 begin in just a few seconds. So I'd like to welcome all of you to the third weekly session in the second annual 2022 Tuskegee Harvard Black History Month bioethics series. I hope some of you had the chance to watch either live or it's on our YouTube site. The first two sessions, which were deeply inspiring. We're going to build from tonight. But before we get into tonight's session on towards health equity dismantling racist barriers for black health care students, there's some housekeeping I'll run through quickly. As is true for all the sessions, this event is being recorded. The event video will be posted on the Center for Bioethics YouTube page, which you can Google. I think that Ashley, our wonderful coordinator, may send a link to other people to all of you afterwards. But you can just Google and find that on the YouTube page, including the prior sessions. Any questions that you have, please submit using the Q&A feature found at the bottom of your screen. The chat function will not be used, except if you want to share comments or technical issues. Although some of our speakers or panelists may post some resources there in the chat. And if you're interested in upcoming events, news, education programs, please subscribe to our email list at the address right there. And then this is the third of four sessions. Next week, the last one, another great session will be on well-being and healing for future generations, including both leaders in mental health and psychiatry care in this country and also people working as teachers with students with younger people, because those fields are inseparable from each other if we're thinking about the future. So my name is Lachlan Faro. I'm a senior fellow in the HMS Center for Bioethics. I'm part of the core group with our Tuskegee colleagues that have been meeting every week, every Friday afternoon, and then organizing a number of events like our Black History Month series for the last almost two years. I'm going to do a very brief introduction because the last two sessions, which focused on history, were really providing background for today's session, which is going to be forward-looking. And on the screen, you'll see there the logo for the National Center for Bioethics and Research and Health Care at Tuskegee University, which the bird there in the center is the Sankofa bird. All of us, whether your skin color is like mine or darker, all of us, our ancestors we know, originated in Africa. So today, we're all distant cousins. And the Sankofa bird is an African symbol from Ghana of a bird, a mythical bird, but I actually think in real life it happens this way, that flies down to the past, finds precious things from the past, fetches them, and brings golden eggs or other things forward into the future. So as much as we've looked at in our Black History Month, some of the horrible, terrible evils from the past that we want to transcend, we also have learned from our inspiring people in the first two sessions about golden things in the past that we need to bring forward. Now, if any of these things are going to be brought forward, if the moment that we're in today that has so many people's attention is going to actually lead to the kinds of changes that some of us, when we were young, when MLK gave us, I have a dream speech dreamed of, but have not remotely close to happen as well as they need to, if that's going to happen, it's going to be through younger people that all the rest of us support. And so this session has been entirely designed, planned by current students. You see the names of the Student Planning Committee there, Jalen Benson, a Harvard Medical student I'd reached out to, Chloe Adams-White, some of you saw as the moderator last week, and the other names there. And I'm now going to just hand it over to Jalen. And he'll take you through this. I will warn Jalen, he knows this, that when Dr. Hajit Tuske found four of his great bioethics honors students, and I found Jalen and then two Harvard Medical students, I said, do whatever you want with this session. It's your session, so it's all theirs. My hope is that the session and what comes from that will build so that six months later, people keep talking about things that were launched from here. But I'm going to stop here and hand it over to Jalen because it's his and the student's session and our great panelists. So Jalen, introduce yourself and take it from here. Okay, well, good afternoon everybody. My name is Jalen. I'm a current third year medical student here at Harvard Medical School. And I've been thrilled to be able to help put this panel together. I'm so excited to introduce you all to our incredible panelists. I want to first thank the Planning Committee. We have Emma Hartzwick from Harvard. We have Chloe, who you all met before. We have Autumn, Sonia, and Jalen Spain. It's been an amazing collaboration working together and I'm so excited about this. Our vision for this session was thinking a lot about the barriers that black health students face as they're going through their careers. So our panelists today come not only from the MD world but from like other allied health professions world. So excited to hear from all of them. I'm going to give them a brief introduction and then they'll introduce themselves. One thing I do want to mention as I'll drop it in the chat is a resource repository. Because as we know our panelists have done amazing things but those of you all are here or may have heard about other amazing things. We want to make sure that you all can share that. And so I'll drop that in the chat shortly. It'll be a link to a Google forum where you can share any helpful documents or templates or programs that you all know of. And that'll be made available publicly on Tuskegee's website. And I'll make sure that we drop that in the chat now and then we'll drop it in the chat or in a follow-up email afterwards. But I want to give lots of time for our amazing speakers. So I'll go ahead and I'll introduce all the speakers and then I'll let them say hello to you. One of our first speakers is Jennifer Diaz. She's a rising third year medical student at the ICANN School of Medicine at Mount Sinai which leads efforts on implementing anti-racist initiatives, cultivating community and conducting clinical research on pregnancy complications and high-res and underserved groups. She's currently dedicating a scholarly year to design and implement and manage a Joshua Macy Foundation funded project with focus on developing institutional capacity for addressing racism and medical education. Before medical school, she earned her BA from Colgate in 2016 where she majored in biology and Spanish and she worked as a research assistant at Brigham Women's Hospital before she came to medical school. Actually, Janet, if you wanna go ahead and say hello. Hi everyone, Jen Diaz here. Such a pleasure to be here with you all today and thank you to Jalen and the rest of the planning committee for having me be here. But we're really excited for our conversation today. Amazing. And then we have Wilina Gould. Wilina Gould is the founder of a non-proof organization Diversity and Nurse Anesthesia Mentorship Program and a former chief nurse anesthetist. For the past 15 years, this organization has mentored 658 diverse clinical care nurses in a 92 into graduate nursing anesthesia programs. Dr. Gould also the lead consultant for the HRSA Workworth Diversity Grant for the University of Tennessee at Chattanooga Nursing Anesthetist Program. She served as the AANA chair of diversity task force from 2015 to 2016. Most notably, Dr. Gould was recipient of the 2019 American Association of Nurse Anesthetists Augusta Hodgins Award for Outstanding Achievement. And in 2021, Dr. Gould was inaugurated in the inaugural cohort as a fellow of the American Association of Nurse Anesthesiology. Presently she served as a vice chair on the American Academy of Nursing Diversity and Inclusion Committee. And she's a visiting assistant professor at the University of South Florida College of Nursing. Go ahead and say hello. Thank you so very much for inviting me to serve on this panel. I look forward to a very spirited dialogue with everyone. Thank you. Next we have Dr. Adobe Ekpezein. She's an MD BSN RN and a first year pediatric resident, former practicing registered nurse and advocate for health equity, racial justice and increasing the number of historically excluded students from health professions. Born in Oweri, Nigeria, integrated with her immediate family to the US and middle school, graduated from St. John Fisher College with a BS in nursing and worked as an RN at University of Rochester Medical Center for three years prior to starting medical school at SUNY Upstate Medical University in Syracuse. She's currently training at Harvard and Boston University affiliated programs in Boston Mass. She's had numerous leadership positions. Nobody she's served as a founding co-chair for the Health Justice Conference and was the first black president of the Upstate chapter of the Gold Humanism Honor Society. She's passionate about global health, mental health, medical journalism, use your social media to assist black fourth year medical students to be successful in the match process. Dr. Ekpeze, if you wanna say hello. Hi everybody, I'm so honored to be here. I'm calling in from St. Lucia. So in case there's any Wi-Fi issues, I will try to hop back on as soon as possible. Next, we have Drey Junzeng. He's a Chicago land native and a current M2 at Roslyn Franklin University. He's a bachelor's in biology from the University of Illinois, Chicago. He's currently the SNMA treasurer at his school's SNMA chapter as a passion for increasing African-Americans in medicine. His current special interests include emergency medicine, urology and radiology. Drey, go ahead and say hello. How's it going, everyone? Happy to be here. And then we have our final panelist, Tosen Owoyemi. She's a third year medical student at the Perman School of Medicine at University of Pennsylvania. She graduated with a BS in molecular and cellular biology from Johns Hopkins, where she called for their interest in minority mentorship, patient advocacy and health equity. At Perelman, she was the co-chair of the Student National Medical Association. She was a patient advocacy and education coordinator for the University