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Pulse - Summer 2019 Destination Excellence: Recruit, Retain, Release

Leon McCrea, MD, MPH, program director, Family Medicine Residency, and associate professor, Family, Community and Preventive Medicine

Leon McCrea, MD, MPH, program director, Family Medicine Residency, and associate professor, Family, Community & Preventive Medicine

As a person who is underrepresented in medicine, I feel a responsibility to continue in an academic career so I have an opportunity to make an impact — to focus on programs that create opportunities for those who would otherwise not have them. I think of it as the three Rs at every level of medical education: there's recruitment, retention and then release (to the next level or goal after school).

The first step is creating an environment where you're able to recruit. That means increasing institutional awareness of the importance of efforts around diversity, equity and inclusion. Data show diverse groups are actually higher functioning. They have better outcomes, which are directly related to better results in patient care. One of the great things about Drexel's College of Medicine is that the spirit of its predecessor schools, Woman's Medical College and Hahnemann Medical College, continues in the commitment to access, community-based service, and leadership development for underrepresented groups.

You can't overstate the importance of optics. People make decisions based on nonverbal communication. People of color will decide where to apply based on what your website looks like. Are other people of color there? Does anything say there's a sense of belonging? I have African-American men in my residency program. But it's not a coincidence. I'm an AfricanAmerican man. The optics say, "This will be a safe place for me to train."

Being There

We do a number of things to support retention. The first is presence: being available, mentoring, offering shadowing opportunities, taking the time to form personal relationships. In the Office of Diversity, Equity & Inclusion, we connect students with physicians who are similar in some capacity. Creating an environment where students feel supported and encouraged is important because medical school can be incredibly isolating. The more ways we find for our students to engage and feel supported, the more likely they are to have better outcomes.

There are always going to be missteps. Another aspect of our job is supporting students so that a small misstep doesn't turn into something they can't recover from. That's where regular engagement becomes crucial. There are two phases to medical school: preclinical and clinical. It takes two very distinct skill sets to be successful in each. We focus on both areas because what it takes to succeed on a test isn't the same as what it takes to perform on the floor.

In terms of release, helping people achieve their goals not only helps with retention, it also puts them in a position to give back as they move ahead. Whether it's someone who wants to go into orthopedic surgery or someone who's looking for a new opportunity to do research, it's our mission to make those connections and to prepare them for their next step. I feel like we have a network across the country that extends from this school. We're never more than a phone call or two away from connecting any student with a mentor, adviser or colleague who can help them achieve their next level of success.

A number of factors, both active and historic, contribute to the challenges African-American boys and men face in making it through all levels of school. Some of those challenges are well documented — the history of oppression, barriers to access, lack of early role models. They continue to haunt this specific subset going forward. Another challenge is that many of the things young men receive positive feedback for in the African-American community are not the things that go along with long-term academic success. They are lauded for achievements in athletics, performing arts, acquisition of material things. Being a physician is all about delayed gratification.

African-American males are not a monolith, though. There's complexity in how we define African American in our culture. There are African Americans who are descendants of slaves. There are African Americans who are first- and second-generation immigrants from the Caribbean and from Africa. Trying to bolster the representation of all those groups, our focus has to be multifactorial. When we talk about early identification programs, pipeline programs, the Drexel Pathway to Medical School, and STEM, then we also have to talk about the importance of encouraging African-American male medical students to commit to careers in academic medicine. Where are your role models coming from?

Those of us who have the opportunity need to give back. We have to say: I'm going to serve on admissions committees. I'm going to allow folks to shadow me. I'm going to do community service. We have to advocate to break down barriers that affect how applicants are selected. What bias is there in college and medical school admissions tests? Is there a correlation between how someone does on their MCATs and how good they'll be as a physician? I'd say there's zero correlation between who I consider to be a high-functioning resident and how well they scored on their board exams.

Quality of Experience

Sometimes we equate underrepresented groups with poverty, inadequate education or lack of family support. I want to dispel those assumptions. Yes, it's important not to overburden people who are financially disenfranchised, but I don't want to characterize people of color as a group who can only matriculate at your institution if you give them a scholarship. What's more important is the quality of the educational opportunity.

Either way, we do need alumni support for our efforts! In addition to scholarships, financial resources can enhance what we offer in the form of pipeline programming, funded research opportunities, support for electives, and housing. How amazing would it be, for instance, if for every student going through our Drexel Pathway master's program, that year of graduate school debt was forgiven? It's harder to follow your passion when you're concerned about your bottom line.

I want to underscore that students are looking for quality of educational experience. So it is incumbent upon us to make sure that we are offering the best experience we can. What the College of Medicine is doing in terms of community-based work, the strength of our pipeline program and our efforts in the Office of Diversity, Equity & Inclusion are, to me, unparalleled.

— Leon McCrea II, MD, MPH
Assistant Dean for Diversity, Equity & Inclusion

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