Continuous improvement and adaptive change are two core elements that have been and continue to be essential to the success of our nation’s medical school communities. As I approach my fifth year as Dean and Chief Academic Officer of NSU’s MD College, I find myself reflecting on the culture of NSU and our medical school looking through the lenses of diversity, equity, inclusion, and belonging. NSU MD has made tremendous progress in matriculating a highly diverse student body, with our class of 2023 consisting of more than 35% underrepresented minorities, a milestone of which we are tremendously proud and will continue to work to improve. The power of the education offered through our unique curriculum is a life-changing opportunity for students to experience one of the most innovative active-learning medical programs in the country while being incorporated in a rich tapestry of contrasting yet complementary faces with a wide variety of perspectives. Considering the ongoing health equity challenges that our country is experiencing, it is crucial to ask how NSU MD can even better nurture a safe, inclusive environment of learning and discovery that fosters an appreciation for all cultures, backgrounds, and points of view.

Drawing from my own upbringing and life experiences as a European-American immigrant, I have acquired a cross-cultural perspective that I believe is helpful in framing broader conversations on diversity, equity, tolerance, and inclusion for our NSU and South Florida communities. Since starting my academic career as an assistant professor at Duke University in the early 1990s, I have been immensely grateful for being afforded a path to success involving the triple-missions of education, research, and the practice of medicine. I realized early on that a relentless pursuit of discovery and innovation was not only highly valued by the institution, but a natural inclination to be inquisitive and analytical were rewarded professionally as well. However, over the course of my professional career, the most valuable and impactful scientific breakthroughs I witnessed were achieved alongside the diverse collection of students, residents, and fellows with whom I had the privilege to work with, and later on, to mentor and advise. These incredible individuals came from all over the world, representing different races, ethnicities, cultures, and creeds. While interacting with them I learned about their personal interests, goals, successes, and failures. I saw myself in many of them, and the bonds, friendships, and connections formed over the decades with students, collaborators, and mentees have been a highlight of my academic career. Hence, it is my sincere desire to provide a similar opportunity to our students.

My immigrant experience helped develop an appreciation for how each of our perspectives is formulated through a complex fusion of cultural influences, personal experiences, aspirations, expectations, fears, and anxieties, many of which are rooted in our formative years. Over time, I learned to appreciate viewpoints that are in contrast to my own with a genuine sense of curiosity and respect. I discovered that as I listened to and pondered others’ perspectives, I always came away with some degree of resonance that was relevant for me. In this way, I was better able to appreciate the new perspective and to incorporate its essence into my own thinking, thus broadening and enriching my own worldview. Broadening one’s perspective fuels authentic curiosity and cultivates open mindedness, forming the very foundation of independent and critical thinking, which is so often absent from our increasingly polarized society today. It is human nature to follow whatever is perceived as the “norm” by the group with which we most identify. But, this “tribal mentality” (an overused term that I do not really like but find applicable here) is often limiting, as it seduces individuals into believing that they are right, and even morally superior while assuming others are wrong without ever really considering the alternatives. By discouraging individuals from even asking questions in the very beginning, it negates the opportunity to understand points of view that are not aligned with their own. However, by intentionally exposing oneself to new experiences and to people who are different from those with whom we most closely identify, we break down the barriers of tribal tendencies, and we open up a whole new world of possibilities that would otherwise not be apparent to us.  It is settings such as this that hold the most potential for personal and professional growth, discovery, and innovation, and this is exactly the setting we are endeavoring to provide for our students.

For physician educators, integrating the cultural dimensions of practice into the learning paradigms and pedagogies that students experience, dramatically influences them personally and professionally for the rest of their lives. It is incumbent upon us to equip our students with the critical thinking necessary to be self-reflective, as well as respectful and curious about other views, so that they are highly effective at cross-cultural care, avoiding implicit and explicit bias in the real-world environment. Health equity is a global challenge and as such, we have an awesome responsibility to create an environment for all of our students that prepares them to be open and curious, equity-seeking, cognizant of the value of all cultures and backgrounds, while actively eliminating bias, prejudice and stereotyping in all of its deviant forms. While it is not necessary or perhaps even desirable for students to agree with every opposing viewpoint, they must at the very least learn to listen, respect, comprehend, and welcome ideas that challenge their own. That is, after all, the foundational strength of our democracy and it is the most efficient and effective vehicle for continuous improvement.  Once students become adept at navigating points of view that are distinct from their own, learning truly occurs. Teaching student physicians how to make good decisions under uncertainty is hard. Teaching them to construct ethical frameworks for clinical decision making is even harder. Such frameworks are achieved by intentionally balancing individual needs with community needs, establishing models of health equity, and always accounting for diverse values and beliefs.

Progressing through the ranks over the years from physician to research scholar, to the department chair and to the dean, with roles and responsibilities shifting commensurately, I made a conscious decision to try approach each role with the same spirit of inquiry and discovery that I embraced as a young physician scientist, and that decision has served me well. Opportunities for interactions with students and other learners have remained plentiful, allowing me to hone my skills overtime in preparation for managing even more complex situations involving diverse perspectives, including those from colleagues in other disciplines and business partners who possess dramatically different expertise, skill sets, and world views. A lifetime of navigating interactions in a broad array of settings and with a variety of diverse individuals has led me to conclude that the most effective path to producing a useful, meaningful, and valuable collective impact is to build bridges that span chasms created by siloed thinking while embracing an authentic understanding of diverse, and often, divergent perspectives.

Perhaps most importantly, in my life’s journey, I have learned that advancing one’s professional career in medicine through intellectual achievement and scientific advancement is only one piece of the puzzle. The interconnectedness of humanity – expressing compassion, empathy, and inclusiveness as a way of life – adds a richness to the human experience that is powerful. This has led me to conclude that in the limited time we have in this world, we must seize the opportunity to live in the richest, deepest, and most meaningful ways. While human connection is innate to all of us, it is also in our nature to seek out those who are most similar to ourselves. That is why, as educators, we have an obligation to create an environment where our students are challenged to appreciate the richness of our human tapestry and to develop a sense of curiosity and wonder about people completely different from themselves and ideas completely different from their own. When we teach our students to listen, to positively engage, and to appreciate and respect all of the people around them, we are helping to create not only better physicians, but more compassionate and inter-connected humans, and hence, a better world.