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AFFIRMATIVE ACTION Boning Up on Diversity Report Raises Issues About Underrepresentation in Orthopedics Orthopedics has a reputation as a "happy field" in which patients' bones can be set, joints replaced, and cures achieved. The somber side is that orthopedics may be one of the most exclusive of medical subspecialties, with few minorities and women admitted to residency programs. Historically, heads of orthopedic departments, who have been almost entirely white men, have shown little motivation to change the status quo. Augustus White says diversity in residency programs depends largely on the program head.     "A lot of well meaning, intelligent males who are in power don't have any reason to have diversity on their radar screen or to think about it at all," says Augustus White III, HMS professor of orthopedic surgery at Beth Israel Deaconess. A new publication by White and his colleagues may help to change that. Diagnosing Inequality The report, which appears in the May Clinical Orthopaedics and Related Research, not only draws attention to the widespread racial and gender underrepresentation that exists in orthopedics—from a historical and personal point of view—but also provides reasons why it is bad for the health of the field and, ultimately, for patients. In addition to meeting ethical and legal standards, hiring more minorities could improve orthopedic practice in several ways.     To begin, minorities tend to make good clinicians, a point made by contributor Alvin Poussaint, HMS clinical professor of psychiatry at Judge Baker Children's Center. They tend to exhibit sensitivity to the suffering of patients, he says, possibly because they have had to overcome adversity in their own lives. But the inclusion of African Americans and other minorities also promotes empathy among residents of different backgrounds, which enhances rapport between them and their increasingly diverse patient populations.     In fact, health care facilities with diverse staffs are more likely to attract a greater variety and number of patients, adding an economic incentive to the mix.     But White is convinced it will not happen until department chiefs wake up to the need. "One thing I strongly believe is that if the chief wants to have a diverse program, there will be a diverse program. If the chief doesn't want a diverse program, you can throw all the money at it, all the politics, you can put it on the front page of the newspaper, but there is not going to be a diverse program," he says. A Rocky Career Path The report grew out of a half-day "consciousness-raising" symposium held a year ago at the annual meeting of the Academic Orthopedic Society, which draws many heads of academic departments. Because the society had previously hosted a symposium on women and orthopedics, White and his colleagues decided to focus on minorities. Contributors, nine of whom are HMS alumni and faculty, presented papers on the history and current state of discrimination. Some described their personal struggles as minorities making their way in the field. Others described the need for more open-minded practices in assessing a residency candidate's potential clinical success. Joan Reede, HMS assistant professor of medicine and associate dean for faculty development and diversity, described research showing that Medical College Admission Test scores and grades do not predict the quality of a physician, though they may predict grades in basic sciences during the first two years of medical school.     Driving home the raison d'être of the symposium, Claudia Thomas, the first African-American board-certified female orthopedist in the country, showed how the number of women and minorities in her department at Johns Hopkins increased dramatically because of a single department head's commitment to increase diversity.     White plans to republish the symposium proceedings as a separate report and distribute it to deans of major medical schools, heads of orthopedic departments, and other medical institutions. He is optimistic that it will have an impact. "Already there's been an extremely supportive response among the leadership of the profession to meeting this challenge—to making orthopedics more inclusive of women and minorities, " he says. —Misia Landau   Future Discussed, Past Honored in Affirmative Action Program Lisa Green, HMS Media Services Rosa Soler and Harold Amos receive the Medical School's first diversity awards. The May 24 program, "Reaffirming the Affirmative: A Recommitment of 30 Years of Affirmative Action at Harvard Medical School," brought William Julius Wilson to campus and debuted the HMS faculty and staff diversity awards. In his keynote talk, Wilson, the Lewis P. and Linda L. Geyser University Professor at the Kennedy School, answered those critics of affirmative action who call for a shift from race-based programs to ones based on economic class. He said research suggests that class-based affirmative action would fail to attain diversity. He urged instead the development of "flexible merit-based criteria" that would gauge individuals' potential to succeed, expand the pool of qualified applicants, and result in "affirmative opportunity." The two new awards that were announced, the Harold Amos Faculty Diversity Award and the Staff Diversity Award went, respectively, to Harold Amos, the Maude and Lillian Presley professor emeritus of microbiology and molecular genetics, and Rosa Soler, associate director of recruitment and multicultural affairs. Honored doubly by the faculty award—having it named in his honor and being the first recipient—Amos has worked to increase diversity at HMS since joining the faculty in 1955. Since then, he has volunteered with the Macy Foundation, the NIH, and other institutions in efforts to support biomedical education for underrepresented minorities. He has been a member since 1983, and for a period the director, of the Minority Medical Faculty Development Program of the Robert Wood Johnson Foundation. Soler, a member of the Office of Recruitment and Multicultural Affairs for five years, was cited for her "enormous sense of work ethic and commitment to increasing the diversity at Harvard, and her steadfastness in holding onto the intent of the faculty, students, and staff who were responsible for initiating affirmative action 30 years ago."   Back to Top