Health Equity & Cultural Competency

Our patient population reflects the diversity of our community in Madison and Dane County. Madison’s ethnic and racial demographics are approximately 9% Asian, 7% Black or African American, and 7% Hispanic. Many of our patients do not speak English as a first language or at all; it’s not uncommon to work a shift and utilize UW Health’s excellence interpreter services for Spanish, Mandarin, or Hmong. In fact, Hmong is the third most widely spoken language in Wisconsin.

UW Health also proudly serves the needs of the transgender, gender expansive, and gender non-binary communities in our area through the multidisciplinary Gender Services Program.

Geographically, UW serves a large catchment area that is extended further by our UW Health Med Flight program, which brings patients from across Wisconsin and neighboring states to our Level I Trauma Center. This large catchment area allows us to care for many patients from rural communities and to better understand their needs and the challenges they face in seeking emergency care.

Madison is the fastest growing city in Wisconsin, and we are exciting to see how this growth influences even greater diversity within our community.

While Dr. Manish Shah stepped into the role of department chair in 2022, he has been faculty in the department since 2015. One of the major priorities he has identified for our department is achieving health equity through diversity and inclusion. Reflecting these values, our entire department believes in promoting inclusive learning and care environments as we work toward dismantling structural inequities in health care.

Dr. Shah has a proven track record with successfully increasing diversity through his work leading a large, NIH-funded training program at UW-Madison (KL2 Scholars Program). Additionally, