Background:

Public Medical Schools in Washington State.  Washington State has two public medical schools—the University of Washington School of Medicine (UWSOM) and the Washington State University College of Medicine (WSUCOM).

 

UWSOM was founded in 1946.  UWSOM has a partnership with four other western states, Wyoming, Alaska, Montana, Idaho, known as WWAMI, to allow those states' medical students to receive medical education as in-state students from the University of Washington (UW).  WWAMI is the only five-state medical school in the country.

 

WSUCOM, also known as the Elson S. Floyd College of Medicine, was created through legislation in 2015.  WSUCOM's first cohort of medical students began classes in 2017.

Summary of Bill:

Health Equity Curriculum.  Each public medical school must develop curriculum for medical students on health equity by January 1, 2023.

 

The objective of the health equity curriculum must be to:

• provide tools for eliminating structural racism in healthcare systems; and
• build cultural safety.

 
Each UWSOM and WSUCOM student must complete a course, or courses, on health equity prior to graduating.  Health equity course topics may include, but are not limited to:

• strategies for recognizing health care disparities and eliminating factors that influence them;
• intercultural communication skills training;
• historical examples of medical and public health racism;
• cultural safety training;
• structural competency training;
• methods of evaluating health care systems; and
• implicit bias training.

 

Goals for Representation.  Each public medical school, by January 1, 2022, must create a goal that their student population be more representative of the demographics of the state of Washington.  The goal must focus on under-represented students and be set for January 1, 2025.  Progress towards each goal must be reported on an annual basis through each of their public websites.

Staff Summary of Public Testimony:

PRO:  Last week my mother died.  Until then my family and I waited every day for an update on her status.  There was a lack of communication between the hospital and my family.  There was a need for a cultural communicator.  This system is not set up for BIPOC communities.  We need to focus on health equity to improve situations like this.  This bill is important and would help my children of color who are disabled.  There is a deficit in our medical health curriculum.  Maternal mortality is not good for women of color.  Living, working, and growing up in eastern Washington, I know firsthand of the diversity of this region.  Rural and under-served settings have a hard time recruiting physicians for the communities that need them.  This bill will improve curriculum and set a goal of parity.  The one request is that the schools should make their curriculum available to all entities in the state of Washington.  It is crucial that the language of this bill addresses racism in medicine.  As a medical resident, medical students must be training on systemic inequities.  This will increase and improve diversity in our medical students and help BIPOC students.  We need a diverse and anti-racist medical physician workforce.

 

Population parity goals are important.  This will help improve underrepresented groups' access.  National and state data show a disproportionate impact on Latinos from COVID-19.  Latino physicians are more likely to serve in under-served communities but are underrepresented in this state.  SeaMar recognizes the need of this bill and the importance of diverse physicians.  As a first-generation college student, and Latina medical student from eastern Washington, I know people who have been directly affected by COVID-19.  I have seen a relief on patients faces when I am able to speak their language.  Medicine practiced in a patient's native tongue is effective.

At UW Medicine, all faculty are required to participate in Diversity, Equity, and Inclusion (DEI) training.  Our office has launched an equity tool that is being piloted.  The training of UW medical students in DEI is important.  The UW has existing curriculum that meets the needs in this bill, but there is more to do.  This bill would require us to build up our current program.

 

WSU has developed a modern curriculum that follows this bill.  WSU medical students look like Washington.  WSU's medical curriculum is heavy on empathy for patients.  The college of medicine is now working on a diversity action plan and individual action plan for each student.

 

CON:  This bill will run afoul of constitutional protections.  This bill seemingly sets quotas for medical schools.  Of course, it is an appropriate goal to increase the number of people from minority communities.  Requiring training and cultural competency is a better way to proceed.

Persons Testifying: PRO: Senator Emily Randall, Prime Sponsor; Dominic Min-Tran, University of Washington School of Medicine; Kia Gianni Thigpen, University of Washington, School of Medicine; Leo Morales, Latino Center for Health; Russell Maier, Pacific Northwest University; Mohamed Khalif, Washington Academy for International Medical Graduates; Karina Yamin, Washington Academy for International Medical Graduates; Suzanne Allen, MD, University of Washington School of Medicine; Jazmine Perez, University of Washington School of Medicine; Sophia Orlando, University of Washington School of Medicine; Jesus Sanchez, Sea Mar Community Health Centers; Samantha Fakharzadeh, Washington Students; Alice Manos, Resident Diversity Committee, University of Washington; Chris Mulick, Washington State University; Paula Houston, EdD, University of Washington Medicine.

Persons Signed In To Testify But Not Testifying: No one.