Diversity, Equity, Inclusion, & Anti-racism

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The Contra Costa Family Medicine Residency Program is committed to enhancing diversity, equity and inclusion. We have a longstanding legacy of prioritizing diversity within resident recruitment, and that foundation has helped us grow further in this work. At our Residency Retreat in March 2018, our leadership, faculty and residents engaged in critical dialogue to evaluate our program's commitment to diversity. From that meeting, we embarked on a journey of crucial conversations, trainings and workshops, deep reflection and inner work that has resulted in a deepening of our commitment to diversity, equity and inclusion. Given the recent protests related to the murders of George Floyd, Ahmaud Arbery, Breonna Taylor, and movement to affirm Black Lives Matter, our program recognizes the need to address structural racism and systemic oppression, and is engaging in the critical work needed to move towards anti-racism. As part of this charge, we have developed a comprehensive strategic framework to incorporate and strengthen diversity, equity, inclusion and anti-racism (DEIA) principles throughout our program. Our program continues to strive to be more inclusive and to help cultivate a place of belonging. We are working to ensure that our program is accountable to and increasingly reflects the lived experiences of the patients, families and communities of Contra Costa County.

DEIA

DEIA Strategic Framework

Residency Retreat March 2018 Following the critical Residency Retreat meeting in March 2018 and a renewed commitment to anti-racism, our program developed a strategic framework that aligned with our program's mission and values related to embracing diversity. This framework focuses on Diversity, Equity, Inclusion, and Anti-racism (DEIA) and is rooted in five main pillars:

Institutional commitment, culture & climate
Recruitment and retention of residents underrepresented in medicine (URM)
Recruitment and retention of URM faculty
Equity-based curriculum, assessment and evaluations
Sustainable community engagement

Successful Outcomes Related to DEIA

Continued focus on holistic review of residency program applicants and appreciation of distance traveled and demonstrated commitment to under-resourced communities
Revised our mission statement to reflect our program's core values around diversity, equity and inclusion
Development and implementation of our program's inaugural Resident Diversity Council (RDC) with enhanced resident engagement and leadership
Enhanced engagement by faculty and resident champions focused on Diversity, Equity, Inclusion, and Anti-racism (DEIA)
Continued emphasis on diversity, equity, inclusion and anti-racism in our faculty and leadership hiring practices
Increased recruitment of residents underrepresented in medicine (URM) from an average of 10 - 20% in previous graduating classes to as much as 69.2% (9 of 13) in our graduating class of 2023

Our program's journey is ongoing, and its success has been rooted in the legacy of prioritizing diversity in resident recruitment; grassroots organizing and advocacy of resident leaders, primarily by the efforts of our resident leaders on the Resident Diversity Council and the allyship of our CoCo Co-Conspirator resident leaders; the commitment and support of our program's leadership; the relentless spirit and tireless efforts of faculty and resident champions deeply invested in this work; and collaboration with key stakeholders including Contra Costa communities, community partner organizations and our health system, to help realize our collective vision around DEIA.

We hope that you join us on this journey!

Resident Diversity Council (RDC) Leaders / CoCo Co-Conspirator Resident Leaders

Angela T. Echiverri, MD, MPH
Core Faculty – Director of Diversity, Equity, Inclusion, & Anti-racism / Anti-Oppression (DEIA)

Estela Hernandez, MD
Associate Program Director & Admissions Committee Chair

Shannon Ladner-Beasley, MPH
Manager, Career Pathways in the Office of the Director of Contra Costa Health Services

Angela Rodgers, MD
Faculty, Residency Leadership Group & Founder / Co-Chair of UBEAM - Unity of Black Health Professionals in Excellence, Advocacy, and Mentorship of Contra Costa County

Brian Johnson, MD
Program Director

Kristin Moeller, MD
Former Program Director & CCRMC / Health Centers Medical Staff President

Commitment

Institutional Commitment, Culture & Climate

Mission Statement
We train diverse, full-spectrum physician leaders who champion health equity in under-resourced communities.

