems. For the business, investor-owned health systems, health systems with medium revenue (vs low revenue), health systems with at least one high-discharge-patient-percentage hospital, and health systems with a system-wide uncompensated care burden tend to gain more benefits, whereas health systems with more hospitals are more likely to gain fewer business development benefits due to a diversity strategy. For service-oriented benefits, some differences were found according to region. Compared with health systems located in the Northeast, those in the South and in the West seem to gain fewer service-improvement benefits ( Table 5 ).

Table 6 shows the different relationships between the three workforce pathways and the D&I and talent strategies. The results indicate a significant and negative relationship between D&I STRATEGY and COLLABORATE, but a significant and positive relationship between TALENT STRATEGY and RECRUIT. The relationship between TALENT STRATEGY and COLLABORATE was significant and positive. The relationships between the two strategies and the IMPROVE pathway as well as the relationship between D&I STRATEGY and the RECRUIT pathway were not significant.

Workforce strategy focus and workforce pathways a .

a The results of the cut points are omitted for parsimony.

c Pseudo R 2 =0.0336 (n=124 observations).

d Pseudo R 2 =0.0940 (n=124 observations).

e Pseudo R 2 =0.0856 (n=124 observations).

f D&I: diversity and inclusion.

Table 7 displays the mediating effects of the three workforce pathways (ie, IMPROVE, RECRUIT, and COLLABORATE) on the direct relationship between D&I and talent strategies and the business benefit. Analysis of the mediating models using Sobel Goodman tests, which determine whether a variable carries (or mediates) the effect of an independent variable to the dependent variable (the outcome of interest), showed that overall, IMPROVE has a higher mediating effect (44%) than COLLABORATE (4%) and RECRUIT (7%) between a D&I strategy and business benefit. Similarly, IMPROVE has a higher mediating effect (13%) than COLLABORATE (5%) and RECRUIT (1%) between a talent strategy and business benefit.

Associations of workforce pathways and business benefits a .

c Pseudo R 2 =0.1209 (n=124 observations).

d Pseudo R 2 =0.1539 (n=124 observations).

e Pseudo R 2 =0.1391 (n=124 observations).

f Pseudo R 2 =0.1334 (n=124 observations).

g Pseudo R 2 =0.1638 (n=124 observations).

h D&I: diversity and inclusion.

i Not included in model.

Table 8 shows the mediating effects of the three workforce pathways (ie, IMPROVE, RECRUIT, and COLLABORATE) on the direct relationship between D&I and talent strategies on service benefit. Analysis of the mediating models using Sobel Goodman tests showed that overall, IMPROVE has a higher mediating effect (27%) than COLLABORATE (2%) and RECRUIT (0.05%) between a D&I strategy and service benefit. Similarly, IMPROVE has a higher mediating effect (26%) than COLLABORATE (0.06%) and RECRUIT (0.02%) between a talent strategy and service benefit.

Associations of workforce pathways and service benefits.a

c Pseudo R 2 =0.123 (n=123 observations).

d Pseudo R 2 =0.153 (n=123 observations).

e Pseudo R 2 =0.178 (n=123 observations).

f Pseudo R 2 =0.135 (n=123 observations).

g Pseudo R 2 =0.194 (n=123 observations).

Implications of Findings

Getting diversity right in the health care workforce remains a challenge, regardless of the widespread realization that D&I is critically important in this sector. Health systems lag in proactive plans, results-driven strategies, and subsequent implementations. Without these, the concept of D&I will be but a fad without any tangible results for decades to come.

This study explored the differences in D&I strategies across different health system characteristics. The findings suggest that health systems with fewer beds, those located in the western United States, with low revenues, with at least one high-discharge hospital, and a relatively low system-wide uncompensated care burden tend to value D&I more and are more likely to have a D&I strategy in place. Plausibly, these systems are driven by a focused strategy, locational alignments, and a manageable suite of complexities to instill D&I plans. Some of these differ from a talent-acquisition approach, indicating that health systems treat these two diversity practices differently. Regarding the diversity benefits, it seems that small health systems with comparatively high revenue have been able to gain both business- and service-related benefits; however, in other aspects of the health systems, the benefits vary across categories.