Hospitals Coalition Medical Clinic, student member of admissions committee and a class council representative. In 2021, she received the Daryl Powell Award, Pricklincliffe Award and the women of color at Penn Graduate Student Outstanding Achievement Award for her consistent dedication to marginalized communities. Her future interests are in research, clinical care, advocacy and public health in the field of he-monk. She's published in the oncologist and plans to continue illuminating and addressing structural barriers and health disparities in her medical career. Tosen, if you want to say hello. Hi, everyone, my name's Tosen. I'm very excited to be here and thrilled to be part of this conversation, a very truly important conversation that I hope everyone kind of takes from tonight. Okay, wonderful. And then diving into our first question. It's a question for all of our panelists. I hope here from everybody you all can answer whenever I've ordered you please. The question being, tell us about your work and how you got involved effort to make healthcare more equitable and how it fits into other efforts that are being done. I could start. Again, I am the founder of the Diversity Nurse Anesthesia Mentorship Program. The thing is, is for me, before I even went into nurse anesthesia, I was what they termed a nontraditional student, right? So as an undergraduate student, I was a single mother on welfare prior to that, right? Three months right before enrolling into school, I was homeless for three months with my son, with my son. So with that said, as a first generation college student, I didn't know, there was no guidance, there was no mentoring going on. So I even went through a whole major, graduated, decided to go back to school for nursing. And I never looked back since that time. But the thing is, is that what I found as a nurse going into the operating room for the very first time, and I actually seen somebody was giving anesthesia. I thought they were anesthesiologists. I didn't know nurses can actually do that position and that job. So I ended up leaving the OR and then going right specifically into a unit, trauma unit to get the necessary experience to go right into a nurse anesthesia program, which I did. But I also found that in Philadelphia, there were not, how can I put it, a representation of faculty. There were six nurse anesthesia programs in the area. There were no faculty of color in any of those programs. And then to this day right now, there's only one. So the thing is, is what I wanted to do, what I'm doing was just a poster presentation of what I did at school, right? So, and basically what I did was I wasn't satisfied with the A that I received. I just wanted to do more. So anything I did was just by word of mouth. For some reason, nurses was finding out that I was giving out information to them about the nurse anesthesia profession, how to prepare for school, if you had a family and things like that. So for some reason, and even while I was in school and then after, that community effort became a regional effort. After I became a CRNA for a couple of years after that and chief CRNA, that community and regional effort now was a national effort. And basically what I did was I changed the face. It's not necessarily adequate or enough, just changed the face right now because of the result of the work that I've done for 15 years is now changing the culture. It is now changing the culture. And I'm very, I'm very happy about that. And it's just being intentional. It's just being connecting with nurses that look like us, making sure that we have relationships with program directors from across the country with our professional association with HBCUs because that's another arm that we do too. We intentionally go into the HBCU schools of nursing because I know as a first generation, I didn't know about nurse anesthesia. So I make sure when I go, it's very intentional that I bring at least 12 other CRNAs with me. And half of them will be black men because black men, for some reason, even though we only represent 3% of the profession out of 59,000, the thing is, is that I wanna make sure that black men are represented. There's more black women that are accepted in nurse anesthesia than there are black men. But there are black men nursing students. There are black men nurses that are out here too. So the thing is, is that for me, I just wanna make sure that relationships, diversity is all about relationship building. And that's what we need to do. And that's what we need to be, is to make sure that we have some sort of intentional effort into changing the culture as we stand now, because we should not be satisfied for what it is today. Thank you. Thank you so much, Dr. Gould. Tosen? Yeah, so I think in terms of like how I kind of got to where I am now, my why medicine has always revolved around health disparities of equity amplifying marginalized voices and marginalized communities. I think starting from when I was an undergrad, like I knew that I wanted to explore pre-med culture, but I didn't have any family members, any distant friends, close friends in the medical field. So I didn't really know what that looked like, how I would get there. And so during that time, I very much relied on those who were with me going through the journey, not necessarily knowing what was going on and how we're gonna achieve some of our dreams and our goals. And I think having undergraduate advisors and mentors who really sought out marginalized voices to help us and to connect with us on our journeys and promote our success within our medical careers was something that really fueled that same passion in me that definitely amplified my original goals of increasing minority representation as well as minority support and mentorship along that path. I continue to do that work at UPEN as well. And more specifically, during my first and second years as the Espiname Co-Chair, I was more so focusing on what we called our 17 evidence-backed initiatives for promoting racial equity at the Promen School of Medicine. And these were things that we really saw as marginalized students were necessary for our community to really demonstrate, not just talk about how diversity and inclusion and equity were part of their mission statement and part of their goals. This was increasing like retention and support for current students, because a lot of times we'll focus on the pipeline and increasing representation towards the field, but we're not talking about how we kind of support the people who are there, how we're continuing to promote the people that are there. Like Dr. Gould was saying, like the fact that they were like, I think you said one faculty member at that level. Right now we see that there are very low numbers of like black women associate professors and professors and like these people are coming in, but like where are they in the later stages? And so that kind of support for trainees was very important as well as kind of intentionally analyzing the relationships that we have with the community around the health system. All the times we'll see academic centers that are surrounded by communities that have some of the worst outcomes in like their whole stator and that whole area. And so what are academic centers doing to kind of improve that relationship and to better the community around them. And then finally just looking at how we continue to support once again still the generation that is coming in after us and how we continue to serve as a resource. And so those are all things that I wanted to create as well with the students that were co-leading with me a sustainable movement in that area rather than just like a moment of, oh, we're just gonna like put these things down and then kind of forget about it. This is something that we wanted to continue to grow on every year and for it to continue to be a large part of the culture even after we had left the institution. Wonderful, thank you, Adobe. Yeah, actually speaking of UPED, it's a very small world because my start with I guess more systemic level changes when it comes to health equity and medical school came after I went to this racism and medicine conference at UPED and I was just really inspired. I saw students, a lot of black students who were doing this work somehow found a way to get their institution to buy in to the conference and they invited just such brilliant people. And so I took that idea and was connected with another individual in my institution, Sydney, who was about that life and literally it was just about that life and we found other people who were about that life and we essentially all contributed to the start of the health justice conference at our medical school and it's just been amazing to see what happens when you really are passionate about something and you connect with like-minded individuals and you build on that momentum and moments where if you do have institutional buy-in and for me it was the support of my institution because at the time my medical school president was a black woman, I'm a Haitian woman to be specific and our Dean of Medicine was a Hispanic man and so it was like capitalizing on the time and who was in leadership, it was getting together with like-minded individuals and that started four years ago this past MLK day was our fourth conference and something that went from having 200 people registered during my first year is now over a thousand people registered and still completely student run and now we have gotten funding. And I'm saying that just to say like you really can't take an idea and it can grow and if you really keep going at it, it can really, really grow and to answer your second part about how I am joining efforts, other efforts for health equity. And my identity as a black woman, I'm proud of 2.8% of us in this profession and I think I've really had to learn that there is so much power in just me existing in my identity and that in itself it's a form of advocacy because in my identity my brain is wired to be more attuned to health disparity information to start to see better the cracks in the system and advocate. And because I'm doing that, that is contributing to the work that's already been laid for people before us. So this is a really good question and I'm glad that you posted like that. Drey, if you wanna go? So I'm currently the president