Transforming our Mission Statement

Our program evaluated our foundational statements and guiding principles around diversity, equity and inclusion. From critical dialogue and a consensus-based process, our new mission statement emerged which demonstrates our commitment to a more diverse and inclusive residency program.

Defining Diversity

As stated above, we embrace diversity as a source of strength! Our differences — of race, ethnicity, faith, sexual orientation, gender, gender identity and expression, age, socioeconomic status, culture, ability, lived experience and more — enhance our ability to achieve our core mission.
- Adapted from the University of CA Office of the President and Contra Costa Health Service

Underrepresented in medicine (URM) includes individuals who identify as one of the following:

African American / Black
Hispanic / Latinx
Native American / Alaskan Native
Native Hawaiian / Other Pacific Islander
Asian: Cambodian, Filipino, Hmong, Laotian or Vietnamese

- Adapted from URM definitions at UCSF and the CA Office of Statewide Health Planning and Development (OSHPD)

Our program appreciates the lived experiences of individuals from historically marginalized communities who demonstrate distance traveled, which may include individuals who identify as the following:

LGBTQ
First generation to college
Living with a disability
Raised in low income households

We recognize that these definitions do not fully capture the richness of diversity and intersectionality of identities that individuals hold. As stated above, we embrace diversity as a source of strength!

Recruitment

Recruitment of Residents Under-Represented In Medicine (URM)

Our program has a long legacy of prioritizing diversity in resident recruitment. We continue to reassess and enhance our admissions processes using a DEIA lens to ensure that we meet our program's mission, and highlight the following:

Prioritize holistic review.
Ensure diverse representation within the Admissions Committee. URM/POC residents are significantly involved in recruitment and the admissions process.
Implement implicit bias training for the Admissions Committee.
Emphasize the importance of diversity, equity, inclusion and anti-racism as part of the accountability to our program's mission and values at the beginning of each recruitment season.
Address ways in which structural racism impacts our recruitment processes.
Recruit at annual regional LMSA and SNMA conferences, as well as annual UCSF and AAFP conferences.
Host annual Diversity 2nd Look Celebrations.

Annual Diversity 2nd Look Celebrations

Learn more about our CCFMRP community
Meet URM/POC faculty, residents and community partners
Engage in panels
Learn more about our curriculum overall, and especially our curriculum focused on anti-racism
Get your questions answered
Optional shadowing opportunities in Emergency Medicine, General Surgery, Hospital Medicine, ICU, and L&D Settings
Hear about our commitment to diversity, equity, inclusion, and anti-racism!
Enjoy dinner with our community of Resident Diversity Council (RDC) Leaders and Faculty Advisors

"I think you did a wonderful job. This event really helped me understand CCRMC and all the work that you are doing towards increasing diversity and inclusion."
- Diversity 2nd Look Attendee

Resident Diversity Council

The Resident Diversity Council (RDC), founded in 2018 by Dr. Jennifer Shrestha, has helped pave the way for heightened resident engagement. RDC Leaders continue to use their voice, advocacy skills and strong leadership abilities to help our program promote diversity, equity, and inclusion, and move towards anti-racism.

For any questions, please email the Resident Diversity Council at residentdiversitycouncil@cchealth.org

Resident Diversity Council Goals

To build a community of support for URM/POC students, residents, and faculty
To actively address learning climate issues for URM/POC learners
To advocate for health equity and anti-racism as core values of our program and Contra Costa County as a whole
To actively recruit and retain URM/POC residents and faculty
To increase our program's visibility through recruitment at regional conferences such as LMSA and SNMA
To promote community engagement and collaboration through health career pathways / pipeline program work
To organize formal and informal didactics highlighting cultural and racial inequities in medicine

Resident Diversity Council Leadership Team

Senior Chairs

Skender Najibi

Shakir Saud

PGY3 RDC Leaders

Joana Loeza

Carol's Montes-Rouse

PGY2 RDC Leaders

Ana Boulos

Carla Castillo

David Pichardo-Gomez

Prachi Priyam

Fatuma Saho

Lilia Sanchez

Marian Younge

Resident Diversity Council Chair Emeritus & Faculty Advisors

The Resident Diversity Council (RDC) Faculty Advisors support the RDC Resident Leaders and help move the RDC's goals forward. In collaboration with the team of RDC leaders, they collectively work to prioritize equity and justice, advocate and hold our program accountable to anti-racism work, strengthen community partnerships, and center community with a focus on health career pathway / pipeline program work.

