UC San Diego Embeds EDI into Foundation of PA Program

This month, our EDI team sat down with Elias Villarreal, Jr., DMSc, PA-C, associate dean and founding program director, and Boyd Hammond, MPAS, PA-C, director of admissions and recruitment, to discuss integrating equity, diversity, and inclusion (EDI) into the developing Atkinson Physician Assistant Education Program at the University of California San Diego School of Medicine.

The program has applied for Accreditation-Provisional from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA.) Leadership anticipates matriculating the first class in January, pending achieving Accreditation-Provisional status at the September ARC-PA meeting.

As the leaders of a developing program, they have the opportunity to weave EDI principles into the fabric of their program, from student admissions, faculty recruitment, curriculum, and more. While they provide a helpful guideline for developing programs, your program doesn’t need to be new to start implementing these EDI practices.

It all starts with the mission statement and defining what you stand for. Villarreal emphasized that centering EDI in your mission statement signals your values to potential students and prospective faculty.

UC San Diego’s School of Medicine Atkinson PA Education program’s mission is to “recruit and retain learners who reflect the diverse population of California.” Diversity should be defined by your program and can include lived experiences, diversity of thought, and more than just demographic markers.

This emphasis on the importance of EDI extends to their third program goal, which is to “recruit, retain, and graduate learners who reflect the diverse population of population of California.” In addition, their diversity statement underscores their commitment to attracting and admitting “culturally and cognitively diverse learners with the potential for clinical excellence, whose interests align with the mission, vision, and core values of the program.”

To ensure they stay on track, Hammond chairs the Justice, Equity, Diversity, and Inclusion (JEDI) committee.

As a public school in California, Proposition 209 has been in effect since 1996 and prevents UC San Diego and “other state entities from using race, ethnicity, or sex as criteria” in admissions. To ensure they live up to their mission, an array of strategies is employed to build a diverse incoming class.

Starting with targeted recruitment, Hammond hosts events for students from local Spanish-speaking schools in La Quinta and participates in conferences focused on individuals from underrepresented in medicine (URiM) backgrounds.

Within the application, optional custom narratives allow applicants to speak to their career aspirations, academic successes and challenges, and commitment to the program’s mission.

Removal of barriers such as the GRE and other entrance exams, unnecessary prerequisites, expiring prerequisites, required PA shadowing, more than 500 hours of healthcare experience, and a deposit to hold an accepted seat is key. By eliminating these barriers that disproportionately affect disadvantaged, underrepresented, marginalized, and systemically discriminated populations, they can focus on finding applicants from different walks of life that will find success in their program.

Recruiting and retaining a faculty and staff team that is aligned with their program’s values is an ongoing process. A similar approach to student recruitment is taken, as they ensure their job postings exist beyond the PAEA job board and are on relevant websites related to increasing diversity in medicine.

Within the application, prospective faculty are asked, among other questions, to provide a personal statement on diversity and how the applicant incorporates these values into their professional life. Hammond reflected on his own hiring process and recalled being asked to build a presentation on achieving a diverse student population in light of Proposition 209.

They also partner with UC San Diego’s Center for Faculty and Inclusion to broaden candidate pools, establish clear criteria for evaluating applications, and guard against biases in decision-making.

An anti-racist curriculum is at the heart of UC San Diego’s PA program. Through use of evidence-based best practices, such as the US-based Association for Prevention Teaching and Research’s anti-racism toolkit, they center on three interconnected components – making systemic oppression visible, recognizing personal complicity in oppression through unearned privilege, and developing strategies to transform structural inequalities.

Based on their sources, an anti-racist medical curriculum includes the following:

• Teaching the structural causes of racism and inequity, including recognizing, and addressing privilege, conscious and unconscious bias, and the concept of race as a social construct without genetic basis.
• Including eugenics and wrongs against ethnic minorities and other marginalized people in science and medicine in the history of medicine.
• Diversifying clinical teaching to include clinical signs on darker skin tones.
• Making “understanding and challenging the health effects of structural racism” an essential professional medical competency, recognized within the domains of good medical practice. 

For further guidance on how the University of California has historically operated in accordance with Proposition 209, click here. In what free time he has, Villarreal works with admissions staff at various PA programs across the country on how to integrate holistic principles into their admissions process. If you are interested in working with Villarreal, contact him at elvillarreal@health.ucsd.edu.