of SNMA. So one of my big goals at my school is to use SNMA as like a platform to sort of attract more African-American students to our school. Currently in my class out of 189, there are only six African-Americans and then the class below me has the same number of 189 students and there's only one African-American in the entire class. So we have a huge problem with diversity at my school and I'm trying very hard to change that. I have joined like diversity boards to help with the admissions process of admitting more African-American students. Creating all these events through SNMA to try to get administration to see that these events matter with other students participating and also attracting other students who may be interested in my school to apply and hopefully facilitate them being admitted. Wonderful, thank you. And then Jen? Thank you. So all really, really great insights. I'll start from why I got involved to where I am now and so I would say that I started doing health equity work or advocacy work really from the first time I interacted with the health system being effort resilient on Medicaid from an immigrant family meant that I had to really fight for my family and what we deserved and what it meant to have our needs or healthcare needs met when one of my cousins actually delivered at 25 weeks. And so I think since that happened when I was in high school and a lot of my work I think in any institution that I've been in has really been around thinking about like what is my, what are my three feet of influence? So how can I positively influence whatever environment I'm in to make it better for the future and whether I'm part of it or not? I think that's kind of how I've always approached my education and so thinking about that through more of a health equity lens I've been involved in starting the maps chapter at my undergrad at Colgate here in medical school. I was involved in supporting students who are underrepresented in medicine through the pipeline both like mentoring high school students supporting applicants interviewing here at Sinai. I did health innovation work launching our inaugural pitch day to really think about how can you tap into some of the VC money to think about addressing some of the disparities and then also addressing some of the social needs of our patients in our student run free clinic especially at the first like the surge of COVID in March, 2020. And so I would say that, you know those first three months of the copent pandemic are probably what shifted my health equity work from being something that was very like this is my project and I'm working within my school to really thinking more systems level and more globally partly because when we were addressing a lot of the needs of our patients we serve about 260 patients. We were providing cash stipends as cash grants since most of our patients had lost their jobs. They were really struggling with rent and providing food assistance. And I think, you know we fundraise several tens of thousands of dollars which we blew through that money in three months. And we're really right at the same place, you know three months later. And I think for me it was a pivotal moment where I really started to see, you know so many of initiatives that we do are really looking at the tip of the iceberg and there's so much more underneath it that really needs to be addressed and are really the underpinnings of the structural piece of racism. And so to Dr. Gold's point around really thinking about culture a lot of my work more recently has been thinking about addressing racism and bias in your learning environment with Art and MedEd which is the anti-racist transformation in medical education which really focuses on building a community of practice of multiple medical schools, right? Because if we wanna see this change really at the systems level it has to happen in every medical school, in every state in the United States or wherever. But it's a part of Art and MedEd which I'll say for sure is really thinking about how do we do the change in a concerted effort, right? And really learn from and with each other because health equity we don't really know what that looks like. We can look at it as taking away the disparities but I think there's really a possibility to dream a little bigger in terms of what that is. And I think an example that's come up a lot is the idea that 60 years ago or 70 years ago no one knew what integrating or desegregating schools would look like but here we are. And that was something that we couldn't necessarily plan or control what that process looked like. And so I think really thinking about what health equity might look like in 2050, 60 years I think there's a lot of possibility there. Amazing, thank you all so much for kind of starting off in that way and setting the stage for us so well. Tosan, Jen and Adobe, like you all in my mind are some of like heroes for where I imagine like students and young trainees can be in terms of like making institutional action successful and making change at a level that like impacts a million institutions but the communities around them. I would love to hear from the three of you and whoever else wants to answer about what success has looked like for you when you were trying to make institutional change and what helped to achieve those successes. I guess I can start. Success for me has looked like whenever we've achieved increased funding to or something that bends the arc closer to justice and equity. Think success for me has looked like also getting this conference off the ground and really showing the power of student advocacy and student work. Oh, there's so much to be said about this. I am someone who I think some of my success were a combination of really good timing, courage and like I mentioned earlier, meeting people who were on the same tip and who felt hungry about doing something even if we didn't really know what that something was going to be. Just knowing that there's something burning within us and we wanted to act and that we would figure out the details later. And so just that idea of something's wrong, we don't, there's no formal way for us to talk about this inequities at our school. We found our own unique solution. And I really, I hope that inspires other people to know that you really can take that idea and make it larger than life and really shake up the way that your institution is doing things. And with that, like we had a huge focus on collaboration with the community. I'm someone who believes that researchers should be focused more on what the community members are saying that they need or what problem needs to be investigated. It's what's important to them or resources they're looking for. And then we take that idea and use our resources to make it happen. And so being able to collaborate with a lot of grassroots organizations in the conference and throughout our work in health equity has been huge because it keeps you very grounded in that the work is so much bigger than this institution or this hospital. And ultimately we're in this in service and the people we are serving are community members and they need to be just as intimately involved in the process as anybody else. Yeah, I 100% echo those sentiments. I think success for me has looked like, like was just mentioned, like students came together and discussed the problems that we saw pretty much at every level of our institution, whether that was directly within our institution, outside of our institution, the community surrounding our institution. We saw that there was obviously a need for change and maybe many of us didn't know exactly how we were gonna get there, but we knew that we wanted to take that moment to meet with administrators and kind of discuss our grievances as well as explicitly state what needed to be done next in order to continue to show that the institution was working towards these missions, statements and values that are constantly expressed and maybe even like that are currently used to kind of promote the institution itself. And so for us that look like necessarily talking about our medical education itself, as you mentioned, it's not gonna be just what happens within one institution, but it's gonna be what affects institutions across the United States, what affects patients across the United States and that really starts as well with what the trainees are learning and how they're gonna use that information to affect patient care, to affect policy, to affect whatever structures and sectors that they eventually work in. And so whether that is completely like reanalyzing our lectures and seeing why aren't we talking about healthcare disparities, but then the specialties that we having physicians speak about why aren't we talking about what ongoing efforts are and maybe a potential spaces where students can get involved in to address some of these concerns as well. And with regards to funding definitely like increasing funding for our marginalized students to build that social and that cultural capital by going to different conferences as well as increasing funding for pipeline programs and increasing funding for health equity projects. If you're not funding health equity projects like what are you necessarily expecting is gonna get researched and impacted on as well as funding experts in these fields. I think a lot of times we focus on like lived expert experiences and how that can impact our populations, but also like people who have studied this work who have done this work for years who have been building on this work. How do we integrate their voices into something that isn't new to them? And so success has looked like tracking these successes very specifically and seeing whether the institution is meeting metrics that were set and how they continue to see where they'll progress from each metric that is reached. Yeah, and I'll quickly just add in terms of successes like I had in the work when it comes to institutional change, are really that I think I have found a lot of not fulfillment but in really getting people to really realize that like the change that we're talking about is really about the week. It's not like Jen is asking for this or Tosin is asking for this or Jaylin, it's really like we're all part of the work and we will all be better for it. And really getting people to kind of engage