Dynamic Learning During a Global Pandemic 

Does COVID-19 threaten or enhance the academic community’s ability to close the gap in diversity and cultural inclusiveness for students seeking higher education? Are we in a better or worse position regarding the recruitment of the very best talent within vulnerable populations? What solutions are institutions grappling with to remain competitive in this ever-evolving environment?

Profound Conversations Podcast

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Our host is Linda Howard and our Profound Conversationalists are

Dr. Marcus Lambert and Dr. Rachel J. Thornton. 

Show Topics and Highlights

This pandemic has had a significant effect on students, especially those with socially and economically disadvantaged backgrounds. 

Is this pandemic going to create a pipeline issue with some of these underrepresented groups not being able to move students into certain medical fields?

Many students who are from economically disadvantage communities, many have had to step away from schooling and taken jobs to help support families.

One of the issues around health disparities and health inequities is that you don’t have those who are serving the community have the cultural competency to serve the community.

Trust issues have been so intense in some areas that it will also likely come into effect when and if there is a vaccine for Covid-19. Communities won’t take it if they don’t trust their medical establishments. 

My CHALLENGE as a Health Equity Researcher is making clear that fixing the TRUST gaps with the medical community is not about fixing the TRUST in the patient. . . It’s actually about BEING TRUSTWORTHY.

We need to think about the challenges that face us and not just us personally but those that are most vulnerable in our communities. 

Profound Conversations Executive Producers are the Muslim Life Planning Institute, a national community building organization whose mission is to establish pathways to lifelong learning and healthy communities at the local, national and global level.   MLPN.life

The Profound Conversations podcast is produced by Erika Christie www.ErikaChristie.com

Full Transcript

Linda Howard

All right, so welcome everyone to another episode of Profound Conversations. Today we're going to be talking about higher education. And we're actually gonna delve in a little bit into to some professional schools, because our two guests here with us today are actually are in professional schools of medicine. And so, you know, this has been a really challenging time for higher ed, I know, we've been hearing a lot about about primary school and the challenges of schools, reopening, not reopening the teachers being uncomfortable going back to school, but we haven't had a whole lot of conversations around higher education. And institutes of higher ed have been really experiencing challenges as well, with breakout remote learning. You have professors, a lot of professors who are tenured and older who have not operated in a virtual environment before. So this is a whole new learning experience for them to have to operate classes virtually. And I think when we start talking about some of the professional schools is really the clinical, they have some unique challenges of a lot of that work requires being in contact with other human beings. You know, the whole practical side, we have issues around recruitment, are students coming back to school, do students should students be paying their full tuition if they're not getting the full experience, so there are a host of issues impacting higher ed. And today, I'm going to ask our guests to jump right in, and start talking with us about some of the challenges that they've been experiencing in this new world of COVID-19, as it impacts higher education. So Dr. Lambert,

Dr. Marcus Lambert

Thank you, Linda, for that introduction. I myself, served as an assistant dean, at a very large academic medical center, particularly in the Graduate School of that medical center. So we have a lot of master's students who are pursuing things, such as you know, being becoming a physician assistant, or health care policy and research or public public Population Health Sciences, which is similar to public health. But we have a lot of PhD students as well, who are studying things like cancer research and neuroscience. And, you know, I think you're right in the sense that, you know, sometimes we think about the impact on, you know, classes, and, you know, just the engagement or the transfer of knowledge and that sort of shift in paradigm from moving from physical engagement to now, sort of virtual world. But you know, even for a lot of those students, they have this component where they're working in the laboratory, they need to sort of physically be on campus and in physical environments. And so it's an impact of those students in many ways. And then, as you would expect, at large academic medical center, you know, with the collaborates with the hospital, we have medical students, and you know, many of those medical students, including those who finished their MD and going off to residency or fellowships, they're still in their training, part of you know, their careers, they have been impacted in very significant ways as well. You know, I think it's just been a reimagining of our sort of the total way that we have thought traditionally about training students. So I'm happy to touch on some of those some of those ways. But I'll give Dr. Thornton, the time to respond as well.