Chair Emeritus
Jennifer Shrestha
RDC Founder

Faculty Advisor
Angela Echiverri

Faculty Advisor
Estela Hernandez

Faculty Advisor
Shannon Ladner-Beasley

Angela Rodgers, MD
Faculty Advisor
Angela Rodgers

URM/POC Faculty

Recruitment & Retention of URM Faculty

Our program has a strong reputation of training physicians in full spectrum family medicine with a focus on working with and for under-resourced communities. Many of our graduates have stayed to practice within our county health system. Below is a partial list of a group of URM/POC leaders and faculty who are committed to resident education, and are part of our Residency Leadership Group. Some of the URM/POC faculty leaders below are graduates of our program (designated by *).

Karen Alingog, MD
Pittsburg Health Center
Pittsburg, CA

Melina Beaton, MD
North Richmond Center for Health
Richmond, CA

Angela Echiverri, MD, MPH
North Richmond Center for Health
Richmond, CA

Erik Gonzalez, MD
West County Health Center
San Pablo, CA

Estela Hernandez, MD
Emergency Medicine Department
Martinez, CA

Kaitlin HollandBerry, MD*
Emergency Medicine Department
Martinez, CA

Geena Jester, MD*
Emergency Medicine Department
Martinez, CA

Mena Ramos, MD
Emergency Medicine Department
Martinez, CA

Lisa Rodelo, MD
CCRMC Family Medicine / Obstetrics & Gynecology Department
Martinez, CA

Angela Rodgers, MD
Emergency Medicine Department
Martinez, CA

Michel Sam, MD*
West County Health Center
Martinez, CA

Sergio Urcuyo, MD
CCRMC Hospital Medicine,
Medical Director
Martinez, CA

Diversity, Equity, Inclusion and Anti-racism (DEIA) Committees & Groups of Contra Costa Health Services

Our residency program is part of a larger organization and public health system. Below is a partial list of committees and groups focused on DEIA work across the Contra Costa Health Services.

Diversity, Equity, Inclusion and Anti-racism (DEIA) Committee of Medical Executive Committee

Ogo Mbanugo, MD - Ad-Hoc Committee Chair
The Diversity, Equity, Inclusion and Anti-Racism (DEIA) Committee is part of the Medical Executive Committee, and are elected leaders of CCRMC & Health Centers. We stand against racism, hate, inequity and health disparities.

COVID-19 Historically Marginalized Community Engagement (HMCE)

Miriam Orantes & Shannan Moulton, MA - HMCE Facilitators

Health Equity Team

Adrienne Sofranko - Coordinator

Lesbian, Gay, Bisexual, and Transgender (LGBT) PRIDE Initiative

Natasha Petit, MSW, Brian Kuennemeier, PsyD, & Adrienne Sofranko - PRIDE Leadership
The mission of the LGBT Pride Initiative is to integrate practices and policies that foster: a safe and inclusive environment, equal access and quality health care services, as well as awareness, acceptance and respect for our Lesbian, Gay, Bisexual and Transgender employees and service recipients.

Perinatal Equity Initiative & Black Infant Health

Natalie Berbick, MSW - Perinatal Equity & Black Infant Health Coordinator
The Perinatal Equity Initiative will focus on improving health outcomes for African American infants and mothers throughout Contra Costa County. Black Infant Health works to empower pregnant and mothering African American women.

Unity of Black Health Professionals in Excellence, Advocacy, and Mentorship (UBEAM) of Contra Costa County

Angela Rodgers, MD & Patrice Ringo, MD - UBEAM Founders & Co-Chairs
UBEAM is an organization for Black health care workers from various departments and specialty areas to focus on addressing issues that affect the Black community, both Black CCHS employees and our Black patients.