with their heart and not have this be something that's just an intellectual exercise. So it's like I see the data but then don't necessarily see it how it translate to how they interact with their colleague or the staff member at the front desk or their patient in the exam room. And so just I think just really making the work personal I think for me has been more effective I think in some of my strategies to kind of straddle the line between like there's an ample amount of data that supports the need for this work but also really bringing in like the human piece and thinking about the relationships and how we collaborate together. And I think like concrete in terms of I think wins that we've had here at SINE, I would be having students who are usually you are and be recognized for anti-racism work. And so we were able to launch six stipend funded fellowships for this past year. That really is a way to recognize and compensate students for the work that is doing especially when we think about minority tax. And I think what's really beautiful about that example is that there were so many of my classmates, Jalen's friend Terrence is one of them who there was this like all hands in it wasn't just the SMA students, it was like our student council president, it was people that ran different student groups that were really that really saw that this was important. And I think that just it meant volumes in terms of not only seeing our humanity as colleagues and friends, but also really elevating the work as something that's really important to us all. And then when I was talking about Art and Med Ed or the community of practice across the 11 medical schools that we're working on, I think a big win was, so I helped write the grant to receive the funding and one of the requirements that we made in order to participate was that you needed to have student representation. So when you really think about the power dynamics involved in all of this work for it to really be anti-racist, there needed to be a little bit more leveling of that hierarchy when we think about who's allowed to make decisions, who has input in policy and decision-making at what point. And so I would say that was also a big win and it's been really impactful for me personally in terms of my own career trajectory. So I'd say those are the two big successes. Like hearing you all talk just gives me energy and excitement and I love hearing about the incredible things that you all have worked on and thinking about some of the other amazing work people have done on our panels, thinking about Dre and Dr. Gould. I know that you all have been really involved in pipeline programs and mentioned programs like that. I would love to hear about what you all see as some of the major successes of the pipeline programs that you've experienced and also what changes that you would make the programs to make them even more impactful. Dre and Dr. Gould. I don't mind starting it all with the work that I have done nationally it's basically the pipeline starts really honestly in high school. Now, do we go to the high schools? Many of us do that individually instead of going in groups but our efforts solely is mostly in HBCU, schools of nursing, Hispanic serving institutions, schools of nursing will go visit collectively together. So when we go to visit on campus, this is pre-COVID obviously, right? We launched it and that's the good thing about this. When you launch something, that doesn't mean that it's going to stop, that effort is going to stop, that effort will grow, right? So we launched this in 2016 going just to the HBCUs at Howard University School of Nursing. So we went there, I have brought my own anesthesia equipment that we received from a grant. Again, there was 12 Black CRNAs that came. We spoke to the nursing students, many of them too were also first generation college graduates. We spoke to them about the trajectory, the educational, the professional trajectory to go into nurse anesthesia. Then we had a Q&A with them because a lot of them, first time they ever met somebody from nurse anesthesia community that looked like them. That was important. Again, half of them were Black men that was with us. And then with the anesthesia equipment that we brought to the school, they were able to intubate, they were able to do spinos and epidurals on mannequins and things like that. So not only were we talking about the profession, now they were able to put their hands on the equipment. And now they can actually see themselves actually doing this at this point. So when we also told them the next steps, exactly what they needed to do, right? So that going starting from Howard University, went to, we went later on to Southern University, then North Carolina A&T, North Carolina Central, Compton State, Delaware State. We went to University of D.C. So we went to different institutions, Lehman College in, I believe this is in Brooklyn. That's a Hispanic serving institution. We went to University of Puerto Rico. So the thing is, is that we're very intentional in making sure that this happens. Now, another thing too, with the major focus that we do is just nurses interested going directly into nurse anesthesia. And that is the nurses of color that are going, that are interested in going in. And I usually have a weekend event that's again pre-COVID announced all Zoom. But this same format, right? I invite four different program directors from different schools from across the country. I have maybe four or five sessions each year. Invite them, they present to nurses that are interested in nurse anesthesia from across the country. Then they hear from nurses of color who are either military that's given anesthesia in military or they are in specific specialties or will present on something else about maybe how to actually balance nurse anesthesia, especially if you have a family because a lot of us do have families and we have concerns about that. Like how do you go to graduate school and you're going from two incomes to one income or one income to no income? And you're totally relying on loans. How do you survive that? How do you actually do that? Especially when right before COVID that second day we would have an all day airway workshop and they would be on campuses across the country. And again, nurses had their hands on the equipment. They would check in the anesthesia machine, they were doing, they were working on the mannequins. They were able to socialize with us. And then after that weekend was over it wasn't an information dump and just saying good luck. The thing is, is that I know that some of them are prepared to put the applications in within three months and then they're ready to go. Some of them are like, well, maybe financially I'm gonna just wait a year and that's fine too after they've just come into the session just so they know exactly what to do. But the thing is this, once that application goes in before it goes in, what we do as a free service is that we have pre mock interviews. So we'll have mock interviews with somebody that lives in California that's trying to get into a program in Texas or somebody that's from Florida that's trying to get into a program in New York or something like that. So the thing is, and also too we'll have personal statements and that's free review. We'll review that before they submit. Once they are, they're prepared, they have the interview, they're accepted. Now we're gonna do is we're going to introduce them to nurse, nurse anesthesia students that's currently enrolled into that particular program whether it's Columbia University, Duke University, University of Miami, Texas, Christian University. We have a huge network now of those that are currently enrolled or that graduated from the programs. So now they have, their network has now increased. Again, they were just like me, first generation college graduate didn't know a soul but once you get into the diversity, nurse anesthesia mentorship program all of a sudden your network has increased with those that actually went before us. So the thing is too, right now as they graduate from nurse anesthesia programs become CRNAs. Now here's the culture part of it that's changing. The culture part of that is changing is that now these CRNAs are becoming chief CRNAs. They're becoming clinical coordinators. They're becoming faculty now in nurse anesthesia programs. They're going back to school for their PhDs. They're becoming now fellows of the American Academy of Nursing. They're becoming now fellows of the AANA which is our professional association. So that changes the culture. That changes the culture, you know. It also is very important too that we increase those in nurse anesthesia that's in pain management because we all know that there's racial bias when it comes to communities of color. So we got to make sure that we are present, that we are trained, that we are going into communities and making sure that we have pain management services for our people. And the thing is, is that this is necessary and this needs to happen. We also know that there's a black maternal mortality. The highest rate is with black women. And the thing is, is that we need to be, we need to make sure number one, as we're training in OB anesthesia that that content also includes black maternal mortality. Like, what are we doing about this? What is going on? What can we do even after we become CRNAs to make sure that we're present in this as well? And the thing is, is that we have to be very, very intentional. So when I say changing the culture it's not just the part that we're doing. Right now it's the institutional change, right? So a lot of this has to do with making sure that these institutions, these nurse anesthesia programs, 124 of them are very intentional when it comes to making sure that they adopt anti-racist policies, right? So the thing is, and that yields racial equity if they do that. For example, for, and to go into some of the majority of the nurse anesthesia programs at this time you still got to take the GREs. With some nurses of color don't want to go into a program that accept the GRE. They'll go bypass that all together, go directly, you know, go into another program. But if you find that the ones that do have the GRE they're the ones that have the less, they have less representation of nurse anesthesia students of color, the