Dr. Rachel Thornton

Thank you so much for the question, Linda, I'm really excited to be in this conversation with you and with Dr. Lambert and grateful to the whole team for for inviting me today. So I wear a variety of different hats within my organization. But one of the things that I am responsible for is the very first course of the first year of medical school, which is a course a topics and interdisciplinary medicine course focused on disparities and inequities in health and health care. And, you know, truthfully, I think that it's medical school in many places starts in the summer, so a lot of people started in mid August, late August. And then other phases of medical training, like their residency programs have their transitions in the July timeframe as well. So you can imagine in pretty short order after, you know, the initial declarations around state of emergency in the springtime, February, March, April, there was a lot of change happening, a lot of reimagining like Dr. Lambert said, of how we were going to do things, you know, in in the context of ongoing uncertainty, frankly, about what would be recommended in any given time in any given place. And so, at a certain point, I think we made the decision with the first course of medical school for the first years, because it is a non clinical course to, you know, to move forward with an abundance of caution. These are students who were coming to our institution from all over the world, frankly, and all over the country and would have been traveling, which can potentially be high risk, time for exposure. And, you know, when we think about what the what the ramifications are of, you know, social distancing, and what kind of space layout would be required, you know, we were considering ways to have students come in for some small group activities and smaller groups. And I don't know if you'll remember back to this, but there was a point in the summer, I want to say, I don't remember all the specific details, but I want to say maybe late June, early July, where there were questions about whether visas, were going to be allowed for students coming internationally, to do remote programs only. And so that precipitated a series of planning scenarios where we were going to potentially be in a position where we sort of had to make the decision to do some, I think it was 20% of the instruction in person in order to be in adherence with that. And, you know, I think the thankfully, there was a reversal at the federal level of that mandate. You know, which I think, in the context of like us all actively trying to reimagine how we were going to do things we had traditionally done in person, we're then going to have to reimagine them, again, to do 20% of that, you know, in person and potentially other parts that we were planning, you know, previously to be 100%, virtual. You know, and I think so. So that's been an evolving picture. I do agree with Dr. Lambert, I'm, you know, I have I'm PhD trained, but also a practicing physician. And speaking to the medical school side of things, you know, I think at Hopkins, there's been a concerted effort for courses like anatomy for the clinical skills development courses, where you really cannot replicate the experience virtually, to identify safe ways to bring students together for those experiences, and, you know, being somewhat removed for that, from those elements of the curriculum discussions, you know, I don't have a lot of visibility into the details, but I can say that I know firsthand just from students testimonials, that having the opportunity to do that, in some of those elements in person safely is really meaningful for their growth and development, their, their learning. And, and also we're really trying to build a community of learners. And you know, there are significant challenges to that when when people are restricted to kind of a zoom platform, so to speak, as their, their primary way to connect. So I know some students who are, you know, sharing apartments together and creating other opportunities to kind of have more interaction with people who are basically now part of their household, and a lot of effort going into kind of planning some virtual social spaces for the students to build connections. But lots of challenges.

Linda Howard

Now, what when you're doing that in terms of having students be together and connecting, you do have the possibility of, of there being some transmission of COVID and you've had some universities that have become real hotspots. So what is the plan? Now that you know students are are coming back into these hybrid environments, some, some in person, some virtual, what happens when if there's an issue? Is there a plan in place?

Dr. Rachel Thornton

What I can say is basically from my vantage point as a member of the faculty at my own institution, which is that institution wide the mask requirements are in place. And, you know, faculty in the on the university side have been given general information about how to address any resistance to adherence to those math requirements. My general sense of the students is that there's a particularly in the medical sciences, which, you know, many of these students are in a position as they transition into their clinical years where they're essentially functioning as an apprentice physician are in clinical environments. You know, we expect them to keep the safety of the patient as paramount. And they're, similarly in those instances required to wear a mask and are given access to the same kind of protective equipment that we expect the faculty in those environments or the other clinicians in those environments to have access to, I know that at different phases in the pandemic, there were decisions made about protecting students from direct patient care with known COVID positive patients just because of the concerns about PPE. And briefly, and a lot of medical schools around the country, there was, you know, rotations were suspended for a period of time, in order to be able to do kind of a full safety assessment to do what was necessary to, to ensure we had physical spaces allocated safely for distance, we usually are working in very close quarters, you know, in the hospitals, and in the clinics, there's commonly a pretty crammed, you know, shared space where the student doctors, and the preceptors, as we call them are all together, sitting shoulder to shoulder almost. And so we had to do a lot of reimagining of how we were going to use clinic rooms, how we would involve them in some of the virtual care we're now doing, and I think there's been a lot of challenges and all of that, but I, I can speak at least at my institution, my sense is that there is a clear understanding of the importance of following the masking and social distancing guidelines that are in place, there's a lot of signage posted, there's, you know, conference rooms that have been repurposed into places where people can safely take breaks and eat lunch and, you know, be distance from one another. And we're really thinking about how the students can continue to learn so that they can stay on track, in their trajectory to you know, transition into residency programs and the like, but do it in a safe way. So I'm sure Dr. Lambert has other things to add to that. There's also the issue of how do you have students engage in their laboratory spaces, effectively and safely. And I know that the bench scientists in our space have been doing a lot of work to reimagine that to create protocols for knowing who's where, at what time and the like.