The most important contribution of this study has been to compare and contrast the three workforce pathways and their associations with benefits. The findings suggest that health systems that value only a D&I strategy may not rely on collaboration with universities to equip their workforces. However, health systems that value a talent strategy will look externally to recruit new workers and seek collaboration with universities.

While examining the pathways through mediation analyses, we established that the IMPROVE pathway is more effective than the RECRUIT and COLLABORATE pathways in enabling the diversity strategy to prompt business or service benefits. Moreover, these pathway effects go hand-in-hand with a talent strategy, indicating that both talent and diversity strategies need to be aligned to achieve the best results for a health system.

Limitations and Directions for Further Research

This study has some limitations that future studies may be able to address. For example, we did not focus on the effects of internal issues (eg, management, coordination) on diversity. Furthermore, the opportunities and barriers to diversity strategies should be studied in detail. Relating diversity to well-known aspects of health care delivery, such as cost, quality, and patient-experience outcomes, is also essential. We also need to note that the 22% response rate is not very high, although it represents the US health systems’ population. Increasing response rates and covering all health systems in a study will require significant resources, and we may perform such a study in the future.

The challenges and uncertainties that COVID-19 presented to health systems in the United States have been unprecedented. The pandemic has propelled many issues to the forefront, including diversity. It is time for health systems to address the diversity issue, which has been a point of conversation for more than two or three decades. However, little progress has been made to date, and few proactive strategies are in place, leading to a nondiverse workforce in US health care.

This study demonstrates that D&I efforts have numerous positive business and service outcomes. Regarding the methods to address the talent shortage, it seems that health systems that value D&I are less likely to seek external collaborations. This may be because external collaboration is not an effective way to promote D&I inside the health systems. A notable point is the importance of professional and executive training programs, and further education for instilling a D&I mindset, strategy, and pathways in a health system. This improvement pathway is beneficial for outcomes; however, diversity and talent-acquisition efforts must be aligned with recruitment to yield multiple benefits for health systems. Following these findings, our recommendations will help health systems establish a more diverse health care workforce and improve outcomes for a diverse population.

Acknowledgments

Our sincere thanks to the active and candid participation of the executives from 135 health systems. The authors thank Naser Shekarian, PhD candidate in the Computer Science and Information Systems Business PhD program at the University of Colorado Denver, for help in compiling chief executive officers’ addresses and for data collection in the climate study. The authors thank the Business School at the University of Colorado Denver for support for this project and, specifically, the Health Administrations and the Computer Science and Information Systems Business PhD Programs for the time and effort of the authors involved with this study.

Abbreviations

Conflicts of Interest: None declared.

Open access
Published: 23 May 2024

Integrating the social determinants of health into graduate medical education training: a scoping review

Nehal Nour 1 ,
David Onchonga 1 ,
Siobhan Neville 1 ,
Patrick O’Donnell 1 &
Mohamed Elhassan Abdalla 1

BMC Medical Education volume 24 , Article number: 565 ( 2024 ) Cite this article

Metrics details

The social determinants of health (SDH) play a key role in the health of individuals, communities, and populations. Academic institutions and clinical licensing bodies increasingly recognize the need for healthcare professionals to understand the importance of considering the SDH to engage with patients and manage their care effectively. However, incorporating relevant skills, knowledge, and attitudes relating to the SDH into curricula must be more consistent. This scoping review explores the integration of the SDH into graduate medical education training programs.

A systematic search was performed of PubMed, Ovid MEDLINE, ERIC, and Scopus databases for articles published between January 2010 and March 2023. A scoping review methodology was employed, and articles related to training in medical or surgical specialties for registrars and residents were included. Pilot programs, non-SDH-related programs, and studies published in languages other than English were excluded.

