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https://todaysveterinarypractice.com/table-of-contents-september-october-2021/
Beyond the Clinic, Diversity, Equity, and Inclusion

Creating a Path to Diversity in the Veterinary Profession

Evidence-based approaches to increasing diversity in veterinary medicine may be an uphill battle, but it is one worth implementing.

Annie J. Daniel PhD, MS

Dr. Daniel is the director of the Veterinary Instructional Design and Outcomes Assessment and the Graduate Certificate for Teaching in Healthcare Professions at Louisiana State University, as well as an associate professor of veterinary medical education and affiliate faculty for African and African American studies. She has more than 20 years of experience in education and is the founder and CEO of the Institute for Healthcare Education Leadership and Professionals and founder of the National Association for Black Veterinarians. 

Creating a Path to Diversity in the Veterinary Profession
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Twenty years of experience in teaching and management in higher education, along with a PhD, led me to an opportunity to work on diversity and inclusion in the School of Veterinary Medicine at Louisiana State University (LSU). As an educator, my role was to work collaboratively with faculty and administrators to improve the DVM curriculum. I also had the opportunity to teach a lecture on cultural awareness to the incoming first-year veterinary students with the goal of raising awareness for diversity and inclusion in veterinary medicine. 

Upon entering the lecture hall for the first time, I was confronted by the fact that I was the only Black person in the room—I felt my own singularity acutely. Being a Black person who earned the highest degree an American university has to offer and gave back to the community by supporting those Black students with aspirations for a veterinary career, I was well aware that success in the field required higher education and mentoring. Still, I could not understand why there were no Black students in this class and only 3 in the entire program, given the fact that more than 30% of Louisiana’s population is Black. The state also has 6 Historically Black Colleges and Universities (HBCUs), which could serve as pipeline or feeder institutions for advanced veterinary education programs. A pipeline program is “a line of connected systems for identifying, developing, preparing, and producing an individual or group of individuals to enter a profession to fill organizational needs, which can be used to increase racial and ethnic diversity, starting at any level of education from K-12 to graduate levels.”1 

Because of this, I did something that most people would not: I asked why there are so few Black students in the DVM program. I received some of the same antiquated responses as Dr. Patti Rose, an expert in health education and diversity issues, including the oft lamented concern expressed by administrators at some predominantly white institutions that they are not able to find Black students who meet their rigorous academic standards.2 I have heard similar remarks in meetings for diversity and inclusion: “Black students do not apply to veterinary medicine; Black students do not have an interest in veterinary medicine; and Black students do not perform well in veterinary science or in the veterinary medicine curriculum.” Not satisfied with the responses, I began researching the subject myself. I started by visiting 3 HBCUs in Louisiana: Xavier University of Louisiana, Grambling State University, and Southern University. I learned that these schools have students that are not only interested in veterinary medicine, but major in pre-veterinary medicine or are pre-vet/animal science. In order to increase diversity, and specifically the enrollment of Black students in DVM programs, it is essential to recruit students from these universities and discontinue the use of racially biased beliefs as excuses for failing to do so.

An Uphill Battle

A review of the current scholarly literature and research on the progress made to diversify the health professions revealed some progress in recruiting African American students; however, veterinary medicine and veterinary medical education programs have never had the level of diversity of other healthcare professions.3 

The U.S. Census reported that the number and percentage of underrepresented people of color continues to increase, and people of  color are expected to become the majority population by 2042.4-6 It has been reported for some time that the racial and ethnic minorities will be the majority of the U.S. population,5,6 further emphasizing how the makeup of the veterinary profession fails to reflect that of the U.S. population.

I also learned about the depth of veterinary medicine’s lack of diversity. In the fall of 2003, the Journal of Blacks in Higher Education published an article declaring the veterinary profession as the most “segregated field in graduate education.”7 A decade later, an article in The Atlantic broadened the dubious distinction by labeling the profession as the “whitest” in America.8 

The number of Black students entering the profession and the number of Black veterinarians in the profession has remained around 2% for decades,9 despite efforts from a few veterinary medicine colleges to diversify the profession and diversity initiatives by corporations in the industry.

To remedy this problem, those who are most affected should identify initiatives necessary to increase the number of Black veterinarians and educate people in who could help implement systemic change, with the aid of evidence-based methods to improve diversity, equity, and inclusion.