Linda Howard

I'm going to shift a little bit and ask the question around impact this has had on different communities. are we experiencing? Are you experiencing that the COVID-19 as a relates to the continuing education of students of color? Have they been impacted? Or is has this impacted communities that your institutions may serve?

Dr. Marcus Lambert

Yeah, I, you know, I'm happened to serve as a dean of diversity Assistant Dean for Diversity in student life. And this is one of the things that I've been paying paying very close attention to. Dr. Gordon, you know, mentioned the impact, particularly on international students and our international scholars with the visas. And, you know, I think, for a lot of international students, you know, just the simple fact of travel restrictions has been quite impactful on on their, you know, educational pursuits. And, you know, just speaking for our institution, for example, our graduate schools is comprised of 30 to 40% students who are, you know, international student and on on visas, so it has a significant impact on, you know, the students and the institution. But, you know, also thinking about students who are from the United States who happen to identify from underrepresented groups in medicine are underrepresented groups in science. So these This includes racial ethnic minorities, individuals who come from social economic disadvantaged backgrounds as well as individuals who have you know, disabilities and who often are faced with challenges and you know, sort of their educational pursuits because of that, I think that this pandemic has had a very significant impact on those communities. You know, one of the things that that we do at our institution that is probably very, very common across the nation, we host summer research opportunity programs for students who are interested in applying to our programs. So for example, if you're interested in going to medical school, we have a sort of pre med summer program, where we usually under normal circumstances bring you to the college, and you get to see what life is like as a medical student, you spend seven weeks and and you do research, and you get a chance to interact with the physicians and the medical students. And it's just a phenomenal life changing experience for those students. We have very similar programs, one that I direct. For those who are interested in graduate school and the PhD route and becoming a research scientist, we put them in a laboratory for 10 weeks. And they interact with graduate students, our postdoctoral fellows, they get to do research, they often at the end of it will do presentations. But it's all really sort of, you know, predicated on the fact that they're here on campus interacting. So the pandemic put a huge wrench into that. And we had to be really creative. As far as you know, what we were going to do a lot of programs across the country, were just simply canceling saying, Hey, we can't, we can't host students if our laboratories are closed down. And one of the choices, the tough decisions that we made, we decided to host a virtual program. So this really involved thinking about the sort of opportunities that we provide those students. So we have a number of programs that target high school students and college students, but I'll just take the college student program, for example, this program, typically will take college students allowing them to do research and academic medical center. What we did, instead, we taught them how to do grant writing. So there's a the National Science Foundation has these fellowships for graduate students that will fund you know, your training. And we taught, we basically did taught them how to write that grant. So they actually wrote one of those grants, so that they could potentially submit for graduate school. That's something that we wouldn't normally ordinarily do, and involves really, you know, a lot of just creative thinking about the type of research that you would propose and, you know, matching with graduate students and labs. But we also supplemented that with other things, you know, we critically read scientific papers and analyze what was going on. Even sometimes, with COVID, we had virtual community building activities, where, you know, we would come on Zoom and have like a zoom game night and no cars here, this program takes students from all across the country, you know, even as far as California or Puerto Rico, and and students who don't know each other, we bring them into, you know, this sort of virtual environment and try to help them get to know each other. That's challenging, that is challenging. But that I think, is one of the key things of why students from underrepresented backgrounds are so successful, especially with us is because we, we have that sort of cohort, where we help build these communities, and we have people that you can lean on for advice. And so you know, that you're not the only one going through these challenges. And it's, remarkably is very successful because of that. But, um, so those sorts of programs, we had to sort of reimagine, but, you know, just the simple fact that a lot of those students are not getting the sort of research experience, or the sort of clinical exposure that they would ordinarily get that would make them competitive for, you know, graduate programs or medical programs, that I think is a huge, a huge piece and a huge challenge. I think it's impacted those underrepresented groups a little bit more, you know, for a lot of students who sort of had the privilege to either know, early on maybe like, let's say in high school, that they should be doing research, they'll do find out research programs in high school, or their parents will connect them with, you know, another parent who's a faculty member and say, Hey, can you take my, my son or my daughter or my nephew or my friend's son in your laboratory, they'll get that research experience in high school. A lot of students who come from sort of disadvantaged backgrounds, they don't, they don't have that sort of privilege. So I think, you know, we're almost faced with this sort of challenge of, you know, how do we now level the playing field and how do we ensure that we are still moving the needle on diversity? And not everybody has the same access?

