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Defining diversity beyond race: A discussion of diversity in medical education


Dean Y. Li, M.D., chief scientific officer and vice dean of research at University of Utah Health Sciences interviews Sidra Qureshi, a fourth-year medical student at Texas A&M Medical Center. Sidra believes that medicine can – and should – take a leading role in promoting diversity and expanding the definition of diversity in healthcare. Broadening our definition, Sidra says, will increase trust in the health care system, improve patient care, and potentially reduce waste and errors.

Qureshi: Not knowing about the culture leads to more catering of that culture. My name is Sidra Qureshi. I'm a fourth-year medical student at Texas A&M Health Science Center, College of Medicine.

Qureshi: These are the conversations happening inside health care that are going to transform health care. The Health Care Insider is on The Scope.

Li: I am Dean Lee. I'm a cardiologist at the University of Utah and I'm the Vice Dean of Research and the Chief Scientific Officer. Qureshi, tell me a little about your unique background.

Qureshi: Well, my background is interesting in that I actually grew up abroad. I'm an oil kid. I've been raised in the Middle East, traveled extensively and I have lived actually in DC and different states throughout the US.

Li: So oftentimes when people think of diversity, they think about, "How do I admit applicants from under-represented minorities, diverse cultures, language skills?" Is that how you're thinking about what we should be doing in diversity and are there other ideas that you think we should do for diversity?

Qureshi: I think it's important to look at diversity of thought. It's important to look at how people perceive diversity in a health care setting and being able to educate medical students and physicians to look at their patient interactions so that there is a curriculum in place allowing them to have a baseline understanding for the different diverse patients that they interact with. Because if anything is a diverse field, I would say medicine is forefront in that regards.

Li: So you're hinting at actually putting diversity training or culture awareness actually in the medical school curriculum? Did I understand what you're trying to lead me to?

Qureshi: I'm more than hinting.

Li: Give me some sense of what you would think would be an incredibly innovative idea to approach this.

Qureshi: Bring in people from those backgrounds. Bring in patients from those backgrounds and have them teach medical students. Have them teach residents about how their unique, diverse background plays a role in their health care and what as a physician someone needs to know about, let's say, someone with a certain disability or certain religious background or ethnic background.

Li: There's always a question of how much should we cater to that culture diversity and how much should we not cater to that.

Qureshi: Sometimes not knowing about the culture leads to more catering of that culture. I've actually been in situations where I personally am a Muslim. And I've had Muslim patients who tell me "It's Ramadan. I am fasting so I cannot take my diabetic medication." And from a Muslim perspective I say, "No, that is forbidden. You can't fast. You have a medical reason not to fast." So my education in that regards actually helps me to counteract their arguments better versus a physician that treated them the previous year, tried to accommodate the fasting, tried their best to help them through that.

Which is admirable but if they knew that the Islamic perspective was actually "You're forbidden to fast when you have a medical condition that can harm you." I think a diverse workforce will lead to better patient and physician interactions and I think that that will lead to better trust and will probably . . . I mean, I would hope that it would lead to reduced health care costs since that someone wouldn't feel the need to overly question, overly come in for excessive visits if they already have a baseline understanding and trust with their physician.

Li: What is the best experience you've had in medical school? You're a fourth-year now where you've sat there and said, "This is why I'm becoming a doctor."

Qureshi: A patient who I took care of for about a week plus, he asked me, "You're Muslim? Is that, is that true?" And I said, "Yes. Yes, I am." And he didn't know much about Islam, but he made a point to say, "You know, you have helped me to break down barriers and understand the positive role that Muslims have in our community." That there weren't many Muslims at the hospital and, "I appreciate you for that. I value you for that." So he was very . . . a positive reinforcement for why I go into medicine. I went into medicine to help others and to practice my faith. Healing is a part of faith in my opinion.

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