The 2011 Diversity Research Forum:
“First Institutional Experiences with the New LCME IS-16 and MS-8 Diversity
Standards”
Association of American Medical Colleges’ 2011 Annual Meeting Denver, CO
EXECUTIVE SUMMARY
Often the Association of American Medical Colleges (AAMC) Chief Diversity Officer receives
requests to help individual medical schools address the Liaison Committee on Medical Education
(LCME’s) standards on diversity. Responding to these requests, AAMC Diversity Policy and
Programs (DPP) conducted an AAMC annual meeting session with a LCME representative and a
select group of schools to provide an opportunity to discuss institutional process on LCME’s IS16 and MS-8 diversity standards. Below is a brief introduction followed by summary themes and
presenter highlights of this session held on November 8, 2011 in Denver, Colorado.
The LCME’s presentation discussed key changes in their programmatic and institutional level
diversity standards and provided guidance on how to avoid the common pitfalls that result in
noncompliance. The representatives from four medical schools shared their experiences at
various degrees of experience and levels of detail about the new process. Specifically, insights
were offered from the first medical schools who needed to meet the new expectations of the
diversity standards, followed by in-depth experiences by those schools that met the 1S-16
standard. The speakers in the order of presentation were:
Barbara Barzansky, Ph.D., MHPE, LCME Co-Secretary;
Andrew Chesson Jr., M.D., Dean, School of Medicine Louisiana State University
Health Sciences Center, Shreveport, Louisiana;
Chenits Pettigrew, Ph.D., Assistant Dean for Student Affairs and Director of Diversity
Programs, University of Pittsburgh School of Medicine;
Jonathan Appelbaum, M.D., Director, Internal Medicine Education and Chair,
Diversity and Inclusion Council, Florida State University College of Medicine; and
Karen Antnam, M.D., Provost, Medical Campus and Dean, Boston University School of
Medicine
LCME’s New Programmatic and Institutional Level Diversity Standards, IS-16 and MS-8
Barbara Barzansky, Ph.D., MHPE, LCME Co-Secretary
Dr. Barzansky addressed three points regarding the changes in the LCME diversity standards.
First, meeting diversity standards is now a deliberate expectation for medical schools. Second,
schools should establish formal policies and practices specific to these standards. Third, the
leading cause of noncompliance is the lack of formalized, resource-supported, data driven
policies, and practices. She then proceeded to describe the revised IS-16 and MS-8 standards.
Regarding specifically IS-16 standard, Dr. Barzansky shared that “an institution that offers a
medical education program must have policies and practices to achieve appropriate diversity
among its students, faculty, staff, and other members of its academic community, and must
engage in ongoing, systematic, and focused efforts to attract and retain students, faculty, staff,
and others from demographically diverse backgrounds.” MS-8 on the other hand means “a
medical education program must develop programs or partnerships aimed at broadening diversity
among qualified applicants for medical school admission.”
Afterwards, she explained the three major areas of noncompliance:
1) Not having a formal diversity policy, preferably, at the medical school level or at the
university level
Dr. Barzansky informed the forum audience that institutions often fail to digest diversity
in the medical school’s or the university’s policies. In other words, a formalized policy
must be in place at one of these levels.
2) Lack of “value added” categories for students, faculty, and staff
A second major area of noncompliance is the failure to define the specific areas in which
students, faculty, and staff will “add value” toward learning. This means schools should
avoid a long list of ambiguous target areas. Rather, schools must be explicit about what is
being done in the learning environment with regard to these groups and how these actions
match the institution’s goals.
3) Lack of documentation of existing programs to enhance diversity and resources to support
them
The third area of noncompliance is a school’s failure to document the programs that offer
more variety and also demonstrate that there are available resources. In other words, a
stated action around diversity must have a formal budget.
FOUR MEDICAL SCHOOL EXPERIENCES WITH THE LCME DIVERSITY
STANDARDS
The next section of the forum targeted the experiences of the four schools. Based on their lessons
learned, each school provided an overall or in-depth account of the steps they took to meet the
new diversity standards.