Prioritizing Lifelong Learning & Faculty Development

In an effort to continue to grow and learn about inclusion, diversity, equity and allyship, our residents and faculty have opportunities for lifelong learning through our residency's Community Medicine – Population Health curriculum and our health system's workshops and home institution's trainings.

CCHS-Based Trainings

Health Equity Team
- Implicit Bias
Human Resources / Personnel
- What's culture got to do with it?
- Cultural Humility

UCSF Diversity, Equity & Inclusion (DEI) Champion Training

Increase awareness and skills
Use shared language and vocabulary to talk about bias and discrimination
Apply practical skills to address bias and discrimination
Apply thoughtful, active listening and empathy to support a more inclusive environment

The UCSF Differences Matter Diversity, Equity and Inclusion (DEI) Champion training is designed for faculty and staff who interact with learners of the UCSF School of Medicine. The DEI Champion trainings are eligible for 7 AMA PRA Category 1 Credits™.

*For more information: www.ucsf.edu

Curriculum

As our program undergoes the critical self-reflection and critical race consciousness needed to move towards anti-racism, faculty and residents are helping to shape longitudinal curricular changes focused on addressing structural racism. In addition, to growing change-agents and leaders, our program provides residents with a foundation in community medicine and population health.

"Having the experience of visiting community sites reminded me of my passion to practice in the community setting as part of a team that is mission aligned. This will challenge me to become a well-versed community advocate for my patients and collaborate with organizations within the community."
– Shakir Saud, MD (PGY2) at First 5 in Pittsburg, CA

Learning & Unlearning to Move Towards Anti-racism

Didactics

DEIA Noon Conferences & Monthly Anti-racism Journal Club
Organized by Continuing Medical Education Committee (CMEC) & CMEC Chair Kaitlin Hollander, MD. The focus is having noon conference talks center health equity and social justice.

Past Journal Clubs have focused on the following article:

NEJM Hidden in Plain Sight - Reconsidering the use of race correction in clinical algorithms by Drs. Vyas, Eisenstein, and Jones (August 2020)

Past DEIA Noon Conference talks include:

Ramadan, COVID-19 and Primary Care by Skender Najibi, MD
Race-Based Medicine by Carla Castillo, MD
RYSE Richmond Youth by Kanwarpal Dhaliwal
Legacy of the Tuskegee Syphilis Study: Implications for HIV Care in Persons of Color by Lawrence Boly, MD

Community Medicine - Population Health (also known as Comm Pop)
Co-lead by Angela Echiverri, MD, MPH, Core Faculty - DEIA & Shannon Ladner-Beasley, MPH, Manager of Career Pathways.

Pillars of Comm-Pop:

Health Equity & Population Health
Advocacy & Leadership
Anti-racism & Anti-oppression
Community Engagement and Collaboration

Past Comm Pop sessions:

Health Equity Series – Contra Costa
- Health of Formerly Incarcerated / Re-entry Communities: Transitions Clinic & REMEDY Group Visits
- Black Maternal Health Outcomes & CCHS Perinatal Equity Initiative
Anti-racism & Anti-oppression Curriculum
- Allyship
- Racism in Medicine
- Race caucusing
Advocacy & Leadership
- Developing a Personal Mission Statement
- Writing Op-Eds
- Storytelling as Advocacy
Community Engagement
- Community Assessment: Strengths & Needs
- Community Site Visits

Informal Didactics

RADical (Reading Anti-racism & Dialogue) Series
Founded & organized by Prachi Priyam, MD, MPH - Resident Diversity Council (RDC) Leader, Marian Younge, MD - RDC Leader, Ne Ferguson, MD - Core Faculty, Angela Echiverri, MD - Core Faculty, & Sarah McNeil, MD - Core Faculty

Past RADical series include discussion of the following:

Fatal Invention: How science, politics and big business recreate race in the 21st century - a critical read by Dorothy E. Roberts, JD
All In: The Fight for Democracy - a film featuring Stacey Abrams by Liz Garbus and Lisa Cortes
The Vanishing Half - a novel by Brit Bennett
"Reproducing Racism" - an episode reported by Priska Neely and Julia Simon from the Reveal Podcast

Elective

Community Health Elective Organized by Angela Echiverri, MD, MPH & Jessica Hamilton, MD with curriculum shared by Rachna Vanjani, MD

The Community Health Elective focuses on centering the experiences of historically marginalized and systematically excluded communities who are currently incarcerated, re-entry, transgender, or houseless. As a community health provider, advocate and change agent, this elective exposes learners to the structural -isms and inequities faced and the resilience and strength that define these communities and the providers that work with folks and support them along their journey.

