RLS Speaker Focused on Dismantling Racism in Medical Education

“I said I wanted to be a nurse because I couldn’t be a doctor,” she said. “My dad asked, ‘Well, why can’t you be a doctor?’ I told him, ‘Girls can’t be doctors. Only men can be doctors.’” 

Wang’s father responded by bringing his daughter, who was then in elementary school, to the cancer care clinic where he worked. 

“Many of the oncologists he worked with happened to be women,” Wang said. “I remember how kind they were, and also how distressed they were to hear me say that girls can’t be doctors. I realized women could be physicians, too, and that really changed my trajectory to see that it was possible.”  

A few decades later, Wang is breaking down barriers for others as program director of the University of Pennsylvania’s Family Medicine Residency. 

“My goal is to mitigate and dismantle the structural racism that exists in medical education,” she said. “I want to create a safe space for our learners of color. By making this a safe space for them, we make this a safer space for everyone. There are studies highlighting that racial concordance between the clinician and the patient contributes to better outcomes, increases patient satisfaction and builds trust.” 

In 2018, none of Penn’s first-year family medicine residents were from underrepresented groups in medicine and neither were the faculty involved in reviewing applicants. That was an inflection point for the residency, Wang said, because two-thirds of the program’s West Philadelphia patient population is Black. 

Wang said traditional metrics used in residency application review processes are systematically biased against applicants that are underrepresented in medicine. In fall 2019, Penn’s Family Medicine Residency began developing a Systematic Holistic Application Review Process to determine which applicants to invite for interviews. SHARP, which also considers factors related to issues such as resilience, distance traveled, clinical potential, and commitment to social medicine, launched in fall 2020 for the 2021 Match. 

“We created a holistic rubric focused on our program’s mission,” she said, “so that we’re able to determine which applicants would be the best fit for our program and community.” 

An article recently published in Academic Medicine comparing a four-year period before SHARP’s implementation to the two Match cycles after it was implemented shows that the proportion of Penn Family Medicine applicants who were from groups underrepresented in medicine increased from 18% to 25%, while the proportion of URiM interviewees increased from 23% to 38%, and the proportion of matched URiM residents increased from 27% to 62%. 

Wang will give a presentation about SHARP during this year’s Residency Leadership Summit, March 25-27 in Kansas City, Mo. 

“It has been really great because SHARP helped us interview and match residents with diverse lived experiences who are committed to reducing health disparities for our West Philadelphia community,” said Wang, who joined the program’s faculty after completing her training there in 2019. She served two years as an assistant program director before becoming program director last year. 

Wang said Penn has made great strides in its commitment to diversity, equity and inclusivity since her intern year in 2016, when she recalled experiencing discrimination. 

“I’m trying to improve this holistic review process because I think it’s important to bring in more physicians and more learners who come from underrepresented backgrounds, because they have unique perspectives and form trusting relationships with our patients,” she said. 

Wang, who serves on the AAFP’s Commission on Education, is a fellow in the Association of Family Medicine Residency Directors' National Institute for Program Director Development. 

“NIPDD teaches us how to be a program director — from finances, to how to meet ACGME requirements, to how to support learners of different stages,” she said, “and it’s also been really helpful to meet a lot of other program directors who happened to be women of color. There is a lot of imposter syndrome that comes with being in this role, and there aren’t that many family medicine program directors across the country who look like me. To be able to create a social network of support has been really helpful.”