The initial search produced 829 articles after removing duplicates. The total number of articles included in the review was 24. Most articles were from developed countries such as the USA (22), one from Canada, and only one from a low- and middle-income country, Kenya. The most highly represented discipline was pediatrics. Five papers explored the inclusion of SDH in internal medicine training, with the remaining articles covering family medicine, obstetrics, gynecology, or a combination of disciplines. Longitudinal programs are the most effective and frequently employed educational method regarding SDH in graduate training. Most programs utilize combined teaching methods and rely on participant surveys to evaluate their curriculum.

Applying standardized educational and evaluation strategies for SDH training programs can pose a challenge due to the diversity of the techniques reported in the literature. Exploring the most effective educational strategy in delivering these concepts and evaluating the downstream impacts on patient care, particularly in surgical and non-clinical specialties and low- and middle-income countries, can be essential in integrating and creating a sustainable healthcare force.

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Introduction

The World Health Organization (WHO) defines the social determinants of health (SDH) as “the conditions in which people are born, grow, live, work, and age, that affect a wide range of health and quality of life outcomes.” These conditions are brought about by the nature in which resources, finances, and power are distributed locally, nationally, and globally and may include economic policies and systems, development agendas, social norms, social policies, and political systems [ 1 ]. SDH can have a significant impact on individual and population health. Studies have demonstrated that marginalized individuals and communities suffering discrimination have noticeably poorer health outcomes [ 2 ]..

There has been a clarion call to integrate SDH concepts for doctors seeking postgraduate training to equip future healthcare professionals with the appropriate competencies to tackle SDH-related factors at the patient and community level [ 3 , 4 , 5 ]. A critical understanding of the causes and impacts of SDH by doctors is needed to provide effective healthcare while offering adequate stewardship of limited resources and promoting health equity of the populations they serve [ 6 ]. Orienting medical training towards SDH is a significant step to equip physicians with the understanding, proficiencies, and attitudes needed to begin to address health inequalities [ 7 ].

Medical education regarding the SDH is crucial for future medical practitioners [ 8 ]. Besides potentially enhancing health outcomes for individual patients, physicians tackling these disparities will adopt the initiatives calling for changes to influence population and community health [ 9 , 10 , 11 ]. Thus, understanding social determinants of health requires a perspective shift for graduate learners, with the desired educational outcome being transformative learning [ 12 , 13 ].

Despite a growing understanding of the importance of integrating SDH into health professional curricula, the optimum approach to incorporating SDH teaching into undergraduate and graduate training curricula has yet to be clarified. A comprehensive guide for SDH teaching strategies would promote consistency in graduate training. A previous scoping review explored the inclusion of SDH in undergraduate medical curricula. The study highlighted the benefits of longitudinal curricula with community involvement in developing retainable knowledge and skills regarding SDH for medical students [ 14 ]. In 2019, a scoping review exploring the graduate curriculum interventions focused on SDH objectives concluded the insufficient physician training regarding SDH covers Canada only [ 15 ]..

This scoping review was performed to explore the extent of integration of SDH in graduate medical education curricula globally. The study objective was to explore the structure, content, training strategies, and evaluation methods used in incorporating SDH into training qualified doctors seeking higher medical training.

The scoping review was performed by searching four relevant databases – PubMed, Ovid MEDLINE, ERIC, and Scopus. The process was undertaken by standard scoping review methodology, including identifying the research question, identifying relevant studies, selecting studies, charting the data, and collating, summarizing, and reporting the results [ 16 ].

Formulation of the research question

All authors formulated the research question, guided by the WHO’s definition of social determinants of health [ 1 ]. The overall question: What has been published on the topic of the integration of SDH into graduate medical education curricula? Specifically, the research question focused on the content of the SDH teaching in the graduate medical curriculum, their presentation, teaching strategies, and program evaluation. It aimed to identify any gaps in the available literature to guide future research.

Identification of relevant studies, including the data sources and search strategy

Authors searched PubMed, Ovid MEDLINE, ERIC, and Scopus in March 2023. Individual search strategies were developed for each database, and searches were run for each database (Table 1 ). The search strategy was comprehensive to capture the diversity of the potential SDH integrated into the graduate medical education curricula. PRISMA-ScR guidelines [ 17 , 18 ] were followed, as illustrated in (Fig. 1 ). The study population consisted of medical professionals (doctors) in any discipline undertaking postgraduate training, including specialty trainees, residents, fellows, and registrars; the concept was the content of the curriculum used for teaching the SDH, with the context being graduate medical schools and training health facilities and institutes globally.