Steps Toward Progress

To address this problem, in 2016, I created the nonprofit Institute for Healthcare Education Leadership and Professionals (iHELP, the-ihelp.org) to support diversity and inclusion efforts in healthcare. The first iHELP initiative is the creation of the National Association for Black Veterinarians (NABV, nabvonline.org). The mission of the NABV is to “build a network of individuals and organizations that advocates for Blacks in veterinary medicine at every level and profession” through its leadership and membership. The NABV’s purpose is to work collaboratively with other organizations and institutions to support and ensure research-based methods are implemented to increase diversity and inclusion in the veterinary medical profession and veterinary medical colleges. I received advice and support from Dr. Raphael Malbrue, a young veterinarian and graduate of the Tuskegee University College of Veterinary Medicine, and his mentor, Dr. Clyde T. Raby (one of a few Black veterinarians in Louisiana). 

In 2009, the U.S. Department of Health and Human Services published a report that offers explicit resources and strategies to implement a pipeline program to increase diversity.10 Looking at models of success in the sciences, we can identify evidence-based practices to increase diversity in veterinary medicine. 

Rodriguez et al. identified 7 core components in the Model Institutions for Excellence program to increase underrepresented people of color in science, technology, engineering, and math (STEM): (1) recruitment and transition initiatives, (2) student support, (3) undergraduate research, (4) faculty development, (5) curriculum development, (6) physical infrastructure development, and (7) STEM graduate school and employment initiatives.11 Although programs were different at each institution, Rodriguez et al. identified the common component among institutions as student support, including social, financial, and academic assistance.11 

In addition to these 7 core components, Dr. Thomas J. Durant, Jr. identified 12 core components of a diversity plan (BOX 1).10 He stresses the importance of creating a positive environment, noting that it will be challenging to retain and recruit more students in an institution that is not receptive to racially and ethnically diverse people by members of the majority group.12

BOX 1 Durant’s Model for Diversity and Inclusion<sup>12</sup>

Evidence-Based Practices That Work

  1. Scholarships Develop a financial assistance package that includes sources of financial aid. Offer competitive funding for reducing the cost of degree programs, including full and partial scholarships.
  2. Mentorship Develop a mentoring program by providing Black faculty with names and email addresses of Black students each semester.
  3. Summer Bridge Identify promising high school sophomores and juniors for summer enrichment programs.
  4. Minority Faculty/Administrative Representative Develop an Office of Diversity Affairs to serve the needs of Black students. Create paid positions for persons with the responsibility of recruitment. Continue to keep open lines of communication between faculty in reference to recruitment and retention of Black students.
  5. Recruitment Hire a recruiter, plan an annual Minority Career Day, and provide rewards to Black faculty who are engaged in recruitment and retention efforts (e.g., reduce teaching load). Provide faculty with recruitment packages to take to local, state, and national meetings that they attend.
  6. Support Groups Develop an administrative unit for planning, programming, and counseling Black students.
  7. Institutional Linkages Institute a “buddy” program for new students from the current student body. Form an alumni network of interested Black graduates of your institution to assist with recruitment.
  8. Multimedia Advertising Promote your program and its Black students and faculty on social media, brochures, and ads.
  9. Direct Visits Encourage faculty members to participate in recruiting by visiting Historically Black Colleges and Universities.
  10. Direct Visits to the Institution Identify promising high school sophomores and juniors for enrichment programs. Sponsor a reception for Black students.
  11. Referrals from Alumni Identify Black alumni faculty at predominantly Black institutions and predominantly white institutions who would be interested in receiving information about the healthcare program at your institution and referring students.
  12. Diverse Environment Improve the university’s environment so that Black students feel more comfortable. Develop the capacity to monitor the progress disposition and status of Black graduate students. A factual database must be developed from which to establish policy.

Developing a pipeline program for colleges of veterinary medicine has proven to be an evidence-based method to create access for Black people in veterinary medicine. These pipeline programs can encourage greater diversity by increasing outreach for K-12 and undergraduate students and educating them about veterinary careers. Dr. Durant developed a simple 5-Year Model for Diversity and Inclusion to document activities, progress, and accountability (TABLE 1). Researchers have shown that if a strategic plan for diversity and inclusion is developed and implemented with evidence-based methods and procedures for increasing diversity, the numbers will improve for underrepresented people of color.1 

During his tenure at LSU, Dr. Durant, along with a group of Black faculty and staff, implemented strategic initiatives that supported diversity and inclusion. In his book he wrote about his experience, detailing the major initiatives strategically developed to increase diversity, inclusion, retention and support of students and faculty of color.12

Finally, pursuing diversity and inclusion is not simply an option for veterinary medicine—it is a necessity. And in order for that to become a reality, Dr. Durant cautions that everyone needs to be aware of the environment to ensure that it is welcoming and inclusive (FIGURE 1).12 Creating policies for inclusion and implementing consequences for not adhering to the policies are imperative to establish this standard. 