ones who don't have more. So the thing is, is that we can do, all of us on this panel can do everything that we are just describing and it's necessary, but it's also necessary for the institutions to make that change also. It cannot be on us, it cannot be on our shoulders to change what's going on systemically in the healthcare profession. So thank you. My journey to medical school was actually through a pipeline program and my school, we have a program called the Post-Marticulation Program. So basically we take medical school classes and then if we do well, we are granted an interview and then if we do well on that, we are granted admission. And I thought it was great. It gave me a taste of what medical school would be like in our florist and my cohort florist as well. I think the positive thing is that it shows that untraditional students or students who may struggle academically can still flourish in medical school. I know plenty of people who have done the same Post-Marticulation Program that I did and they are all not only, not only do they flourish in medical school but they all match into every specialty that they want, ranging from surgery to interventional radiologists to family med, to OBGYN. The list goes on. So we have set a tone that people who do this post-marticulation program typically do well. I think it's kind of interesting that majority of African-American students from that attend my school are from this post-marticulation program. So although I do see it as a positive, I see it as a negative as well, just because I feel like a lot of these students did not need to do this program. I felt like they were recommended to this program as just a way to see if they were really good enough based on their race. Because I think there is a stigma in medical school that African-Americans struggle a little bit more than other races. And I felt like that was just a way of, creating another barrier for people to get in. So I definitely want to make sure that people who are getting into the program are actually people who come from maybe an academic challenged background or some form of disadvantage versus people who typically have those scores and marks that they could be able to matriculate into a regular medical school. And also I want to, at my school, I want our program to be more well-known. A lot of my professors and even administration had no idea what our program was. And that created a lot of barriers as well as, typically about getting resources for people in my cohort who are participating in this program. So I think more awareness outside and inside of the institution needs to happen. Do you mind if I just add on something? I know that you said that you were one of nine out of 139 students, correct? One out of six out of 180 students. Right, and see, and that's another issue too because not just in medical school and nursing school and graduate school, when you're at an institution such as that and that has that type of representation, what we experience is a lot of social isolation as a result of just that competition alone. And sometimes also too, not sometimes, but many times, we also experienced the microaggressions as well. And that's why it's vitally important that the diversity of the co-student cohorts are consistently increasing every year, that the diversity of the faculty needs to increase as well. Because the thing is, is that even with the program that I have, like for example, there's a nurse anesthesia student that I'm thinking of right now who's out west in the nurse anesthesia program. And he's the only black male in the nurse anesthesia program, but he's introduced to five other black men CRNAs across the country. And he's also introduced to other black men nursing, nurse anesthesia students from other programs across the country. So that at least that social isolation is starting to decrease significantly a lot more. So that he can progress in the program himself. So I think it's important that this needs to happen in medical schools as well as nursing schools too, so that that network is there, even though you're not represented, you still should have someone from either another institution to be mentoring. Thank you so much for those comments. I feel like this panel with people like you all flies by so fast, there's so much to learn and so much growing to do. So this is the closing question that I will have. And then we'll start doing questions from the Q&A section. So if you have questions, add them into the Q&A. We will not be able to get to all the questions from the Q&A, but I'll make sure they're shared in the chat so everyone can see the question that I've been asked to help poke thought and understanding, but just so that you all know. So the kind of closing question that I wanna ask is what do you all think the next step are in this work that you all been doing? Like what new ever do you wanna see going forward? And also think about people who are on this call. We have program directors, we have deans, we have professors. What do you think specifically people on this call can do support the work that you all are doing and support black students at their institution? And to be specific, we're gonna start with Jen for this question. I'll start with the hardest question. Thanks, Dalen. So I would say that I'm a big believer in and in bulk. So I don't think there's one specific area of work that I think needs more attention than others, but I would say the biggest things are, I guess, focused more on people in process as opposed to the content of what exactly needs to change. So it's more along the lines of not looking at health equity as something that's a task and that you can just check off. And that if I met my recruitment numbers for underrepresented students in my incoming class this year, that it means that it's done and I've reached diversity in my student class. I think we've elicited a lot of information around there needs to be support for those students and what happens next year and the year after that and what's really the culture that we're bringing the students into. And so I really, I guess, urge, or even where my brain is at in terms of this work is thinking about how can I bake in health equity into everything I do? And so how can it be part of my decision-making, my clinical reasoning, how I interact with my classmates and my professors or my teachers? And the second thing would be, don't be afraid to take the time to do it right. I think there's a lot of sense of urgency around like, this is such a problem and we need to fix it. But there's, I think that the sense of urgency while it gives it importance and emphasizes the need for it to be done, I think also, I think tends to push people to kind of rush through thinking through all the possible ways that we can approach different solutions to what we're talking about today, whether it's pipelines, the disparities that we actually see in terms of health outcomes and just culture at institutions. So I'd say make room for the conversations and the difficult conversations. Invite people into the room, but again, just big it into every day. Because I think doing the work every single day, considering that this is our lifelong work, we will not solve racism tomorrow. It's something that we each need to do. And so just encouraging people to think about what's something that you can do in your day to day to practice anti-racism. Thank you so much, Dr. Ibiza. Yeah, ways to support black medical students. One thing that I've learned from my institution was when it came to financial support for any type of initiatives that's either increasing the number of historically excluded students or advocating for change for inequality, what was lacking was that financial support, right? And we understand it in the context of white supremacy, capitalism and white supremacy go hand in hand. And so with that, for me, if an institution wasn't contributing financially and there were means to contribute financially to whatever issue that was trying to be solved, then their heart wasn't really into it, right? And so I think one way, if I was a student right now, how I'd like to be supported is, you know, I think having some type of funding and not taking students' agency away by deciding how funding should be delegated, right? People are coming from different backgrounds. They have different needs. Somebody might need money just for groceries and might not need academic support. Somebody might need money for your world and might not need money for groceries. You know, like people have such unique needs. I think a lot of times we fail students by not asking them what they need. And yeah, those are my thoughts on that. And I agree, Jennifer, that this work is lifelong. It's not gonna be fixed tomorrow. And with that, I really want to emphasize the need to also have rest as a product of, or as a model of productivity within your model of doing this work, because you'll burn out very quickly if you don't. These are issues that not only affect us individually, but affect pretty much everyone that we know within our own identities. And it's important that you realize when it's time to step away for your own health. And when your company isn't full, because you won't be doing your best work that way. And it's okay to exist in those two worlds in which you're prioritizing yourself. And when you've prioritized yourself enough, you then have some to give to it to work. Thank you, I hear you. Dre? As a current medical student, I think the financial support piece is huge just because there's so many things that we have to pay for outside of our tuition, whether that be for test prep materials, tools, rent, groceries, travel to rotation sites, travel to away rotations, travel to interviews, technology, the list goes on. I think that is a huge, huge thing. And also the social support is critical. It could be as simple as asking a black medical student, how are you today? Checking in on them, making sure they have access to the resources that they need. Because social isolation definitely has affected me and my institution very negatively. Being one out of, six out of 189 students combined with COVID, I was very isolated. And you can't really go through medical school alone. You need someone where that, whether that is to like study with or to practice maneuvers