Action is a simple word with multiple meanings. Merriam-Webster dictionary offers more than 25 nuanced definitions, but “a thing done” is the most basic definition.*
This new Bulletin column will highlight where diversity, equity, and inclusion (DEI) actions are implemented to improve a situation or solve a problem across the House of Surgery. With an emphasis on action, the column’s authors will share how DEI principles and practices have been applied in real-world surgical settings, and how these actions are developed with intention—to get things done with predetermined goals. This column’s aim is to raise awareness of the value of DEI and motivate readers to initiate and enhance DEI actions in their own careers, practices, and organizations.
This inaugural column highlights two examples of DEI in Action at the American College of Surgeons (ACS). One primarily serves ACS members; the other focuses on ACS staff. Both have resulted from ACS leaders activating the College’s stated DEI commitment and a call to action issued in June 2020 by the ACS Committee on Ethics and the Board of Regents. As summarized by Immediate Past-ACS Executive Director, David B. Hoyt, MD, FACS, the call to action recognized racism as “a public health crisis, resulting in health care inequities” and asked “all members of the organization to treat all patients, regardless of race, ethnicity, religion, or sexual preference with compassion, skill, and fidelity.”†
Grant for DEI and Anti-Racism
In 2020, DEI-related statements abounded from corporations and organizations across the US. Evidence of actions resulting from those statements has been less prevalent. The ACS leaders, however, promptly moved to ensure their actions had intentional aims and outcomes. The ACS Board of Regents appointed the Task Force on Racial Issues, which issued its report and recommendations in November 2020. A key recommendation that was swiftly acted upon was the establishment of the Regental Anti-Racism Committee (ARC).
One of the ARC’s objectives was to catalyze efforts of professional societies, academic departments of surgery, and surgeons in all surgical specialties toward the goal of advancing anti-racism, diversity, inclusion, and gender equity in surgery. In June 2021, the ARC announced the ACS Innovative Grant for DEI and Anti-Racism (DEI&A), a matching grant program focused on funding innovative and meaningful research projects and programs.
In November 2021, the ARC announced the grant recipients, with 10 primary investigators receiving a total combined award of $325,000. Each grant is for 1 year beginning December 1, 2021, with an identical amount matched by the recipient’s specialty society, institutional department, or practice. Seven grantees received $25,000 each, and three received $50,000 each.‡
Improving Opportunities for URiMs
Another definition of action is, “the most vigorous, productive, or exciting activity in a particular field, area, or group.”
These terms describe the actions that the ACS DEI&A grant recipients have undertaken. Four grant projects address some aspect of DEI in the surgical pathway to leadership.
For example, the Junior Faculty Promising Leaders Program, sponsored by the Society of University Surgeons and Association of Academic Surgeons, will produce a formal leadership development and mentorship program for underrepresented in medicine (URiM) assistant professors of surgery. The program will prepare participants for promotion to associate professor roles and leadership positions in their institutions.
Four other ACS DEI&A grants focus on developing curricula for different phases of surgical training. For example, principal investigators from the department of surgery, The University of Texas (UT) Southwestern Medical Center, Dallas, are working to develop and implement a structural disadvantage curriculum for the department of surgery trainees and faculty. Core to this work is the concept of structural competency, which the UT Southwestern department of surgery describes as the “capacity for health professionals to recognize and respond to health and illness as the downstream effects of broad social, political, and economic structures.”
A grant project from The University of Chicago, IL, department of surgery, has a similar focus: reducing structural and moral injury in patients and trainees by creating a new structural justice curriculum. The project’s principal investigators are designing the curriculum for medical students. One aim of the project is to understand the perspective of medical students of color on the structural challenges facing vulnerable patients in surgery and personal sources of moral distress.
All 10 of the ACS DEI&A grant recipients have made notable progress toward achieving their respective project’s intended outcomes. Over the course of the grant period, the Regental ARC and the ACS Office of DEI are coordinating with the principal investigators to help ensure the transferability of the projects’ outcomes.
ACS-Staff Anti-Racism Task Force (ACS-START)
On June 12, 2020, Dr. Hoyt issued a call to action at an all-staff meeting for volunteers interested in addressing racism. About a week later, the inaugural meeting of ACS-START took place, with approximately 50 ACS staff in attendance. ACS staff at all levels of the College met virtually to outline recommendations to advance DEI&A practices for ACS staff and operations.
Since then, ACS-START has continued to accomplish its objectives incrementally. The initiative began with forming 12 work groups, which have been distilled into nine:
- Access to Care
- ACS Values
- Advancement Opportunities
- Affinity Groups
- Behavioral and Cultural Change
- Education, Training, and Resources
- External Collaborations
- Safe Space
- Supplier Diversity
The ACS-START work groups regularly offer educational lunch‐and‐learns, disseminate information, and provide opportunities for staff to offer their input and contribute to cultivating an inclusive, equitable, and diverse ACS workplace.
Ongoing Effort
This inaugural column provided a brief overview of ACS activities related to DEI&A. Future columns will center on how the ACS is achieving these goals.
*Merriam-Webster. Action. Available at: Available at: https://bit.ly/3qmMEkC. Accessed February 28, 2022.
†Hoyt DB. Looking forward. Bull Am Coll Surg. July 2020. Available at: https://bulletin.facs.org/2020/07/looking-forward-july-2020/. Accessed February 28, 2022.
‡American College of Surgeons. ACS announces recipients of matching grants for innovative DEI and anti-racism initiatives. Bull Am Coll Surg. January 2022. Available at: https://bulletin.facs.org/2022/01/acs-announces-recipients-of-matching-grants-for-innovative-dei-and-anti-racism-initiatives/. Accessed February 28, 2022.