Identifying relevant studies

PRISMA flow diagram for the systematic scoping review of the SDH post-graduate training program

*Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers). **If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools. From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: https://doi.org/10.1136/bmj.n71 . For more information, visit: (38)

Two authors (DO, NN) reviewed relevant articles after the initial removal of duplicates by exporting the references to Mendeley Reference Manager [ 19 ]; articles were analyzed using Rayyan [ 20 ], an online software that helps with a blinded screening of articles. Two authors (DO, NN) then independently screened the titles and abstracts without limiting the articles’ publication dates, population, and study locations. The remaining articles underwent full-text screening, and a third author was called to arbitrate where there were differences in screening outcomes.

Inclusion and exclusion criteria

Articles were deemed eligible for inclusion if they focused on graduate SDH curricula, including fellows, registrars, trainees, and residents. Studies had to contain structural curricula to qualify for inclusion. Articles published in English between January 2012 and March 2023 were included in the current study. If the program did not intend to integrate the SDH in graduate medical education or did not indicate a mechanism for evaluating the curriculum, they were excluded from this review. Also, the following exclusion criteria were applied: undergraduate programs, reports, systematic reviews, pilot programs, unstructured programs, programs not focusing on SDH teaching, programs not in English, internship studies, and studies that focused on allied health programs such as nursing, public health, global health, dentistry, and pharmacy.

Charting the data

The main characteristics of each graduate SDH medical curriculum were detailed, including the discipline integrating the program, the program title, length, educational methods, teaching concepts, and methods of curriculum evaluation. In this stage, data from the selected articles were extracted to a Microsoft Excel sheet, and key information about the authors and year of publication was included.

Quality assessment tool.

Two reviewers (DO, NN) performed an independent quality assessment for each article. The Medical Education Research Study Quality Instrument (MERSQI) [ 21 ] was selected for quality appraisal of the included articles. The appraisal tools assessed the articles over six domains – study design, sampling, type of data, validity of the evaluation, data synthesis, and outcome. All the included articles had a score of 9 and above, which is acceptable.

The original search yielded 970 articles. A total of 141 duplicates were removed. In the initial title and abstract screening step, 829 articles were examined. A further 801 articles were removed upon applying exclusion criteria. The exclusion criteria were: unrelated to SDH ( n = 229), associated with undergraduate curricula ( n = 129), not curriculum-based ( n = 97), irrelevant ( n = 71), nursing curricula ( n = 62), related to public health and disease prevention ( n = 57), allied health curricula ( n = 50), considered with global health and elimination of global issues ( n = 25), internship ( n = 20), unstructured programs ( n = 20), social accountability ( n = 13), pharmacy curricula ( n = 11), dentistry curricula ( n = 9) and book chapter ( n = 8).

Only 28 articles met the inclusion criteria. The next step was a full examination of the 28 articles that met the inclusion criteria and whose focus was oriented toward the contents of the SDH in graduate medical education. At this point, we removed seven articles as they did not meet the quality assessment criteria.

A total of 21 articles met the inclusion criteria and were included in the review. A hand search through the references of the included articles yielded another four studies; three were deemed eligible for inclusion, and one pilot program was excluded. The final number of articles included in the review was 24.

Summary of the graduate SDH training programs

Of the 24 programs included in the current scoping review, 22 were from graduate residency programs in the United States of America(USA), one from Canada, and one from a residency program in Kenya. Almost 50% ( n = 12) of the articles were based on pediatric graduate curricula, while nearly 21% ( n = 5) were from internal medicine programs, as indicated in Table 2 .