Linda Howard

So do you think you think this is going to create a pipeline issue in terms of, you know, some of these underrepresented IT groups, when we look two or three years down the line, in terms of that whole admission and recruitment process in terms of getting them into, to these programs.

Dr. Marcus Lambert

Yes, it very well could. And I think that's something that we're just gonna have to watch and see, you know, what happens, because, you know, some things are, you know, it's, it's on the student side to gain the experience and to, you know, do the work and get the grades that's necessary. But the institutions also have to realize the times that we're in as well. And it they play a particular role and the types of students that they want to accept. So it's on both sides. And I think we have to see how this plays out. And just

Dr. Rachel Thornton

maybe to piggyback on that a bit as well. First of all, at least in in medical education, and I would hazard to say this is not unique. There are long standing issues around the socio economic diversity of students who are matriculated to medical school, as well as their racial ethnic diversity, that have been persistent problems, I think many of those are potentially byproducts of other structures in terms of the way that what gets prioritized in the, in the selection processes in many institutions, I will say that the potentially another another thing that the pandemic has, has pushed is that many institutions have gone from a hierarchical grading system to a bit of a flatter grading system for rotations. And even in things like college admissions, there have been shifts away from LSAT scores, given the all of the structural challenges and even accessing a site where you can take the test. And I can say that definitely for those students who are so there's a couple ramifications, I think in medical education and postgraduate training of physicians. One is that there are students, particularly those students who are from lower economic backgrounds who already are not the norm, unfortunately, in terms of the population of people training to be physicians, and to potentially are more likely to be otherwise from underrepresented or marginalized groups have had to go back and support family, right, like they've had to go back and take on a job or something else to support a family that is economically more at risk from the financial ramifications of the pandemic. And then if you think about those safety net training programs, in places that are otherwise underserved by or sort of in terms of having access to a robust healthcare workforce, many of those programs rely on international medical graduates who've gone through this sort of extraordinary extra step of getting passing all of their boards in the United States. And I know, just having been, you know, involved with a few students recently, or a few employees recently, who were going through the process of passing all their boards and applying to residency programs in the United States, in the context of the pandemic, there are not only ramifications for the composition of those classes, because people were delayed and being able to get to their destination because of all of the challenges around travel. But also those are people who are potentially working in environments where for a variety of reasons, there may be high higher concentration of infections, or where there may be potentially, you know, resource challenges in those safety net institutions and in being able to respond and I think at different points, you know, just coverage in the media has highlighted the issues around safety net hospitals in you know, rural environments is one example or places where there's sort of less resources to make sure all the PPE is in place, you know, not every hospital is equipped with negative pressure rooms, your ability to convert facilities, and so I think there are a lot of things to consider in a lot of ways that that you know, disadvantage or marginalization or what we might expect and, or even, you know, what people are, you know, contributing to patient care in in, in difficult circumstances, may not always take into account some of those issues in terms of the workforce and the fact that people may also be, you know, disconnected from family that is very far away and facing a variety of challenges and getting here, not just because of the pandemic, but potentially also because of other, you know, federal policies that have sort of negative ramifications on people that work that are here essentially serving a safety net function in our healthcare system.

Linda Howard

Okay, just so for those listening, tell us what you mean by safety net.

