Leave Downstate and Go Anywhere: Diversity and a Vision for Urban Health

A conversation with Carla Boutin-Foster, MD ’94, MS
SUNY Downstate Associate Dean for Diversity Education & Research
Carla Boutin-Foster, MD

The SUNY Downstate Office of Diversity Education and Research supports diverse students interested in pursuing medical education. It’s an important initiative for SUNY Downstate, Dr. Boutin-Foster said. The students are increasingly diverse, medicine is increasingly global, and Brooklyn, in particular, provides a singular opportunity to develop standards to impact urban health worldwide.

Support for a diverse community
“The office was formerly known as the Office of Minority Affairs, but we changed the name when I got here. I wanted to be more inclusive of what diversity is. I really wanted to capture differences in perspectives, experiences and abilities, as well as gender identity, sexual orientation and gender. I wanted it to be more comprehensive in our approach and, in doing so, allow more talents to contribute to the diversity that is Downstate.

“The office is really here to allow students who may sometimes feel marginalized, or may have barriers because of the way they look, the way they sound – any attributes that are placed upon them, and any barriers that happen as a result of that. We want to be a place where we talk about it, and where we embrace differences, look at similarities and bring about change. The students are telling me what to do, really. They live this every day.”

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Improving medical care
“Diversity, for me, is about providing patients with the best quality of care possible. SUNY Downstate happens to be in a community that’s largely minority. Our doctors need to understand that when you see a patient, you’re seeing their culture, their family, the stressors placed upon them. You’re sometimes seeing bias inflicted upon them. You’re seeing the total patient.

“And diversity, for me, is a way to address that. I think the more diverse a medical school is, the more likely students are to learn from each other, and to realize, ‘Wow, we’re from different places, and we do the same thing.’ You focus on differences when you don’t know someone. When you get to know someone, you realize we’re the same.

“It’s important for medicine. It’s important for student education, so students can function in an increasingly global society. I mean, Brooklyn is global. You’ll speak with someone who is from Bangladesh, and you’ll go to another patient, and they’re from Haiti or Russia. I want students to be able to ask questions. But it comes with being comfortable. If you’ve never interacted with a minority group and the first person you see is a patient who’s vulnerable, and sick – that will impact the treatment of that patient, inadvertently. So, it’s about providing the best care for our patients, and providing the most enriched medical education for the students who come here, and diversity does that.”

bar-chartEvents

The Office of Diversity Education and Research hosted its first event in July for diverse residents, fellows and fourth-year students, supported by Joseph Merlino, MD, Faculty Affairs and Professional Development, Kevin Antoine, JD, Diversity and Inclusion, and Stephen Wadowski, MD ’87, Associate Dean for Graduate Medical Education.

In October, the office hosts an event for Latino heritage and health, and in February, focuses on minority men’s health. The theme shifts to women’s health in March, and to LGBT health and wellness in June.

“When I was at (Weill Cornell), there was a strong LGBT support group, and I worked with some amazing faculty and colleagues around that. They’ve done things like have a speaker on transgender health, and faculty from Callen Lorde in the Bronx. I’m looking really to build on that. Or if there’s something already happening with the Pride Club at Downstate, to be supportive.”

Students, faculty and alumni are invited to contact the office with ideas, Dr. Boutin-Foster said. Two fourth-year students are planning tours for local youth to Brooklyn cultural centers. A male faculty member volunteered as a mentor after witnessing professional inequity in the treatment of women in medical research.

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Professional past, preparation
Born in Haiti, Dr. Boutin-Foster’s family moved to Brooklyn when she was 5. She and her best friend decided in high school to study medicine to make a change in the world. Dr. Boutin-Foster first wanted to specialize in OB/GYN, when her classmates started to get pregnant, but ultimately chose internal medicine.

“It really started out as—I enjoyed science,” she said. “But it was public health, social change, that I wanted to do way back when, and medicine was one way to do it.”

Dr. Boutin-Foster completed her residency in Internal Medicine at New York Presbyterian, and earned a Master’s from the Weill Graduate School of Medical Sciences of Cornell University in Health Services Research and Clinical Epidemiology. She later served as an associate professor of medicine, associate professor of healthcare policy and research, and associate dean for diversity and inclusion at Weill Cornell Medical College.

faculty-diversity-final“After residency, I did a Health Services Research Fellowship, a clinical research fellowship to learn how to ask and answer questions using rigorous research methods. I started doing health disparities research and looking at social factors that impact health. So, I’m looking at diversity as a health behavior. How do you get people from diverse backgrounds to engage in the activity of medical education? I’m always thinking about the research question. What’s the evaluation outcome? Because that’s what we’re trying to do, trying to change behaviors. We’re trying to help people have cultural humility, and to be culturally sensitive and aware.

“I loved my residency, I loved my training at NY-P, you know, but coming back here, and seeing the patients and the students, and the community. And walking on Clarkson Avenue, and just seeing people’s lives, and being in the midst of this daily is something I hadn’t seen in such a long time. It’s been a tremendous blessing to come back and use what I learned, and to build on what’s already happening. There are a lot of folks here doing amazing things.

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Vision for Downstate
Dr. Boutin-Foster said she’d like more interdisciplinary programs between Downstate’s five schools. Each has a unique diversity profile, and all the schools, uniquely concentrated on one campus, could form complete models for urban health.

SUNY Downstate at Brooklyn can be the place “students and faculty come to learn how to train students in a culturally diverse community. How do you increase cultural awareness and sensitivity in this population? We’re the place that can really do it, and set the stage and create models. I’d like Downstate to be the place where faculty and students come to learn about social justice and equity, and with that, violence prevention.”

She wants the Brooklyn community, if asked, “What’s in Brooklyn?” to answer, “Well, we have the Barclays Center, we have Coney Island and we have SUNY Downstate.’”

“Downstate’s doing it,” Dr. Boutin-Foster said. “It’s happening here. Community is here. We want students to leave this place and know they can go anywhere in the world and practice medicine. The problems that we see here are everywhere – from Chicago, to LA, to Wisconsin. I think one of the ways to get students to stay, is letting them know what can be done here. This is what happens when you graduate from Downstate. You can go anywhere.”


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