Structure and duration of the postgraduate SDH training

As Table 3 illustrates, of the 24 articles analyzed, the duration of the program relating to SDH varied. Twelve programs had longitudinal modules, spanning one to 3 years in the postgraduate medical residency [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ], while five other programs spanned two to 9 months in the postgraduate medical residency [ 34 , 35 , 36 , 37 , 38 ]. Seven programs took between 2 weeks and 6 weeks [ 39 , 40 , 41 , 42 , 43 , 43 , 44 ], while the shortest program involved three online simulations; each simulation is 4 hours (one-half day) and completed during a module on advocacy [ 45 ].

The structure of the programs related to SDH varied across a range of thematic areas. A total of five courses had a focus on home visits and different community healthcare interventions [ 23 , 30 , 31 , 40 , 41 ], while another set of 10 programs was in the form of case-based workshops on a variety of topics such as prison healthcare, housing issues locating pharmacies and follow-up of patients after discharge [ 24 , 25 , 26 , 28 , 29 , 32 , 34 , 39 , 43 , 45 ] Lastly, nine programs focused on health advocacy topics, such as opportunities to integrate SDH at community health clinics, housing, education, and legal issues, integration of health disparities to clinical practices and equity, diversity, and inclusion [ 22 , 27 , 33 , 34 , 35 , 36 , 37 , 38 , 44 ].

Programs presentation methods

The approach to presenting the graduate SDH training and learning activities varied. All the programs used participatory learning, “where the learners are actively participating instead of being passive listeners,” as an educational strategy in combination with other teaching modalities. Eleven programs combined participatory learning with community placement and didactic teaching [ 23 , 24 , 25 , 28 , 31 , 33 , 34 , 36 , 40 , 41 , 42 ]. Another six programs relied on a participatory approach, with community placement and no formal lectures [ 27 , 35 , 36 , 43 , 44 , 45 ]. Three programs integrated didactic teaching and a participatory approach with no community engagement [ 29 , 37 , 38 ]. Another set of four programs included participatory learning only, requiring participant engagement, such as information gathering, group discussions, and activities [ 22 , 26 , 32 , 39 ].

Evaluation of the graduate SDH programs

All the reviewed programs ( n = 24) had an evaluation component in their curriculum. Six programs used pre- and post-learning evaluation surveys [ 24 , 25 , 30 , 32 , 35 , 38 ], while 11 programs used only post-learning evaluation surveys [ 22 , 27 , 28 , 31 , 36 , 37 , 39 , 40 , 41 , 44 , 45 ]. Three programs used thematic analysis of participants’ written reflections and interviews [ 26 , 34 , 44 ]. One program used both post-course interviews and participants’ reflections analysis [ 23 ]. One program combined pre and post-surveys with participants’ reflections [ 29 ]. Another program used pre-surveys and post-course reflections [ 43 ].Only one program evaluated the participants and the patient’s primary guardians’ views [ 33 ].

Five programs evaluated the participants’ affective learning, including their awareness, interest, and empathy combined with their level of knowledge regarding the SDH within the local context [ 23 , 29 , 31 , 42 , 44 ]. Another three programs used affective learning assessment solely [ 33 , 35 , 41 ]. One program adopted a comprehensive assessment on the three levels, including participants’ attitudes, knowledge, and performance [ 43 ]. Another program incorporated knowledge and performance as an evaluation tool [ 38 ], and one used the candidate’s performance as the main evaluation aspect [ 34 ]. Additionally, 13 programs only used the participants’ knowledge level as an evaluation indicator [ 22 , 24 , 25 , 26 , 27 , 28 , 30 , 32 , 37 , 39 , 40 , 41 , 45 ]..

This work details a scoping review of literature relating to incorporating the SDH in graduate medical training curricula. Notably, of a total of 24 included articles, 22 programs were implemented in the USA medical schools [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 45 ], with one program in Canada [ 44 ] and only one from a low- and middle-income country (Kenya) [ 22 ]. The evaluation of the programs varied on different levels; most programs performed post-learning evaluation only for the participants, and only one program added the patient’s perspective on the quality of service provided. The evaluation modules used need more clarity in reporting. The programs with extended training over the years reported a more favorable impact on the knowledge and the participant’s skills regarding SDH concepts. Participants favored training programs that blinded academic knowledge with community placement.