Addressing Environmental and Climate Issues

Morse reports that underrepresented veterinary students may experience a less welcoming social and academic climate on their campus as a result of overhearing intolerant language, lacking mentors, and experiencing discomfort in less diverse learning environments.13 These issues need to be addressed immediately, as they may also dissuade underrepresented people of color from pursuing faculty positions. The American Association for Medical Colleges contends that academic health centers can enhance the number of underrepresented minority faculty by: (1) creating an environment that allows for a more balanced personal life, (2) supporting community-based initiatives, (3) encouraging interdisciplinary work, and (4) rewarding quality teaching efforts.14 These are recommendations that both veterinary and academic medical health centers should seriously consider adopting.

Taking Action

Speaking up to identify inappropriate admissions and hiring practices that are biased against underrepresented applicants of color and speaking up when racial language and actions are targeted at underrepresented people of color are imperative to stopping this behavior and creating a more inclusive environment. In the words of Congressman John Lewis: “When you see something that is not right, not fair, not just, you have to speak up. You have to say something; you have to do something.” 

References

Daniel AJ. Diversity in Healthcare, Making It Happen and Sustaining It. In: Rose P, ed. Health Disparities and Diversity: Context, Controversies and Solutions. 2nd ed. Burlington, MA: Jones & Bartlett Learning; 2020.

Rose P. Why Veterinary Medicine, The Whitest Profession in America, Needs Black Students. Huffington Post. huffpost.com/entry/why-veterinary-medicine-t_b_8211558. Accessed January 2021.

Wilbur K, Snyder C, Essary AC, et al. Developing workforce diversity in the health professions: a social justice perspective. Health Professions Education 2020;6(2):222–229. doi: 10.1016/j.hpe.2020.01.002

Taylor P. The Next America. The Pew Research Center. pewresearch.org/next-america/#Two-Dramas-in-Slow-Motion. Accessed
December 2020.

Day JC. Population Projections of the United States by Age, Sex, Race and Hispanic Origin: 1995 to 2050. U.S. Census Bureau; 1996. census.gov/prod/1/pop/p25-1130/p251130.pdf. Accessed January 2021.

Wang C. Evaluation of Census Bureau’s 1995-2025 State Population Projections. U.S. Census Bureau; 2002. census.gov/library/working-papers/2002/demo/POP-twps0067.html. Accessed January 2021.

Holy cow! The near-total racial segregation in veterinary higher education. The Journal of Blacks in Higher Education 2006;(13):46-48. doi:10.2307/2963161

Thompson D. The 33 Whitest Jobs In America. The Atlantic. November 6, 2013. theatlantic.com/business/archive/2013/11/the-33-whitest-jobs-in-america/281180. Accessed December 7, 2020.

Association of American Veterinary Medical Colleges. Annual Data Report 2013-2014. aavmc.org/About-AAVMC/Public-Data.aspx. Accessed March 2014.

U.S. Department of Health and Human Services. Pipeline Programs to Improve Racial and Ethnic Diversity in the Health Professions: An Inventory of Federal Programs, Assessment of Evaluation Approaches, and Critical Review of the Research Literature. aapcho.org/wp/wp-content/uploads/2012/11/PipelineToImproveDiversityInHealthProfessions.pdf. Accessed December 2020.

Rodriguez C, Kirshstein R, Hale M. Creating and Maintaining Excellence: The Model Institutions for Excellence Program. air.org/sites/default/files/downloads/report/MIE_Report_final_0.pdf. Accessed December 2020.

Durant TJ. A View from the Inside: Thirty-Six Years of Desegregation. Baton Rouge, LA: Durant Publishing Company; 2015.

Morse EM. Minority student perceptions of the veterinary profession: Factors influencing choices of health. MA Dissertation, Cleveland State University; 2008. ETD Archive. 699. engagedscholarship.csuohio.edu/etdarchive/699. Accessed December 2020.

Lewis D, Paulsen E. Proceedings of the Diversity and Inclusion Innovation Forum: Unconscious Bias in Academic Medicine. Association of American Medical Colleges. aamc.org/downloadable/download/sample/sample_id/168. Accessed December 21, 2020.

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