Dr. Rachel Thornton

What I mean is, you know, not the Johns Hopkins and the Cornell's of the world, but community hospitals, and, you know, small communities that don't have a bunch of research dollars coming into them or, you know, may not have the highest tech intensive care interventions available to them, you know, maybe a place that has, you know, only a few beds where people can actually get, you know, respiratory assistance, like a ventilator. And sometimes in those settings, those are also settings, where we struggle to, you know, fully staff up those, those environments with, with clinical workforce and clinic and physicians in particular. And so there are programs in place, either through kind of loan repayment programs to medical students who are graduating, to incentivize them to go and train in those places, or after training to go to those places and provide clinical care. We know that underrepresented students and international medical grads are more likely to take those safety net roles, where they're really providing a sort of they may be, you know, one of a few physicians serving a significantly larger patient population and their colleagues and dense urban areas. And that comes with a variety of challenges. And I think, you know, it's important to just remember, you know, the people and, and, you know, sometimes underrepresented students in particular have a particular commitment to giving back to their communities and, and maybe more likely to take on those really challenging clinical assignments. So it's another way that these kinds of dynamics play out around privilege and disadvantage and marginalization in the American healthcare system. And not to mention, the patients that they're serving, you know, may also be patients who have limited access to insurance or financial limitations and the like.

Linda Howard

And Dr. Lambert, I know, you want to jump in. And on this issue around just, you know, who do we have available, coming out of the institutions coming out of the medical schools coming out of the sciences, that would go back into the community, whether it's their community, or as Dr. Thornton said, whether they're going into that community because it is one of those safety net, hospitals or facilities or jobs that they are being incentivized to go into?

Dr. Marcus Lambert

Yeah, I very much agree with Dr. Thornton. You know, I think one of the biggest sort of challenges that we face as a nation is really just the our health disparities, you know, just access to health care, but also, you know, the sort of, you know, individuals that are providing that health care as well can can really help in terms of really achieving health equity. I say that to say that, you know, a lot of the encouragement for helping to diversify academic medicine, diversify the medical workforce, and even the graduate workforce. Really, I think, you know, comes from this notion that a lot of individuals from underrepresented groups have a tendency and a desire to go back into medically underserved areas, and work with populations that also are, you know, coming from the same sort of, you know, they look like them, they, they, they're getting care from the physicians and the the health workforce from individuals who also, you know, look like them. And, and I think there's been a number of studies to show that, that that does make a difference. So I think, you know, we, you know, certainly on my side, we're charged with really trying to produce as many individuals as we can, who are interested in serving in those sorts of areas, not just so that we can tackle health disparities and achieve health equity, but really so that we can have a really versified physician workforce and we just, we frankly, we need more And it's already been projected that we need to increase the number of physicians that we're producing. And we certainly need to increase the diversity of those positions. And I think there's there's only good things that are going to happen from that.

Linda Howard

You know, one of the issues around the sum of the health disparities and health equity is, you know, you have issues, really what you don't have the those that are serving the community actually having that cultural competency to do that. And, and having a diverse, more diverse practitioners help solve some of those some of those challenges, you also have a lot of issues in certain communities around trust, in that creates all kinds of issues around confined with with medical recommendations, medication compliance is whether or not people are even going to go to position it. If that physician doesn't look like them, if it doesn't, if it's not somewhere that trust is there. So you're actually pointing out a really big issue that isn't healthcare, around those health equity issues, that when you don't have diverse positions, when you don't have people in your community that look like you, it does create trust issues. And I think, you know, we look at some of the things that we're seeing with COVID-19. These are some of the challenges that we're even having, addressing COVID-19. And, you know, spinning off a little bit here, but I think we're going to also have some of these challenges, when we do get a vaccine. If we have a vaccine, and people are not trusting the vaccine, and those that are the scientists behind it, those that are administer those vaccines, if the community has a trust issue, we all have an issue.