with, it's a very hands on interactive curriculum. So to have to go through that alone is very damaging both academically and mentally. So I definitely would encourage anyone to look into like the local medical schools around them to see what are the numbers for diversity because we definitely should be representing more. There are more than enough qualified African Americans that are able to successfully matriculate into medical school and successfully graduate into any specialty that they want. Which is why that is my passion for increasing more African American students in medical school. Troy, thank you. Dr. Gold? Yeah, I just wanna say something. I think for the next steps, I think it's vitally important that the mentorship is there present for those that are in HBCUs, that's interested in pre-med or nursing. But it's not just about mentoring, it's making sure that they're professionally socialized before they even enter the School of Medicine, before they even enter the School of Nursing. I think it's important that that happens. For example, I know that there's something that just happened, it was just announced yesterday or day before yesterday. There was a program right out of the University of Pennsylvania School of Nursing. I believe there was a $125 million grant that was going for nurse practitioners. If you train and go to school there, the tuition is going to be paid for through this grant, but you would have to promise to work in underserved areas. Now, just imagine if you were a nursing student of color applying for that grant, knowing that you wouldn't have to have that increased debt, going into a profession that you want to go in, that you already knew that you were gonna be serving in those same communities, but that debt is raced. And I just wish there were more schools such as that that was actually doing something like that. So like I said, our work is what we're doing is necessary, but it's the institutional side of what are they going to do to make sure that we are getting the education that we need in order to advance our careers. That's fine, but it's that debt level too. We need that needs to be addressed as well. So the thing is, is that it's necessary for both of us to do our work, all of us to do our work, but it's also is vitally important that the institutional side needs to change as well. Thank you, and then Tosen. Yeah, so I guess I'm focusing on next steps for kind of cultivating this environment for a historic excluded students and seeing how that they progress obviously to physicians who will have impact in the fields that they work in. I think we often, like as I wrote in the chat, we often talk about the leaky pipeline and how there are multiple steps along the way where we kind of notice that our systems, our institutions are failing students, trainees, faculty members even in their work and promoting health equity and diversity. I think that looks like the institution's kind of understanding what I call like the myth of meritocracy in which they kind of feel as if, oh, like, yes, we've defined, you know, unfortunately society has defined that it's this academic paper and like this number specific like contributions that are gonna determine like who is valued in our institution, who is valued in our community. But that really is very much an institution decided aspect. And so if the institutions are truly prioritizing a community kind of centered approach and community success and opportunity and access, then their resources will also be directed towards the individuals that are making those impacts, individuals that are looking into those areas and having interventions that are affecting those areas. And so I think it really looks like, honestly pestering the hospital administrators institutions to kind of like put their money where their mouth is in terms of kind of prioritizing those decisions within their community and within their health populations. And once again, like even going back to what was said earlier, like a lot of us were kind of finding our ways as we made these steps into like these large projects. And so like Jennifer was saying, like just making one step at a time can get you to where you need to be in the future and can kind of be that pathway towards, not necessarily like achieving some certain milestone but reaching and kind of progressing towards health equity, racial equity. And these are things that it can seem larger than life and larger than us. And like I said, one day at a time is what's gonna chip away and make that difference. Thank you all so much for your amazing words. And I'm excited now to kind of go to some of the audience questions. I know they've been inspired and excited by some things that you said. The first question I wanna go to is from Dr. David Hodge. Dr. Hodge says, I like Adobe's word, courage. It's interesting that one would need to be courageous about basic things in the 21st century. What challenges have you come against that have forced you to be courageous in this work? Has any challenge pushed you to a particular sacrifice or protest? Which I'm sure some of that all of you could speak to the challenges in this work. Whoever wants to start off, Cam. I know in the work that I have done initially when I started, now I was in school in 2002. So there was no social media. So we didn't have this as a forum, if you can just imagine. So right out of graduating from the Sally University and the North Santa Cesar program, it took a huge risk on my part to even speak out about this. Cause there was no diversity champion during that time. So I got a lot of pushback at, and now 15, 17 years later, and I have nurse entities programs knocking on the door. Can you have a diversity event at our school that wasn't necessarily acceptable the first five years especially? For some schools, we weren't even allowed to go onto their campus. They said they didn't have room for us, which was fine. I mean, I just kept going. And that even meant that I had to do it at my own church. I had to do that. But guess what? The nurses still came from four states to just that event within that five year period. Because I think, like I said, this is work that is necessary. This is something that we need to do. But it does take a lot of risk and a lot of time and effort. And all of this is a time element with this. It's not going to change overnight, but still you need that commitment from someone that's actually going to make sure that it happens. So, but the thing is, is that taking that risk, I just basically, I don't even want to say risk. I just put this, I stepped out on faith. And just, I knew that this is the lane that I was going to be in professionally for the rest of my life. And this is what I was going to commit to. And I think this is very, very important for any of you that's on the panel, that whatever you do is that you commit to this is very genuine with what I'm hearing from for you. And I think just from this panel alone, it's just, I'm inspired about your career, what you're going to do in the impact that you're going to have on this community. So, I'm really excited about this. And Adobe, that question was kind of coming off a quote that you made. And I know you commented that you wanted to expound even more. Yeah, you know, one of my mentors in medical school, her quote that she always said to me was do it afraid. And what that really spoke to for me was that there shouldn't be an expectation to be fearless in order to act that that is professionalism at its worst and not realistic. And she was saying, it's totally okay to have fear while doing this. And for me, I understood that the work that I was doing, either within health equity or any other social justice work, like I mentioned in the comment was poking a bear. The bear being white supremacy, the bear being tradition at my institution, the bear being continuing to perpetuate this inequalities and me speaking out was really poking a bear. And that for me meant that I was a target in many ways, right? I'm grateful because at that time, like I said, I had administrative support from people who had real institutional power to protect me. And that shielded me a lot from some of the retaliation, but I can't imagine if I didn't have that in place because I know at any step, they were waiting for me to mess up or have some type of like academic issue in which that can somehow justify pushing out of the school. And that threat is real. And I always kept that in mind that like, yes, I'm really passionate about speaking up, but understand that there could be a price, there could be a real price that included leaving medical school. And I just had to do it afraid and be okay with the idea that something could happen that negatively affects me because of me speaking out. And the floor is open, the Toast Center, Jen or Drea talk about other challenges that you all may have in times where you have to be courageous in this work. And we also have more questions. So we'll go on to the next question that was asked by an anonymous attendee, but that Tosen began to answer. And so I want to invite her to make sure that she has a chance to answer anyone else. It's a question that's very fundamental. It's asking, where do you think the lack of representation comes from of Black students within healthcare professionals? I know I have strong thoughts on the ideas, but panelists who would love to hear from you starting with Tosen. Yeah, so I kind of mentioned this in my comment as well, but I think that the lack of representation isn't in from one area in particular. I think there's like multiple aspects along the way in which the system is failing, underrepresented trainees and underrepresented, like I said, even full physicians and faculty. I think often we'll see that maybe people aren't having mentors and allies and advisors early on who, unlike Dr. Goldworth saying, aren't just the mentor aspect, but also like the sponsorship aspect and like promoting those people for specific opportunities that are gonna get them to that next level, not just saying, hey, you got this, you're good at this, for getting them those opportunities. I think that makes such a strong difference. Additionally, I think as trainees, we're also looking to those above us to see, how are they being treated in the system? How are they being supported? Is