One School’s Overall Experience and Processes that Led to Partial Success Followed by its
Next Steps
Andrew Chesson Jr., M.D., Dean, School of Medicine Louisiana State University (LSU) Health
Sciences Center, Shreveport, Louisiana
Dr. Chesson explained that the School of Medicine (SOM) at the LSU Health Sciences Center in
Shreveport, Louisiana moved forward to “partially” meeting the new standards based on various
historical, political and administrative actions. He noted that as the region’s second statesupported medical school, admission is only available to Louisiana residents because of the
region’s community and political commitment to expand the local healthcare workforce. Beyond
the residency restriction for admission to the school, he noted that the race-neutral admissions
approach set forth by Hopwood (U.S. 5th Circuit Court, 1996) and the affects of hurricane
Katrina are challenges toward increasing diversity for both the student and faculty.
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Dr. Chesson shared the details of the school’s attempts to meet the LCME’s diversity standards
that occurred between 2007 and 2011. He noted that their process always involved a rehearsal in
preparation for the LCME meeting. In 2007, the school’s report to LCME stated that it
experienced recruitment challenges due to Katrina. The school reported on actions around
diversity that included its variety of initiatives and faculty recruitment. These actions were
supported by data that showed a modest outcome. LCME responded that student recruitment
needed to be addressed and that due to the natural disaster; a report of the SOM’s financial
stability was needed to show how the school would stabilize certain pipeline programs. In 2009
the school submitted a progress report to LCME highlighting its partnership program to grow the
science education pipeline and that there were no negative financial impacts due to the natural
disaster. Dr. Chesson explained that LCME’s response to their 2009 report directed the school to
further address medical student diversity and classified the progress for this population as “in
transition” An update was required in 2011.
Dr. Chesson informed that the 2011 report to LCME highlighted four specific tactics to meet
LCME expectations. First, they filled a key administrative position in the Diversity Affairs/Equal
Employment Opportunity office. Second, the SOM’s integrated the Road Map to Diversity
guidelines and demonstrated participation in the AAMC’s Holistic Review Program. Third, they
expanded the AHEC program. Fourth, they stood up the LSU’s System Diversity Task Force to
address campus climate, student diversity, and workforce training needs. LCME responded that
this report showed that the school “partially resolved” its student diversity deficits and that a
report was due in 2012-2013 to show that it met the “intended results.” Dr. Chesson completed
his presentation with two questions about LCME’s 2011 requests. First, what does the LCME
mean by “intended” results and what are examples of achieving these aims? Second, how does
an institution resolve the apparent conflict between LCME’s accreditation expectations and the
SOM’s diversity goals as outlined by the state legislature and budget office?
An Experience Early in the Process
Chenits Pettigrew, Ph.D., Assistant Dean for Student Affairs and Director of Diversity Programs,
University of Pittsburgh School of Medicine
Dr. Pettigrew outlined how the success if the University of Pittsburgh School of Medicine’s was
influenced by envisioning MS-8 and IS-16 working together. He explained that the school drew
on its foundational and historical efforts that increased student and faculty diversity and actions
to eliminate discrimination. These experiences helped the school provide activities it would
report to the LCME that AAMC’s Group on Diversity and Inclusion (GDI)’s definition used to
anchor their school’s actions. The report included their plans to align key players around their
diversity efforts such as the physician inclusion council that includes chairpersons by specialty,
the senior associate vice chancellor, faculty, and residents.
Dr. Pettigrew continued that Pittsburgh SOM’s report explained how the diversity definition was
used to guide perception and to collect associated surveillance data. The data collected was used
to strategically realign the school’s actions (e.g. student recruitment and retention). He
summarized their process that allowed for successful reaccreditation through 2019 in the
following four points: a) have a framework; b) identify and share a definition of diversity with
key players; c) keep diversity as a high priority, and d) look back to give direction for the future.
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LCME’s response to their report noted their success for students but required that the school
address faculty, house staff, and staff diversity. Dr. Pettigrew noted that their current actions
involve developing a response and realignment strategy to address these challenges.
