Improving equity and diversity in medical schools has become an urgent topic, however efforts to do so may be hampered by discrimination policies that don’t support minority students.

Dr. Javeed Sukhera, chair of psychiatry and the Institute of Living and chief of Department of Psychiatry at Hartford Hospital, recently published a study about how discrimination and harassment policies may be enacted by academic medical organizations.

“The idea for this research came from my work as an academic, to examine how are medical schools addressing discrimination in action,” Dr. Sukhera said. “It is important to see how policies are implemented to support people when they have negative experiences. We convened a team of experts from across Canada to analyze the data.”

The study, “Freedom from discrimination or freedom to discriminate? Discursive tensions within discrimination policies in medical education,” was published ahead of print in Advances in Health Sciences Education journal in January.

The research team found through their analysis many contradictions in policy discourse. The study found policies are often written to protect institutions or because they were required to do so, rather written with the intent to create inclusive environments. Policy language upholds the ideal of an organization free from discrimination, while making it difficult for those who experience harassment or discrimination to report or follow-up on their concerns.

When discussing implications of the research, Dr. Sukhera shared that there should be an accountability mechanism built into the policies, to see how policies are achieving desired results. He also suggested that organizations report policy outcomes more transparently and co-write policy with diverse stakeholders.

The study included data from 13 English language medical schools in Canada, of 22 publicly available discrimination and harassment policy documents that were active as of November 2019.

He said although there are some different dynamics in the United States, he thinks there is a similar general framework to these types of policies.

“We need to be writing and co-designing policies with those who are affected by it,” Dr. Sukhera said.

Usually a discrimination policy is designed by the organization itself, and they were initially modeled off of OSHA regulations, which were adapted around movements to bring attention to sexual and gender-based violence, rather than race-based discrimination. Dr. Sukhera said policies need to be updated to reflect these realities as well.

He said it is important to assess and help drive organizations toward change. He has heard from Canadian colleagues that they have distributed and discussed the paper with their organizations and are looking to update their policies.

“It depends on the organization, but as these findings are discussed more, more awareness is raised about the issues,” Dr. Sukhera said. “We need to use an intersectional approach to address gender and racial discrimination and update policies accordingly.”