Elective experiences include:

Adolescent Health in Juvenile Hall with Sofe Mekuriat, MD & Tamra Groode, FNP
Adult Health in Detention Facilities with Brett Curtis, MD, JD; Jessica Hamilton, MD; Joan Hoffman, MD; Elizabeth HollandBerry, MD, Troy Kaji, MD, Jessica Standish, MD
Reproductive Health at West County Detention Facility with Asher Vance, MD
REMEDY: Re-Entry Community Group Visits with Michael Changaris, PsyD, Charleszetta Brown, Sherae Frost, Arlinda Timmons-Love
Transitions Clinic for Re-Entry Communities with Joe Mega, MD & Malaika Scott, MD
Harm Reduction / Needle Exchange Clinic with Mariel Lougee, MD & Nurse Manager and Community Health Workers
Health Care for the Homeless Clinic at Mobile Units, Tent Encampments with Mariel Lougee, MD
Gender Health Clinic with Michelle Orengo-McFarlane, MD

Community Engagement

Sustainable Community Engagement

As part of our program's commitment to diversity, equity and inclusion and our move towards anti-racism, we have been invested in community engagement by providing opportunities to young folks through health career pathways or pipeline programming. Currently, our residency program partners with Shannon Ladner-Beasley, Manager of Career Pathways, and her Health Career Pathways team.

Health Career Pathway Program Goals

To grow the next generation of leaders from our local communities across Contra Costa County
To provide young people with mentors as they move forward with their education and careers
To introduce young people to our amazing staff and to expose them to different health careers
To diversify the pipeline of health care staff and providers that share in the lived experiences of patients, families and communities we partner with

CCHS Health Career Pathways (formerly known as Public Health Solutions)

Since 2016, our residency program has partnered with Health Career Pathways to provide summer health career shadowing opportunities to high school, community college, and pre-health interns. Between the summers of 2016 to 2020, we have had over 150 students participate in this program. This past summer, the HCP team revamped the program to provide virtual mentoring opportunities to young people with one on one virtual meetings, live virtual panels, and recorded interviews with mentors from different health careers representing our hospital at the Contra Costa Regional Medical Center, and our county's three major health centers, Martinez Health Center, Pittsburg Health Center, and West County Health Center. Overall, we had over 30 student interns matched with over 50 volunteer mentors.

During the summer of 2019, in partnership with HCP, we expanded clinical shadowing opportunities to our hospital at the Contra Costa Regional Medical Center, and our county's three major health centers, Martinez Health Center, Pittsburg Health Center, and West County Health Center. Overall, we had 55 students matched with over 60 volunteer preceptors to shadow a variety of health careers, including Radiology Technicians, Nurses, Orthopedic Surgeons, Family Medicine Primary Care Physicians, Physical Therapists, Emergency Medicine Doctors, General Surgeons, Cardiologists, and Psychologists.

The Ladder

One of our graduates, Dr. Mariel Lougee, launched a pipeline program in 2018, modeled after the program, The Ladder, founded by her faculty mentor Dr. Renee Crichlow at the University of Minnesota School of Medicine. One Saturday every other month, residents lead sessions focused on hands-on science activities and health careers. Over the past year, over 50 students have learned about different science topics (refer to list in left hand column). Like the original Ladder, this program works with young people to do the following: "Lift as you climb. Build as you grow."

The Ladder

Contact

For more information regarding diversity, equity, inclusion and anti-racism (DEIA) work at our residency program, contact us using the following form.

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