Dr. Marcus Lambert

No, absolutely, Linda, I appreciate you bringing up that point. And I want to you know, even acknowledge that, you know, it's not just, you know, how you look, and how you perceive automatically gives you this sort of pass, you know, that trust goes a long way. And it takes time to establish, you know, just because you may be, you know, an underrepresented position, or, you know, a person of color, who's a researcher or scientist doesn't automatically mean that you're going to have the trust of that community. And that's pretty evident. And I've seen time and time again, examples of that, you know, I think, which is why, you know, one of the things that you often find, being closed and, you know, research circles is this idea of community based participatory research, you know, where you actually bring community members at the table, as you're designing research projects, engaging them. Before you, you you sort of, you know, write the grant, or before you sort of say, Hey, here's the research that we're doing, and going into the community, you have those members at the table, along with you helping to design and helping to develop the project and the research idea. And not just saying, hey, here, here, we know what's best for you let us go in and try to experiment and fix things. So, you know, I think even when it comes to the idea of, you know, vaccines for Covid, 19, you know, that one of the things that I think we need is really people at the table, you know, we certainly need to understand, you know, who's involved in these processes? And who are people that we can trust and hear from those individuals and understand, you know, what's going on with that process? And, and have those individuals being able to communicate with members of the community who are not necessarily physicians or scientists?

Dr. Rachel Thornton

Thanks, guess the only thing I would add is that the, the trust gap is legitimate in many regards, if you think about, you know, people's experiences, and what we know to be these sort of persistent structural challenges and to the way that black patients in particular, but many patients of color may be perceived, by the end construed and and evaluated within the healthcare system, this idea that, you know, my challenge in this space as a health equity researcher is making clear that fixing the trust gaps is not about fixing the patient's trust, it's actually about being trustworthy in the care of those patients and not and not continuing to, you know, reinforce these misplaced notions about, you know, about differences that are not biologically based and that are not actually factual, you know, the examples abound in history, you know, examples around misperceptions of pain tolerance in, in, in African Americans that are wholly based in, you know, kind of racist conceptions of, of black people in this country. And I think that's something that the medical profession, you know, needs to do more grappling with, to be sure that we are providing care that is worthy of our patience, trust. And, and then I think the whole issue of vaccines warrants the show all to itself on what the myriad challenges are around creating enough, you know, around providing good information around ensuring the safety of products and the like, that sort of exceeds my own expertise. But I do think you raise a really important point, Linda, that all these things are connected, and that it's not only about, you know, a misperception on the part of the patient, but in fact, these may be grounded in, you know, reproduced consistent patterns in people's lived experiences and in the behavior of institutions, that that needs to be addressed. And hopefully, you know, with people like Dr. Lambert at the table, in the educational process of physicians, we are, you know, I hope, you know, positioned to start really holding ourselves accountable for who we train, how we train them. And, and, and who, and, and ensuring that the people responsible for training and educating our future, you know, health care workforce for everyone from the folks who are doing Population Health Sciences, who may end up running quality programs and the like, and the folks in finance and, you know, business who are going to have roles in health care, delivery, all those people need, need to understand, you know, how we, how we steward the profession, and there's no better time than now with this sort of confluence of events happening right before our eyes. For us to really take that on. So I appreciate you, you know, centering us on on that important aspect of the dialogue as well.

Linda Howard

It's, you know, when we start talking about, you know, we we set this up to talk about this show to talk about higher education, but, but so much flows from that hole, from higher education from the missions process, the readiness process to power people being trained, when they're in institutions, what happens when they leave institutions? Is this creating, you know, pipeline issues? How are clinics being, you know, service, I mean, it's just so many things, just that before and when you were talking before I was, something came up for me just thinking about, you know, how is this impacting just even scholarships? funding our students is the, you know, when you start talking about some of the socio economic challenges, you know, is the money even available, even if they're the readiness is there, they want to go to school, they're, you know, they've gone over, gotten past all the hurdles of the virtual versus in person, and hydrates and all of that, is the money even pressed? Or are we going to see some of these challenges later on down the line as endowments start to suffer? And, and you know, and when you have students that are working in a virtual environment, sometimes when students go away to college, they escape an environment that is not a great learning environment. And so that's also another challenge when students are working from home, are they working at home in an environment that is conducive to learn? And so, you know, those are some of the things when I start thinking about higher education, thinking about certain population is, you know, is this real? Is this something that people are really experiencing? So I asked either one of you, have you, you know, identified some of these challenges or see some of these challenges coming down the line?