this a system where I feel like I'll be able to be supported and have the impact that I'm looking to make? And so I think that also looks like focusing a lot on retention of the people that we do have here and promotion of the people that we do have here. So that looks like valuing, when we say we value health equity work and community engagement, actually truly valuing that and funding that and supporting that and awarding that, those are all things that people who are like making those next steps are looking at and saying, oh, okay, like I could be this person and if I'm this person, like I'm gonna be valued within my institution and I know that I'm gonna be supported in the activities that I'm trying to promote within my institution and within my community. And I think that makes all the difference for even the person in that position to take that back and mentor and sponsor the people below them because they know that those who were gonna be in their shoes one day and they know those who were gonna be supported just as they were. So yeah. The question is also open to anyone else about what do you think the lack of representation comes from for black professionals in healthcare? I'll quickly add that I think there's also so many like historical events that have happened that include like the Flexner report which is the closure of majority of historically black medical schools that would have educated. I mean, there's some data on that. That's like we would not be where we are today if a lot of those schools were still open. And so it's structurally there's just so many barriers that are put in front of students that keeps them from reaching medical school or attaining this or really seeing this as a profession. I think that's completely by design. When I look at some of the stats even in my like incoming class I think like 70% of students have physician parents. And so there's a lot of social capital and hidden curriculum. They think that's involved in the pathway that isn't always talked about. And I think Tosin really touch on a lot of those really eloquently, so I won't expand too much but I think that there's a lot of structures in there and policies historically that I think have also been influential. And if I could just add that for particularly in nursing and especially going into nurse anesthesia as a specialty. We meaning black students in high school, black students in nursing school. For many of us, again, we're a first generation college graduates, a lot of us did not, we're not exposed to nurse anesthesia so we don't know or we'll find out much later on as a nurse that this is a possible career opportunity but the thing is, is that, and I don't think I've heard anybody saying anything about gatekeeping and all of that but the gatekeeping when it comes to even trying to get ICU critical care positions sometimes that's even difficult because even if you go to a hospital and the higher the floors you go to the more critical the patients are the less diverse nurses that you have. So that means that who are these nurse managers hiring these nurses, right? So you have that you got to deal with. And then you have on the other flip side of nursing school and especially nursing anesthesia programs who's on the admissions committee. Are we meeting the criteria? Are we, do you have structural barriers in place and things like that? So a lot of that contributes to the lack of diversity when it comes to student cohorts especially in nursing programs. And I'm sure the very same thing when it comes to medical schools from school, school industry and pharmacy trying to diversify the healthcare profession. Thank you so much for that. And also thank you, I'm Adobe for bringing us the facts and the data which always is so important on the comment posted made about the flexing report. The last question I have is gonna be once again for everyone on the panel. As well, as well, I hope you can see now there are other questions that we didn't get to but I want to make sure everyone can see the questions that were asked and what people have been thinking about. And also as we've heard about the amazing things these panelists have done, we'll be emailing out office this reshapes repository whereas if there are panels or presentations there's like work that's been done that you all wanna share and make available for more students, more people who access in the future, please submit that in there. And everything that's submitted will be made available on Tuskegee Center for about at the website for people going forward in the future. But the final question that I wanna ask is recognizing that this work is daunting but also that it can be rewarding. And so I would love to hear a meaningful moment where you felt joy, energy or hope through this work that you all have been doing which has been so wonderful. And we'll start with Dre for that. Something that was super meaningful to me was finishing my research at the middle of 2020 right before I started medical school. Basically my research was about trauma deserts in the Chicagoland area. I think Chicago, I think the media portrays Chicago as a very violent place. And I'm not saying it's not, we definitely have an issue with violence but what isn't talked about a lot is who's caring for these people? Who's caring for these victims of violence? We have huge trauma deserts here in Chicago that cost so many people their lives. And I think it's kind of crazy that we don't have adequate emergency rooms available for these areas that are afflicted with high violent areas. So during that research, I was able to publish it. And I actually got a lot of positive responses from attendings and people in power who are in emergency room settings. So I was able to help implement some changes, help get some exposure. And now there's been sort of a new push to really expand emergency services further into these high crime areas. Incredible, I love that. Dr. Gould? For me, I love mentoring nurses going directly, going into nurse anesthesia within a year or two. But I do love going to the HBCUs and having that connection with the schools of nursing and the students. And also two students that are in majority in predominantly white institutions of black nursing students there too. But a couple of years ago, and it hadn't been around 2014, 2015, a nursing student reached out or I reached out to her dean when there was an article, it was an article written about her that she was doing very well. She, you know, she's rather in the highest honors and she was the only black student in her cohort and her interest was in nurse anesthesia. I read the article like, oh my goodness, so I can touch with the dean and see if she can, if I can get permission to speak with her. So what I did was I invited her, this nursing student that was graduating that year to come to one of our adverse events that we had at University of Maryland. We paid for her tuition, I mean, excuse me, we paid her transportation in her hotel. But what happened was that weekend, and this is the first time she met other black CRNAs, black nurse anesthesia students. Since that time, she became a nurse. She went, she worked in ICU. She got them, received them the CCRN. She also shadowing experience because you need to shadowing experience before you go into nurse anesthesia. Right now she's a first year student at University of Penn nurse anesthesia. She's not the only one that we have mentored through this program because the thing is, is that, yes, we can mentor you from nursing school all the way up to, you know, you're going into nurse anesthesia. But the differences right now is that I'm proud of the fact that I can mentor cohorts, cohorts of students that look like us, that's going through. But the thing is, is that what I expect them to do is to do the same and reach back and mentor others as well. So I'm really happy to support her, not just her, but other nurse anesthesia students. That's the only one of color that's in their program. So it's that social isolation. You just make sure that you can try to diminish it in any way that you can by making sure that you increase the network of mentors that they have. So I'm really proud of that. It's amazing work to be proud of, Dr. Ibiza. Yeah, I think one thing that stands out to me was just establishing a legacy of student work and health equity. And now being able to carry that on year to year is very fulfilling to me and being able to now act as a mentor to all the other chairs is really fulfilling. You know, I mentioned, you mentioned earlier when you read my bio about my work in social media, I decided that I was gonna just be a lot more intentional about my visibility. Being a Black woman at Boston Children's is a diamond a dozen and also being a Black woman at Boston Medical Center with my unique background. And so I felt that it was important to put myself out there to let people know that one, you can do the same work. You can achieve whatever you put your mind into and being able to inspire other students has been probably the most fulfilling part of my whole journey either through mentorship or through panels like this or through meeting people on the wards and the medical students I'm working with now is definitely made everything worth it because I'm now able to share some of my experiences, successes and failures and be able to guide somebody through that same process without having to struggle as much as I did. I really love and appreciate that. Tosen? Yeah, I think my joy really came from just kind of going back to the beginning and thinking about how our initiative work started. I think, you know, students from the SNMA organization spend multiple hours almost like daily in the beginning of summer of like June, 2020 kind of just talking about our sentiments, talking about our experiences as well as talking about what actionable steps we felt that the institution needed to make. And so I know like so many students had dedicated such a strong like emotional energy to this project. And then just going back and being able to speak with upperclassmen as well as the new like incoming MS-1s and kind of talking about like where we came from and like where we are now and just really appreciating the amount of student efforts that went into this as well as the like the tangibles that we were able to