A Commentary on Equity, Diversity and Inclusion at Canadian and American Scientific Institutions

Recent world events have popularized the catchphrase equity, diversity, and inclusion (EDI). The University of Toronto defines these terms as follows: “Equity is the fair and respectful treatment of all people. Equity is the process; equality is the result. Diversity is the demographic mix of the community, with a focus on the representation of equity-deserving groups. Inclusion is the creation of an environment where everyone feels welcome, is treated with respect, and is able to fully participate.” While on paper these terms sound good, it is important to question who is writing them and their true impact. In the words of activist Angela Davis: 

“Virtually every institution [has] seized upon that term, ‘diversity.’ And I always ask, ‘Well, where is justice here?’ Are you simply going to ask those who have been marginalized or subjugated to come inside of the institution and participate in the same process that led precisely to their marginalization? Diversity and inclusion without substantive change, without radical change, accomplishes nothing. ‘Justice’ is the key word. How do we begin to transform the institutions themselves? How do we change this society?” 

Several instances of “surface level” university support for EDI played out across Canada and the US in the summer of 2020, in the wake of the police brutality protests following the murder of George Floyd. For so long universities have ignored the calls to stand against oppression on campuses, so the sudden institutional support for EDI was met by many students and communities with valid skepticism. For example, students criticized Queen’s University’s recent decision to designate 10 seats of their fast-tracked undergraduate medical program for Black and Indigenous students. As expressed by Iku Nwosu, Chair of the Black Medical Student Association Canada, “Despite the fact that no current Black or Indigenous medical students/ stakeholders were consulted prior to this program change being voted on, we have now been requested to participate in promotional photos for the website/ program.” This example is one of many that illustrates poor attempts in tackling the thriving beating heart of racism and anti-Indigeneity, without even beginning to delve into instances of sexism, ableism and anti-LGBTQ2S+ (Lesbian, Gay, Bisexual, Transgender, Queer, Two-Spirited) discrimination. However, oppressions and injustices are not new – what is new is the popularization of institutional support of EDI causes. It makes sense then that institutional statements can feel disingenuous. This is not to say they shouldn’t happen. They should, and in fact are overdue – but they are not sufficient. They must be coupled with actionable plans for moving forward and with genuine commitment to learning and unlearning internalized biases on a personal level by all university students, professors, and staff. 

So often EDI-promoting promises and initiatives can appear performative. While intentions may be good, the exclusion of certain members during the creation and implementation of such platforms renders such attempts more harmful than helpful. Insitutions have a responsibility to construct mindful goals in a collective manner that engages people not already at the table. Those with power cannot conduct EDI discussions in a silo, talking about what is best for someone else. There is a tendency for inherently privileged people to hold EDI discussions without first asking, “Who is at the table? Is anyone at the table being silenced?” Instead, universities should center community members and students in these discussions. Herein I want to say that I myself have an extreme amount of privilege. I am a white, cis-gendered female whose family financially and emotionally supported her through school. I, for example, am not the important voice in this conversation. I do not have all the answers for what should be done, nor should I. Rather, there are people who have devoted their entire careers towards these causes and who should be given massive amounts of credit. 

Ike Okafor and La Toya Dennie, both of whom work in service learning and diversity outreach at the University of Toronto (UofT) Faculty of Medicine, have worked tirelessly to set up programs for student engagement focused on relationship-building, community, and longitudinal support. The Black Student Application Program (BSAP) has made significant impacts on the number of Black medical students enrolled at UofT (from one in 2014 to >20 incoming Black students in 2020) by intentionally including members of the Black community and Black physicians, faculty members and students in the admissions process. BSAP has no quota to fill, and applicants are held to the same academic and professional requirements as other applicants. Rather, BSAP gives Black students an opportunity to share their life experience and ensures that alternative paths to medicine are valued and treasured. For example, students coming from a low socioeconomic background may not have had the opportunity to volunteer at the same capacity that a student with financial support would have. Valuing lived experience in working class jobs is one example of acknowledging accolades and experiences outside of the normalized expectation for pre-medicine extracurriculars. Okafor and Dennie also lead the Summer Mentorship Program, which provides Black and Indigenous high school students with exposure to the field of health sciences, skills-based workshops, and mentorship support. Meanwhile, the Community of Support program offers mentors to university students from underrepresented backgrounds. These programs allow both mentees and mentors to learn from one another, and for students to have access to support in the process of pursuing medical and health professions. This is especially important for first-generation students that are navigating the academic system on their own. These are just a few highlighted examples of change that can come from the hiring and support of people like Dennie and Okafor. Examples of such positive change will only increase as institutions recognize the value in the centering of marginalized voices. 

EDI initiatives must also go hand in hand with calling out the culture of meritocracy within science. What experiences and characteristics are valued, and used to judge whether someone gets hired or promoted? If we value international conference presentations, how do we reconcile the fact that some trainees have caretaking responsibilities or financial constraints that prevent them from travelling? What about brilliant scientists who are unable to spend as many hours in the lab because they have to work another job to support their livelihood, or have long commutes because they cannot afford city rental prices? Who receives the scientific funding to pursue their degrees? Where are large investments such as the University of Toronto’s recent $250-million Temerty donation spent? Even more insidious is the mental toll that oppression and discrimination can have on an individual. For example, a study by Samuels et al. in JAMA Network Open showed that US medical students identifying as lesbian, gay, or bisexual experienced higher rates of mistreatment and burnout compared to heterosexual students. How does racism, sexism, ableism, anti-Indigeneity, and anti-LGBTQ2S+ discrimination in the workplace affect someone’s ability to succeed? We must ask ourselves these questions constantly, otherwise there is no accountability. 