Dr. Marcus Lambert

I just was going to jump in, as you were talking and made me think, you know, just about the the sort of financial impact and our sort of almost first thoughts and concerns as we begin to sort of see the pandemic sort of unravel in our own higher education. You know, our I'm just kind of really speaking in general terms here. But, you know, at my institution, certainly our hospital and our medical center became one of the the major hubs in New York City for taking care of COVID patients, we largely essentially became a COVID, hospital, all of the other sort of aspects to care were sort of ramped down, and the focus was on COVID. And there were a few other hospitals around, you know, the city that did the same thing. And, but just speaking largely across the country, you know, it's a lot of institutions had to shift their sort of focus, given the times, and that created a pretty large financial hit. I know, you know, certainly, for a number of institutions, there have been cuts to staff, you know, I think in many sort of academic medical centers, the sort of clinical enterprise helps to to help the education, you know, world in terms of, you know, the financial support, but there's been, you know, cuts, as far as, you know, programming and staff that have, you know, tripled, trickle down to various departments. You know, one of the things that we talked about, and I think, you know, among my diversity colleagues in the diversity world, you know, we were wondering, because of the impact of COVID-19, how would that now impact diversity efforts? You know, for a number of years, we, we, we were, we were moving, we have this sort of movement of ramping up programs, and starting new initiatives and starting fellowships and getting grants and, and now that, you know, the resources are shrinking and tightening, how is that now going to sort of impact our efforts, which oftentimes, the bottom line require resources. So, you know, I'm talking really from a sort of institutional side. But that's one of the things that that we were concerned about. And I think we still, to some extent, share those concerns about how, you know, institutions will be able to support activities of inclusion and belonging and diversity, given the sort of strain on financial resources. And, you know, I'm happy to say that at my institution, we've been able to continue all the things that we're doing, if not grow in certain areas, where we had plan to grow, we've had to think about things a little bit differently and get creative in some areas. But I know I'm at a very sort of resource rich institution. But at a lot of institutions, they may not necessarily have that luxury. So you know, that's one of the things that had been on my mind as you brought up scholarships.

Linda Howard

I think both of you are both of you are with institutions that are probably in a different position, and some of your smaller colleges that might not have as many resources may not have, may not have the endowments that that you you've likely have. So, so you're in a little bit different position. But I think in the country, we were also dealing with kind of these these two major events happening at one time. And that's the COVID-19. But it's also an awareness around the disparities. And the US, whether it's the health disparities, that's been really outlined with the difference, and how COVID is impacting some communities over other communities, whether it's the the racial inequities that have been highlighted by some of the the, the racism that has been captured on video, not that the racism wasn't there before, but it's been captured for the world to see. So even though we're experiencing some of these financial downturns in institutions and organizations probably ordinarily would say, Hey, listen, we got to cut the diversity program is now in this challenge of is this a time to cut the diversity program when the world is looking at us saying, how are you handling these issues around diversity, equity and inclusion? So it's a it's a really interesting time that we're in.

Dr. Rachel Thornton

I agree, and I would just say that, in addition to that even, you know, sort of normal, quote unquote steady state before this, we know that many students in higher education You know, we're struggling to make ends meet before the pandemic to do school and, you know, feed themselves and their families. And I think many times those issues are, you know, particularly hitting hard folks who are trying to work and better themselves professionally at the same time, whether that's in getting, you know, a two year degree or a four year degree. You know, and now more than ever, I think those are both the, you know, the strains of the economic challenges compounded with the strains of, you know, potentially things they relied on, if they were, you know, parents, students working to have those additional, you know, the support of like, in person school, for your children, all of those things may be hitting, and this is not an area where I really have expertise at all, but maybe hitting those students even harder than in places where particularly in graduate education where people are. And then, you know, we're talking about very rarefied here, you know, academic medical centers, where it's, it's a highly select intense resource, intense environment where the training is full time, you know, and like I mentioned, there are students who I know of, who are also trying to hold down a job on the side, while they're doing full time programs to help supplement what family members have lost with job losses. But I think if you think about the totality of, you know, students in higher education programs, and what people are up against, particularly people who are already, you know, really seeing, you know, having to work and do schools simultaneously to better themselves or, or to get access to that next opportunity, you know, maybe particularly at risk or hard hit. And so I think there's a lot of questions, you know, not to go completely off topic, but there's so much investment needed to help all segments of our economy and our future workforce really recover, I think about all of the young people who graduated high school on Zoom, or who graduated college on Zoom, and we're looking at a job market where potentially, you know, the best opportunity in some places back in March or April might have been to get yourself, you know, trained up and being a contact tracer or something, I mean, just creates a lot of challenges for people making that progression and for us ensuring that we have really developed the talent that will need, you know, to continue to prosper, and even, you know, hopefully, in the future to, you know, to prosper in new ways, as a, as a nation, and to recover from, you know, all of the ways that, that people are being affected, we need, we need to be investing in our youth right now. Because we need them more than ever to be prepared, you know, to enter the workforce. And, and I will say, I'm just constantly amazed at, you know, from all ages, how quickly they adapt to using the technology and use and making sense out of these kind of remote platforms that were, and get conversant in them and figure out ways to be creative with them, to use them to connect with one another. You know, I like it, I don't think I just I believe in that human to human personal contact. But you know, I think this is really one of those times where our youth, our young people, and you know, college graduate school, we really need to be figuring out ways to invest in them, and to give them a pathway to know that they can, you know, that to support their success. You know, because we need that talent, that pipeline of talent to continue. And, and, you know, it's just so critical. And it's one of those things that I, I think a lot about, I still try to like set up zoom coffee meetings with undergraduate freshmen who are, you know, in their childhood bedroom, trying to figure out how to be a college student. I mean, it's just really, really challenging for them. And so as faculty, I think that's something we take very seriously trying to support them and understand what's gonna help them succeed and get through this really difficult phase.

