Equity, inclusion, and diversity (EID) are core tenets of our internal medicine residency program and Kaiser Permanente. At Kaiser Permanente San Francisco, we serve an urban patient population with tremendous socioeconomic, ethnic, gender and cultural diversity. Thus, we seek residents from a variety of backgrounds, life experiences, and nontraditional paths with the goal of training the next generation of physicians to better reflect the needs of our patient population, including the health disparities and social injustices that exist today.
To meet these goals, we have made deliberate changes within our residency program, which include:
- Formation of a Resident Diversity Committee (including residents and faculty) to strengthen pipelines for outreach and recruitment to the program; improve equity and address health disparities in patient care; educate resident and faculty on EID resources, and examine the hospital and clinic environments to ensure an inclusive workplace.
- Participation in outreach efforts with organizations such as the Student National Medical Association and the Latino Medical Student Organization. We also host medical students in the Kaiser Permanente Introduction to Integrated Health Care.
- A commitment to a holistic review of applicants to support the pipeline of diverse physicians in medicine. We also have resident and core faculty-led quality improvement projects that seek to promote the recruitment of a diverse internal medicine resident workforce.
- Supporting and mentoring our residents from underrepresented in medicine groups. Dr. Sandra Torrente, Director of Medication Education, and Dr. Amber Wheeler, core faculty and subspecialty education lead, are active members in Kaiser Permanente San Francisco’s Equity Task Force.
- Creating and maintaining a tailored EID Curriculum to meet the current needs of physicians in training.
In response to the racial injustices in America, highlighted by the killing of George Floyd and others, our residency program is working to further explore ways in which we can address these inequalities as physicians. Our residents participate in a regional Kaiser White Coats for Black Lives, engage in safe space discussions to share personal experiences of racism and discrimination, and attend grand rounds presentations that specifically address health disparities, implicit bias, trauma-informed care, microaggressions in healthcare, etc.
We hope to cultivate a community of physicians and leaders with cultural humility who are engaged and dedicated to improving the health disparities and injustices affecting our patients.
In San Francisco, non-Hispanic whites comprise less than half of the population and nearly half of all households speak a language other than English at home. In addition to our patients with traditional Kaiser health coverage, we care for more Medicare patients than any other health system, many of whom have multiple complex medical conditions. Homelessness, substance use disorders, food/housing insecurity, and low health literacy are common challenges for our patients, which we work to address through a multidisciplinary approach in our fully integrated health care system.
We also think it is important that our residents experience other health care settings and thus encourage electives outside of our system. All second-year residents spend two weeks rotating in the emergency department at San Francisco General Hospital. Residents care for uninsured patients at the Clinic By The Bay weekly during their month-long Ambulatory elective, and next year, our residents will work in a community FQHC setting under the supervision of our Community Medicine fellow. Lastly, we encourage interested residents to pursue away rotations at other institutions or international medical experiences through the KP Global Health Program.