bring out of this. And I think it inspired a lot of upperclassmen who maybe had been jaded about, you know, past efforts not necessarily resulting in the results that they wanted as well as MS-1s who came in thinking that, oh, okay, like these things are kind of just are the way they are, but kind of having that shared collective understanding that like, okay, when we come together like students and allies across the entire health system can really kind of finalize and promote different structural changes and really put the institution to kind of hold their words. That makes sense. There's powerful that meaning that was spread to so many students. And then Jen. Sure. I'll quickly, I guess, close with a session that we did in our art-med ed program. It was one of our very first community of practice sessions across all 11 medical schools that we work with. And I think partly the session was about everyone like airing their grievances about like what's not working in their institution. And I remember Mike Whittier from UCLA brought up a comment. And he was like, if a handful of people in a basement of a Baptist church started the civil rights movement, you know, look at how much we can do 165 people with positional power. And I remember feeling like I went to church that day, not gonna lie, and I really left really energized but moments like these panels and an opportunity to really connect personally, I think are the moments that I've found joy and hope in this work. So thank you. Thank you so much, Jen. And thank you to all of our panelists. I wanted to end on that note because you all have done such amazing work that's challenging and impactful, but also I want, I appreciate you all sharing some of the joy of the work with everyone who's been on this panel. I'll turn it over to Dr. Faro now for our closing comments. Thank you. And actually, Jen, I just wanna build from that word joy because I think anybody who's been watching this felt radiating from the screen from every one of you panelists, not just, you know, courage and hard work and all of those things, but the humanity was a theme and what almost all of you said really makes this work happen. We need to be evidence driven. We need to be data driven. And all that's true in order to know what's working or not, but the energy is not in the data. The energy is in the human relationships. The energy to be sustained has got to have moments and maybe even lots of them of joy. And what I will say, I think it's true for all four of us who basically look like me, you know, they're women too at Harvard over the last almost two years with our colleagues at Tuskegee. If you'd asked any of us when we first met, could we spare an hour every single Friday afternoon to be talking with the Tuskegee people? We said, no, we're way too busy for that. And yet what it's turned out is that those hours are for all of us the most meaningful, enjoyable hours of our weeks. And diversity is not a statistic even though statistics tell us whether we have some of it. What's so sad, Dr. Kamara Phyllis-Jones you hear many of us says racism is not just evil, it saps the strength of the whole society by depriving us of some of our incredibly talented people. And I would just add to that in addition, and I'll say this introducing now my close friend, we think of each other as brothers, Dr. David Hodge. Year and a half ago, we thought each other was so different and we are in so many ways, but actually the joy, we have our own hour together one-on-one because it's the differences in the diversity and the richness of that that creates the joy. So if we can take the energy of the five of you, people my age realizing that there are hundreds if not thousands of others like you, so you're busy, but give us those names and help bring those into our richer more diverse communities. We really can have the dreams that you guys have put before us. But I'll let my friend, brother, Dr. David Hodge, give us our closing words and because he's an ordained minister, maybe a benediction. Thank you very much, Lachlan. Thank you very much to each of you, Jan, Tulson, Adobe, Dre, Dr. Gu and Jalen for participating in this momentous occasion. And I think I'll tell you that when I first met Lachlan, I didn't need to think I'm gonna like him not because he was white, but that was part of it. How do you trust this white dude from Harvard in Boston? I wasn't sure. And then, and the key term that was used a moment ago is a notion of relationships. What does it mean? What all of this means is participating in relationships. We were all strangers once. I was even stranger to my mother, right? Then she gave birth to me and she became my best buddy on planet Earth. So we were all strangers once and we'd be done into relationships. And most relationships happen to have meaning. And the key term that Dr. Gu kept mentioning is hitting on it or hitting on it. And it hit on it so hard. The notion of mentorship goes back to the term Dr. Lachlan introduced earlier from the Tuskegee mantra that is the notion of Sankofa, which is deeply African. The notion of Sankofa, go back and fetch it. So each of us, each of us participating tonight, whether you're a panelist or you're elsewhere, have a responsibility to take this back, take this, fetch it and go back and take it and give it to somebody else. Mentorship is important. You and I have this opportunity now because we're able to mentor somebody else. What makes this program and this conversation so near and dear to me is that I am doing it with like what gives me strength in the bioethics honor students. Many of whom you've already met all you were meeting next week. Those who are on the conversation were particularly Autumn and Chloe, who you met last week in Jail in Spain and Sonia. Those who are, who I work with on a daily basis because they're heading in your direction and have the challenge of getting into a medical program and coming against, not just to flex the report of the, as Dre said, one, I mean six and 189 and this is the 21st circuit that is absolutely scary. So what each of us have to do and Adobe, I just love the notion of courage, right? That we have to have the courage to challenge and Dr. Boone said it, not just the student body and those who are empowered to accept other students but to challenge the system that says that blacks coming into programs as Dre pointed out may not be as prepared, of course they're prepared. Even though, as a matter of fact, there may be more prepared because they're coming out of some hard situation, many of them. I was the first person in my family of there's 12 of us to graduate from high school. I was a baby and then to go on to college. So I didn't, every degree I earned was an exciting moment, it was a family reunion. So this is what we have to be at the go back and such it. I've closed with this, what this pandemic has given us is a couple of things. One is some bad language. We should Dr. Warren at the National Center have always told us at the beginning, I said, wait a minute, not social distancing. It should be physical distancing. Social distancing could lead to social isolation and it did lead to social isolation. It did move to social isolation. We've led to a whole lot of mental health issues. The number of young black and brown people committing suicide especially in graduate school are going up astronomically. So therefore these are some concerns we must have. So what I wanted to say to that is I wanna tell you but my pastor, his father had an old mule and his old mule, you know, kind of flowered it on the farm. They would, he would garden and hold the ground and they had this old oak tree in the middle of the field and he never cut it down. He said, why is it there? He said, I just mow around this oak tree and then I use it for shade when it gets too hot. That's what we need to do in terms of mental shifts become advocates by those people who stand in our way just mow around them. And those people have the capacity to use them for shade build ways of the relationship with them so that those persons could cover us as we fight to make it better not for us but for the next generation and the next generation so that Dray in 20 years from now, you look back now, well, Dr. Dr. Dr. Dr. so the hundred years from now when you look back it wouldn't be six in 189 but it might be a hundred and 189. So let us use this at the beginning and not as an end. So thank you each and every one of you for coming out to be with us tonight. This has been an exciting moment. I heard every last thing of what you said. I'm very, very impressed and I'm prayerful for what you're going to, what you're going through and what you're going to because there's not so much about the journey the destination is about the journey you're really going through right now. So we thank you and I thank all of my students from the Wired for Public Program and the Tuskegee University and those at Harvard Medical School and other part of Harvard University all who have participated participating in jail in Benson. We thank you for your moderating tonight you're hosting this. We appreciate your strength of character and will to push not just this. Couple years ago, there was a new and new racism conference I was invited to I'm not sure why but a young lady started it with six students and now there's over 4,000 students with less than 4,000 people in your racism participating. The second thing that the pandemic has offered us for the use of technology is webinars are free. So therefore, each of you start a webinar just start the conversation to reach others and it will grow because sometimes we just need people to just talk to talk to when we're in isolation. Thank you very much. And as we say, I want to tell you who's able to keep us from falling and present as partners before it's over the amazing grace. We thank you and we bless you. Have a wonderful rest of the evening. Lachlan and the rest of our Harvard and that's Dr. Robert Trug, Ms. Christine Mitchell Dr. Rebecca Bendo and of course Lachlan and to my director, Dr. Mubin Walid the National Central Biographies Research and Healthcare. We thank each of everyone if you play a participation and we can't forget Ashley and the team who make this all happen. Asalaamu alaikum, please, please. Blessings upon you. Take care. Thank you, bye-bye.