This year, the president of the American Academy of Ophthalmology (AAO) is, for the first time, an African American woman: Tamara Fountain, who trained at the Wilmer Eye Institute, Johns Hopkins Medicine. As we celebrate Black History Month and Fountain’s landmark achievement, we also recognize Wilmer’s continuing efforts, led by Diversity Council co-chairs Ashley Behrens and Adrienne Scott, to provide a diverse and inclusive environment — one that represents our community and the world in which we live.
In recent years, efforts to increase the number of underrepresented minority (URM) students in Wilmer’s residency program have proved fruitful — Wilmer has matched at least one URM student in each of the last three cycles — but Shameema Sikder, an associate professor of ophthalmology and director of the Center of Excellence for Ophthalmic Surgical Education and Training at Wilmer, says more work needs to be done.
A member of Wilmer’s resident selection committee, Sikder says one of the most important steps toward increasing diversity in residency programs is recognizing that not every applicant has a linear pathway. “At the end of the day, we’re about training the next generation of leaders, and taking a more holistic approach to understanding applicant strengths and seeing how that fits into the narrative may give us and the applicants the opportunity to better represent the real world in positions of leadership,” Sikder says.
She also points out that the interview process can be a learning experience for applicants, too. “Interviews are a career stage for applicants,” Sikder says. “They are important networking opportunities and a chance to see what it’s really like at a place like Wilmer.”
Increasing Awareness of the Field
Several years ago, Scott led a study examining factors that influence URM students’ participation in the field. The study concluded that targeted mentoring, among other things, is vital to increase representation. “Our research study showed that one reason underrepresented minority medical students may not choose to pursue ophthalmology careers is that they may not have role models of the same race or gender,” says Scott, who points to the expression, “You can’t be what you can’t see.” “It is important for students, particularly those from traditionally underrepresented minority backgrounds who may not personally know a family member or friend who is an ophthalmologist, to ‘see’ themselves in us, and to consider ophthalmology as an attainable career, where perhaps they had never previously considered our specialty.”
Scott’s work inspired Albert Jun, chief of the cornea, cataract and external eye diseases division at Wilmer, and Divya Srikumaran, vice chair of education at Wilmer to establish Wilmer’s Diversity Scholars Program in order to expose underrepresented first-year medical students to ophthalmology. In this program, now jointly run by Srikumaran and Fasika Woreta, director of Wilmer’s residency program, students are paired with a faculty mentor, gain clinical experience, attend Grand Rounds and are encouraged to submit work for publication in a peer-reviewed journal. The program covers the cost of student travel, housing and living expenses during the six to eight week rotation. This year, four students will participate in a virtual program.
Wilmer also participates in the Johns Hopkins University MERIT Health Leadership Academy, a summer program in which Baltimore City high school students shadow professionals in various departments across Johns Hopkins medical campuses. At Wilmer, this summer’s program will include lectures on anatomy and the basics of eye diseases, an overview of eye surgery and the chance for students to use a microscope under the guidance of Wilmer faculty members.
Some initiatives aimed at increasing exposure to the field are less formal, but no less instructive. Wilmer Director Peter McDonnell, Srikumaran and Woreta have invited students from historically black colleges and universities that lack ophthalmology programs to attend Wilmer’s weekly Grand Rounds, and Scott hosts a dinner for URM students at Johns Hopkins each year. “Dr. Scott mentors countless underrepresented minority students and has been integral to our recruitment efforts at Wilmer,” says Woreta.
Panels and Programs with a Purpose
Woreta is involved in numerous endeavors to increase diversity and inclusion in ophthalmology. She is frequently a panel member during an ophthalmology application information session for URM medical students sponsored by the National Medical Association, the oldest and largest organization representing African American physicians and health professionals in the United States. In addition, she and Pradeep Ramulu, chief of Wilmer’s glaucoma division, are mentors in the Minority Ophthalmology Mentoring Program, a partnership between the AAO and the Association of University Professors of Ophthalmology (AUPO). Woreta is also a member of a new AUPO subcommittee dedicated to diversity and inclusion education and, along with Sharon Solomon, Wilmer’s first Black full professor, is a member of the AAO’s Diversity Task Force.
Woreta serves on a Johns Hopkins graduate medical education (GME) subcommittee for diversity. She, Johns Hopkins URM medical student Ugochi Aguwa and others recently authored an editorial in the American Journal of Ophthalmology titled “Improving Racial Diversity in the Ophthalmology Workforce: A Call to Action for Leaders in Ophthalmology.” Aguwa and Srikumaran also presented a paper at AUPO titled "The State of Diversity and Diversity Training in U.S. Residency Programs,” and Srikumaran and Henry Jampel, the Odd Fellows Professor of Ophthalmology at Wilmer, led Wilmer’s participation in a diversity and health equity elective offered by the GME office.
Wilmer is also addressing deep-seated beliefs that can undermine efforts to increase diversity. In July, faculty members and trainees received training to help recognize assumptions and biases and to think more critically and consciously when making decisions about topics like residency matching. In the works is a curriculum for Wilmer trainees that will include training regarding both implicit bias and cultural competency, which involves understanding, acknowledging and embracing cultural differences among faculty and residency groups.
Sikder recently established An Eye to Anti-Racism in Medicine, a monthly discussion group during which trainees talk about a variety of issues regarding race. The first meeting featured a discussion about ways to leverage relationships with patients in order to foster communication about vaccine hesitation. Future meetings may touch on topics such as how race factors into the management of ophthalmic disease. Glaucoma, for example, is more prevalent among people of African descent, for whom access and continuity of care are also statistically more likely to be an issue. In that case, says Sikder, it could be helpful to consider treatment options that don’t require frequent follow-up visits.
Read about America’s first Black ophthalmologist in Florida Today.
Learn more about the Wilmer Eye Institute residency program.