Honoring Excellence: Q and A with Teresa Y. Smith, MD, MSEd of SUNY Downstate Health Sciences University

11 March 2022

This interview is one in a series of interviews with recipients of the 2022 ACGME Awards. The awardees join an outstanding group of previous honorees whose work and contributions to graduate medical education (GME) represent the best in the field. They will be honored at the ACGME Annual Educational Conference, taking place virtually March 30-April 1, 2022.

SUNY Downstate Health Sciences University, located in Brooklyn, New York, is one of four honorees receiving the ACGME’s Barbara Ross-Lee, DO Diversity, Equity, and Inclusion Award in 2022. Dr. Teresa Y. Smith is the institution’s designated institutional official and serves as Associate Dean of Graduate Medical Education and Affiliations. She answered the ACGME’s questions about the outstanding measures this Sponsoring Institution has taken to foster diversity, equity, and inclusion.

ACGME: Can you tell us a little bit about your Sponsoring Institution? 

Dr. Smith: SUNY Downstate Health Sciences University is the Sponsoring Institution for 51 ACGME-accredited programs that educate and train 957 residents and fellows. The institution is located in Central Brooklyn, New York, with the College of Medicine being the only medical school in the borough. SUNY Downstate also compromises of the School of Nursing, School of Graduate Studies, School of Health Professions, and School of Public Health. SUNY Downstate trains its residents and fellows across various teaching hospitals in Brooklyn and the Greater NYC area, with the largest affiliation being at NYC Health + Hospitals Kings County Hospital Center, which is located across the street from the institution. The mission of SUNY Downstate Health Sciences University is to care for and improve the lives of our globally diverse communities, and to foster an environment that embraces cultural diversity. Our value statement is P.R.I.D.E., which describes our satisfaction in the work we do every day and to value our collective contributions to the Downstate community (Professionalism, Respect, Innovation, Diversity, Excellence). 

ACGME: Why is your institution so dedicated to the concepts of diversity, equity, and inclusion?

Smith: SUNY Downstate serves a community that is rich in cultural diversity within one of the most globally diverse cites in the world. Our patients, many of whom come from an immigrant background, comprise a wide range of ethnic and socioeconomic statuses. It is for this reason that SUNY Downstate regards diversity, equity, and inclusion as paramount in its mission to the community. We not only appreciate diversity, equity, inclusion in our trifold mission of clinical service, education, and research, but we practice it in every aspect of what we do on a daily basis, starting with the recruitment efforts from faculty members to residents to students. We believe our workforce should reflect the diversity of our patients.

ACGME: Can you tell us about the work for which you are being recognized with this award?

Smith: We have worked hard to organize efforts of diversity, equity, and inclusion as a fabric of our medical education across the continuum from undergraduate medical education to graduate medical education. We have several pathway programs that expose students to medicine and have even developed a program that guarantees admission into medical school. In graduate medical education, we have developed a Diversity, Equity, and Inclusion Housestaff Council, which has led the campus through several community engagement initiatives that have allowed our learners to serve as role models outside the walls of the hospital. Our research mission focuses on addressing health inequities that impact our patients. We have woven DEI into aspects of our curriculum; examples are the HEAL (Health Equity Advocacy Leadership) pathway for medical students and the community engagement requirement for the pediatric residency program.

ACGME: Can you explain what that work looks like?

Smith: An example of our UME programs is the BRIDGES into Medicine program, which allows participants of historically excluded and/or low socioeconomic communities to take MS1 courses and, upon successful completion, to enter into our medical school. Our GME DEI Housestaff Council has completed projects including a Food Box Distribution, giving out non-perishable food packages to those patients presenting to the hospital with food insecurity; a VotER registration campaign to help patients register to vote; the Health Sciences Academy where residents give science lectures to elementary school students, and a three-day Diversity Virtual Residency Recruitment Fair for diversity recruitment into our residency and fellowship programs. SUNY Downstate is also the academic center for the Brooklyn Health Care Disparity Research Center and the Arthur Ashe Institute, which has conducted community-centered research to address health inequities impacting our patients.

ACGME: How has this work helped make your institution more diverse and/or inclusive?

Smith: Diversity begets diversity. The more successful we are with our diversity recruitment efforts from faculty to trainees, the more we are successful in our diversity, equity, and inclusion initiatives and consistent recruitment into our schools and programs. We have recognized, as has been published in the literature, that having more doctors of diverse backgrounds improves the care of patients coming from diverse communities. In addition, having students and residents from diverse backgrounds improves the education and training of all residents. These trainees are also more inclined to continue to work in diverse, urban communities such as the one served by SUNY Downstate. In fact, SUNY Downstate produces the most practicing physicians in the State of New York. Our next step is to ensure that our clinical learning environments are inclusive and comfortable for all trainees; this was the focus of our annual Faculty Development and Resident as Teacher Symposium this February. The speakers discussed implementing equity across graduate medical education, the power of language when communicating with each other and patients, leading with love, building psychological safety into the learning environment, and how to address professionalism disruptions. We continue to strive towards excellence in diversity, equity, and inclusion in all aspects of education and training on our campus.

ACGME: How could others use your work as a model to become more diverse and inclusive? What advice do you give to GME leaders who are looking to do just that, but aren’t sure how to start?

Smith: Go beyond appreciating diversity and truly practice it. It starts with the recruitment of faculty members from diverse backgrounds. Residents, fellows, and students identifying as URiM (underrepresented in medicine) do not want to enter programs and schools as "the only." Along with recruiting faculty members, there needs to be supportive environments that fosters these faculty members' academic development, including promotions to leadership roles. Academic centers should weigh community engagement and DEI work as heavily as research for academic promotion so that these faculty members feel their efforts in DEI are supported in academia. Our GME has appointed an Associate Designated Institutional Official (ADIO) of Diversity, Equity, and Inclusion, Dr. Christina Guillen, to ensure that we have focused and organized efforts, and I would encourage other institutions to do the same, as well as supporting this role with funding and protected time. In addition, it is important to not only recruit a diverse workforce, but to ensure that our clinical learning environments are safe, comfortable, and inclusive for all. Finally, it is important that we all go the next step in DEI work and hold our institutions accountable through data collection on recruitment and other measures of health equity in patient care. This is our next step in the pathway to diversity, equity, and inclusion excellence.

Learn more about the ACGME’s Barbara Ross-Lee, DO Diversity, Equity, and Inclusion Award and nominate a deserving individual for the 2023 Award – nominations are due by April 6, 2022.