Linda Howard

I tell you in this con, both of your contributions to this Profound Conversations has been excellent. I've thought about three, four, maybe five Profound Conversations, just from what you've been talking about. What Yeah, we can really do a deep dive into that. Yeah, whole that's a whole nother. That's a whole nother segment. So it has been absolutely wonderful. The conversation And I do want to just pose one other question, because I've seen a question come through in terms of, how do you foresee transformation happening in terms of the income, the upcoming semesters as a result of kind of the lessons learned so far?

Dr. Marcus Lambert

Yeah, thank you, Linda, for asking that. And I really appreciate Dr. Thornton, you know, mentioning, you know, this sort of aspect of, in some sense, you know, we're in a new world now, where, especially for parents or college students, you know, trying to navigate, you know, virtual workspaces education, almost simultaneously, you know, I have, you know, four kids myself, and certainly, when the pandemic hit, we were just having a very tough time with the virtual learning. I mean, you know, I thought I was pretty good with computers, but it just was, it was a complete challenge. And, you know, I think we've, we've tried to sort of come to some scramble to some sort of solution this, this academic year, you know, my wife is largely taken on the brunt of homeschooling. But you know, even that was that was is still a huge sacrifice. But not everybody has that, that sort of privilege. And, you know, there are people who are, you know, working full time and also trying to manage, you know, the educational atmosphere of their students. So I think we need to really think about the challenges that face us, right. And not just us as individuals, but like our communities and the most vulnerable people in our communities, like, you know, whether there's challenges around, you know, Internet access at home, whether it's challenges around, you know, working and higher education, you know, maybe we need to be thinking about scholarships, you know, for college students who have children so that they can get daycare so they can take the classes that they need to take, you know, maybe we need to be thinking about the sort of childcare services that we offer our employees, especially during this day and age, you know, we need to be coming up with with real, you know, solutions to some of these challenges that don't just affect the most privileged among us.

Linda Howard

All right, I think we got we got about two minutes before we are at the top of the hour. And so I'd like to thank our Profound Conversations. Ellis, Dr. Thornton and Dr. Lambert for being with us today. Your information you shared with us today was an invaluable and we look forward to having you back again. And Karim, do you want to say some closing words before we close out?

Karim Ali

I'd like to actually thank you, I'd like to just do some basic acknowledgments MLPI as the executive producer, Profound Conversations, media expression and productions done by Leah network, webinar, technical and logistics are produced by Erika Christie and Khadija Ali. graphics and animation are from design cafe. Today's host is the wonderful Linda Howard, yours true. And our guest today, Dr. Marcus Lambert from Cornell while on University, and Dr. Rachel Thornton from Johns Hopkins. And next week, I will be looking at issues around HR 40, reparations and reconciling the debt that America owes to a former slave people of this land. So I also want to bring mentioned to a we have a YouTube channel of Profound Conversations and we also have an after a broadcast toolkit. If you're interested in receiving the links, the video, audio links and plus more, subscribe on our website, and then you'll receive that every week after our broadcasts. Thank you so much for a wonderful episode, doctors. And thank you Linda.