Two In-Depth Examples of Meeting the IS-16 Standard
Jonathan Appelbaum, M.D., Director, Internal Medicine Education and Chair, Diversity and
Inclusion Council, Florida State University College of Medicine
Dr. Appelbaum provided an in-depth look at how Florida State University (FSU) College of
Medicine (COM) met its IS-16 standard. He explained that their reports to the LCME started
with using the SOM’s mission to identify the populations it served: elder, rural, minority, and the
underserved. Dr. Appelbaum noted that this direct link to the school’s mission statement helped
simplify their initial experience with the LCME in 2005 and again in 2011. The report in 2011
from the LCME noted the strength of their pipeline programs. The elements that contributed to
their success included disaggregating student, faculty, and staff data by race and ethnicity.
Dr. Appelbaum noted that the school fulfills its mission related to IS-16 through pipeline
programs, holistic admissions, student support systems, trainings in the community setting, and
one-on-one instruction by community physicians. In particular, their pipeline program included
specific trainings and data collection concerning their progress regarding on-going services
between students’ middle school and clinical years. The report also noted the school’s efforts to
conduct and track outreach and advising activities. The progress of the pipeline programs were
captured through data collection that included numbers and percentages of participants and
graduates that were separated by background, specialty, track, and location of practice (e.g.,
rural).
Boston University School of Medicine
Karen Antnam, M.D., Provost, Medical Campus and Dean, Boston University School of
Medicine
Dr. Karen Antnam shared that the Boston University (BU) School of Medicine’s
success at meeting IS-16 began with BU has a statement on diversity which is outlined in the
faculty search manual. At the medical school, diversity is an integral part of the mission
statement, strategic goals, and institutional learning objectives. She noted that in addition to the
school’s history of inclusiveness towards all gender, religions, races, and national origins, there
are seven areas of activities where the school addresses diversity: 1) recruitment, 2) coordination,
3) admissions, 4) pipeline programs, 5) financial aid, 6) the curriculum, and 7) community
engagement. Dr. Antnam further explained that the medical school’s recruitment strategy is
stated in a manual where diversity and excellence are twins aim thus deliberating steering clear
of unconscious bias. The school reported on its coordination efforts that formed a campus-wide
Committee on Diversity and Health Disparities and an Office of Diversity and Multicultural
Affairs.
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Actions to increase diversity are noted in the admissions process of the schools mission. A
holistic review process is re-enforced by a trained faculty committee as they select applicants. In
addition, the school reported on the type, duration, and target populations of the pipeline
programs. Dr. Antnam also noted the report of their financial aid activities to enhance diversity
involved allocating funds based on need. The school’s curriculum changes to address diversity
were described in the report by stressing the content, exercises, and format of the sessions.
Finally, Dr. Antnam explained that the BU SOM reported its community engagement actions
include its relationships with community health centers, efforts to address health disparities
through clinical trials that target community members and the availability of pipeline programs
for public school children.
THEMES FROM THE FACILITATED DISCUSSION
Following the presentations a moderated discussion followed between presenters and the
audience. Below are three key summary themes on how to address various challenges associated
with MS-8 and IS-16 standard.

Set your school’s diversity goals and report outcome data on how they were met
The LCME views data as an indicator of the extent to which a school met the goals it set
for itself. This means reporting the progress made for the population it values. For
example, if a pipeline program starts in college then the data collected should track the
students through enrollment into medical school.

Use the holistic review approach and electronic voting devices to facilitate equity in
admissions and in the classroom
The holistic review process can make certain that both minorities and non-minorities
benefit from diversity efforts. Also, electronic voting devices can encourage participation
by a wide range of diverse identities in the classroom.

Explore using definitions of diversity that cut across multiple systems
Schools must take steps to ensure that its definition of diversity accounts for global,
system, and legal considerations. For example, one school combined information from
the AAMC professional group on Diversity and Inclusion (GDI), the school’s local
circumstance, and other environmental factors to outline its definition of diversity.
Next Steps and the LCME
The AAMC will explore with the LCME the development of a website to support medical
schools throughout the accreditation process. This website would provide guidance on best
practices and how to address the common challenges schools experience throughout the process.
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