One Small Grand Rounds Innovation to Increase Equity
Author: Eileen Barrett, MD, MPH, SFHM, MACP
Keywords: manels, women in medicine, gender equity, DEI
The literature shows that most CME speakers are men – and that ‘manels’ are still too common. On CME planning committees, I have deliberately recommended speakers, who were outstanding clinicians, great presenters, and as diverse as the audience. Often the best presenters are those who have been overlooked due to implicit biases that we all have about who we perceive as experts and as leaders. Several years ago, I helped start a Grand Round Steering Committee in the Department of Internal Medicine at the University of New Mexico to provide more flexibility, more relevance, and more equity. What we did is scalable to other places, and I hope others consider following suit – and doing even better.
In once monthly grand rounds slots we introduced content outside of department subspecialties on addiction, health policy, and leadership, as well as on health equity, gender equity, and race and racism in healthcare and society. We invited experts from groups that are underrepresented as speakers, including minoritized people, trainees, and assistant professors. Through this deliberate approach, we achieved gender equity in presenters, had multiple assistant professors give grand rounds (which helped them in the promotions process), and had the highest representation of African American, Native American, Asian American, and Latinx presenters in the history of the Department.
Faculty and learners benefited from the content presented by diverse faculty, and also benefited from seeing diverse presenters as leaders and role models for us all. When speakers better reflect the diversity of the community, it can increase feelings of belonging and possibly reduce imposter syndrome among trainees and faculty. It also positively affects the learning climate by showing that we value expertise and not solely years in practice that is often misunderstood as aptitude or excellence in presenting when selecting speakers.
A final innovation in grand rounds was creating the annual trainee research symposium, where trainees submit abstracts and receive mentorship on giving a great presentation. When trainees serve as grand rounds presenters, we are highlighting that trainee achievements are valued and that learning is bidirectional between faculty and trainees. Presenting at grand rounds also provides another achievement on their CV, and since our trainees are more diverse than at many other programs, the new opportunities to showcase their achievements was a form of equity and justice.
Like everything that we do, inviting speakers can provide recognition and validation of people who due to personal and group identities are less often offered professional advancement opportunities. When we overlook diverse speakers, we miss out on their expertise and we risk perpetuating a glass ceiling and sticky floor that keeps minoritized people from the career recognition that is deserved. Reading about this one easy innovation, I’d like to ask you: what is your next step for supporting a peer or trainee in getting the professional recognition and career acceleration they deserve?
About the author: Eileen Barrett, MD, MPH, SFHM, MACP, is an internist in Albuquerque. She is a former Governor and Regent in the American College of Physicians, a multi-state District Chair of the Society of Hospital Medicine, and the Chair of the American Medical Women's Association’s Advocacy Committee (Twitter: @EileenBarrettNM)