Paediatric training programs took the lead in training healthcare professionals in SDH. Other specialties, such as internal medicine, family medicine, and psychiatry, needed to be more proactive in integrating the SDH into their curriculum. Incorporating SDH concepts for all healthcare training is essential for weaving socially accountable healthcare into healthcare systems [ 46 ]..

Participants rated the SDH programs with a multi-year longitudinal structure highly. This finding agrees with other studies suggesting that spiral training programs improve trainees’ community integration, mentorship, confidence, knowledge in evidence-based medicine, patient-centred care, and reflective practice [ 47 , 48 , 49 , 50 ].. Our study found heterogeneity in each program’s content, as SDH factors can differ from one geographical location to another. The WHO study states that educators should apply a local context approach to tackle this issue [ 51 ]..

All the programs’ teaching strategies involved the participants in the teaching process, so-called “participatory learning.” The programs integrated academic knowledge with community placement and significantly impacted the comprehension of SDH concepts and their application in real-life situations. These findings correlate with studies emphasizing that combining theoretical learning with community engagement will enhance participants’ ability to cultivate an understanding of the core principles of the taught subject [ 52 , 53 , 54 , 55 , 56 , 57 ]..

Finally, most programs evaluated the participants’ knowledge level and confidence in recognizing SDH-related factors pre- and post, or post-program only. The reported evaluation outcomes included improved knowledge, awareness, and trust in dealing with diverse and underserved communities. Only one program interviewed the patients’ guardians and evaluated the care received by the trained physician [ 33 ]. This finding highlights a gap in program evaluation and the need to identify standardized criteria to monitor the success of SDH teaching in postgraduate curricula [ 58 ]..

Study limitations and strengths

The number of published articles demonstrating the implementation of SDH training in postgraduate programs is limited. This limitation is likely a significant under-representation of the innovation and scope of SDH integration into postgraduate curricula and again highlights the need for more high-quality literature assessing the effective incorporation, delivery, and assessment of SDH competencies. The scope of articles available in English primarily limited our study. The study focused on the programs including SDH teaching as a separate module not included with public health or global health. Our study is constrained by the unavailability of data from specific databases, which has restricted the scope of our research. Despite these limitations, our study has several strengths. Our study represents a pioneering effort in the field by conducting a comprehensive analysis of integrating SDH into graduate medical training programs. The significance of this research lies in its ability to shed light on the current state of these programs and identify critical areas for improvement. This study displays the heterogeneity of evaluation for such training programs and the deficiency in following the downstream impact of this training on patients’ health. These findings further support questions raised by medical education experts such as Sharma et al. (2018), who explained the importance of SDH teaching and the role of educators and training institutions yet criticized the focus on integration rather than evaluation [ 59 ]..

Implications for practice and future research

Our review has identified several future research implications; there needs to be more representation of the published literature about the topic in general and from low- and middle-income countries. The different expression of the SDH training programs by the developed countries’ training institutions may be because of the influence of The Accreditation Council for Graduate Medical Education (ACGME). The ACGME approves complete and independent medical education programs in the United States and Canada. The ACGME standards include addressing health equity and enhancing cultural competency through the taught curriculum of the accredited graduate program, which compels medical institutions to integrate SDH into their curricula [ 60 , 61 ]. This shows the critical influence accrediting bodies have on the content of medical curricula. As the United Nations (UN) stated in 2015, low- and middle-income countries face triple the burden of health issues and, therefore, creating a well-trained healthcare force and robust health system performance will decrease social disparities [ 62 , 63 ].

Integrating SDH into graduate medical education curricula is a dynamic and evolving area of research and practice. While the literature highlights the growing recognition of the importance of SDH education, it also reveals gaps in standardized curriculum development, assessment strategies, and long-term evaluation. Providing a multi-level structure approach for the methodology, implementation, and evaluation of SDH training programs will allow training bodies and institutions to integrate SDH concepts more effectively and produce a transparent blueprint for others to follow. Addressing these gaps will ensure that medical graduates are prepared to overcome complex SDH in healthcare.

Availability of data and materials

Data are available upon request by the corresponding author.