Among others, Dr. Alon Zivony argues that this pretend meritocracy is hurting the scientific field. If the gatekeepers of academia only value one sort of experience and measure everyone by the same metric of success, we end up with a homogenous group of people that, frankly, gets boring fast. A lack of diverse ideas, experiences, and professional backgrounds leads to less creativity and pushes science farther from the reality of what people experience day to day. That is the beauty of programs such as BSAP – if mainstream academia learns to value the alternative, there is a lot to be gained from varied perspectives and interdisciplinary work. 

Lam, Phillips, and Okafor write in their commentary for the Canadian Medical Education Journal: “In recent years, medical schools have recognized that achieving a diverse student body representative of the communities they serve is key to reducing population health disparities.” It is time for the same philosophy to reach academic research. For example, while the development of COVID-19 vaccines was a massive scientific achievement, mistrust of the scientific community has resulted in widespread vaccine hesitancy. Diversity in academia has become increasingly important as a means of increasing trust between the public and the scientific community. Diversity in life experience and educational background – particularly in humanities backgrounds – allows people to see gaps in research that those in the positions of privilege may not. Several advocates, such as Neha Malhotra, a UofT medical student, and Dr. Goldenberg, a philosopher of science at the University of Guelph, have noted that vaccine hesitancy must be reframed from an issue of health literacy, as it’s been traditionally thought, to a natural mistrust towards systems plagued by historical and present-day inequities. This perspective has proved to be very valuable in increasing vaccination rates. For example, Willy Nuyens, an environmental services worker for Kaiser Permanente Los Angeles Medical Center, helped increase the number of people in his department getting the vaccine from 20% to 45% by talking to his co-workers and reassuring them of their worries. As scientists, we have a responsibility to ensure that the work we do at the bench applies once we leave the confines of the lab. In this regard, intersectional and interdisciplinary approaches can only serve to benefit us. 

A Nature News Q&A article on the Twitter hashtag movement #BlackInTheIvory talked about how the influx of lived experiences of anti-Black racism shared by Black scholars on Twitter shocked some, “who said their eyes had been newly opened to the difficulties that their Black colleagues faced.” This statement in itself outlines how ignorant privilege can be. So often grassroots advocacy movements arise from the strength of communities that are advocating for themselves. It should not take a hashtag to get the attention of those with privilege, nor should it be upon those that the system works against to have to bear the brunt of fighting for their human rights. As Dr. Lisa Richardson, the Vice-Chair Culture and Inclusion at UofT Department of Medicine, eloquently Tweeted, “Bringing a critical, Indigenous, anti-racist, feminist analysis to the discussion means that you are often not the most popular one around the table. And so allies have a powerful role to play by amplifying ideas and deflecting/ containing/stopping the attacks.” We all have a responsibility to drive our own education, to search for resources readily available at the click of a few buttons and to resist the structural forces aimed at excluding and erasing particular narratives from the story of science. 


References:

Aca Duvernay. AVA DUVERNAY INTERVIEWS ANGELA DAVIS ON THIS MOMENT—AND WHAT CAME BEFORE”. Vanity Fair. September 2020.

[Twitter Thread] @IkuNwosu. Twitter. Aug 27, 2020, 12:55 PM.

Meredith Kolodner. “After George Floyd, students sick of ‘lip service,’ want action from colleges over racism.” USA Today. June 20, 2020.

Wendy Glauser. “Ontario emergency room chief who hired no women for 16 years resigns amid discrimination probe.” The Globe and Mail. January 31, 2019.

Seana Adams and Nelson Saddler. “Increasing Diversity in Medicine: The ‘BSAP’ Approach at the University of Toronto.” First10EM blog. July 6, 2020.

Liam Mitchell. “Encouraging high school students of Indigenous and African ancestry to see themselves here.” U of T News. March 13, 2015.

Alon Zivony. “Academia is not a meritocracy.” Nature Human Behaviour. 3, 1037. 2019.

Justin Lam, Chantal Phillips and Ike Okafor. “COVID-19: An urgent opportunity to decrease financial barriers to medical school admissions.” Canadian Medical Education Journal. 2020.

[Twitter Thread] @itsNehaMalhotra. Twitter. January 8, 2021, 4:31PM.

Sabina Vohra-Miller. “What good are COVID-19 vaccines if people are afraid? We need to build trust with racialized communities, specifically PSWs facing vaccine hesitancy.” The Star. Jan 8, 2021.

Thomas A. LaVeist and Georges C. Benjamin. “60 Black Health Experts Urge Black Americans to Get Vaccinated”. The New York Times. Feb 7, 2021.

Hannah Recht and Lauren Weber. “Black Americans Are Getting Vaccinated at Lower Rates Than White Americans.” Kaiser Health News. Jan 17, 2021.

“How #BlackInTheIvory put a spotlight on racism in academia.” Nature, News Q&A. June 2020.

[Tweet] @RicharLisa. Twitter. Feb 8, 2021, 5:15PM.

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Alexandra Florescu

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