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Nour, N., Onchonga, D., Neville, S. et al. Integrating the social determinants of health into graduate medical education training: a scoping review. BMC Med Educ 24 , 565 (2024). https://doi.org/10.1186/s12909-024-05394-2

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Humana Ranks 6th Overall in Fair360 National Companies for Diversity

LOUISVILLE, Ky.--(BUSINESS WIRE)-- Humana Inc. (NYSE: HUM) has ascended to No. 6 on Fair360’s prestigious list of the Top 50 Companies for Workplace Fairness, marking its seventh consecutive year in the top rankings. This significant move up from No. 10 last year showcases Humana's dedication to diversity and inclusion, as recognized by one of the nation's most comprehensive analyses of corporate diversity practices.

Humana's culture of inclusion and belonging underscores its commitment to creating a workplace where all employees feel valued and empowered to excel. (Photo: Business Wire)

“Providing high-quality care for our customers is centered on our understanding of the unique experiences that shape their health journey,” said Humana CEO Bruce Broussard . “Advancing equity across the healthcare ecosystem relies on caring for diversity, equity and inclusion across all areas of the company. We remain committed to ensuring this work is part of every aspect of our business.”

Fair360’s Top 50 list is a highly regarded barometer of diversity management practices across corporate America, assessing companies with a minimum of 750 employees based on rigorous data analysis within their respective industries. Humana's high performance on the list is complemented by its strong showing on several of Fair360's Specialty Lists.

In 2023, Humana maintained its diversity, equity, inclusion, and belonging efforts, with key highlights including:

Continuation of cultural competence and awareness commitments, with nearly 100% of senior leaders in vice president roles and above completing cultural competency professional development.
Achievement of the highest percentages of BIPOC talent in Director+ roles at 22% and Women at 50%. Hiring through requisition for BIPOC talent in Associate Director and Lead roles reached 35%, while hiring through requisition for BIPOC talent for Director+ roles reached 26%.
Advancement of inclusivity through mentorship and sponsorship. Approximately 6,000 employees engaged in individual mentorship and participation in group mentoring programs like Catalyst’s Men Advocating Real Change Dialogue Teams (MDT) and Transformational Leadership for Multicultural Women (TL MCW), and the company launched a new sponsorship program focused on equitable advancement of Black/African American, Hispanic/Latino and female leaders from the senior management (associate vice president) to VP level.
Investment of approx. $360 million with diverse suppliers, representing 6.5% of the total supplier spend, and continued support for Humana’s Supplier Diversity Mentor-Protégé program.
Contribution of more than $160 million to philanthropic causes, with the Humana Foundation donating more than $5.3 million to support healthy emotional connections for seniors, school-aged children, and veterans. An additional $12.9 million funded 23 grants and 4 Health Equity Innovation Fund projects to advance health equity across the US.

“At Humana, we believe that every individual has a vital role to play in fostering a sense of belonging within our organization,” said Carolyn Tandy, Humana’s Senior Vice President and Chief Diversity, Equity, and Inclusion Officer. “By integrating diversity, equity, and inclusion practices across our company, we empower all employees to thrive and reach their full potential. Our commitment to celebrating diversity and creating an inclusive environment is deeply ingrained in our health-first mission, enabling us to better understand and care for the communities we serve.”

Humana's culture of inclusion and belonging underscores its commitment to creating a workplace where all employees feel valued and empowered to excel. The healthcare company's journey towards equity remains ongoing, steadfastly dedicated to advancing diversity and inclusion for employees, members, patients, and communities.

For more information about Humana’s diversity, equity, and inclusion goals and progress, please read Humana’s 2023 Impact Report .

About Humana

Humana Inc. is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell health care services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com .

About Fair360

The mission of DiversityInc is to bring education and clarity to the business benefits of diversity. The DiversityInc Top 50 Companies for Diversity list began in 2001, when many corporations were beginning to understand the business value of diversity-management initiatives. DiversityInc is a VA certified veteran-owned business and a USBLN certified business owned by a person with a disability. For more information, visit www.diversityinc.com .

Jasmine Weatherby Humana Corporate Communications Email: [email protected]

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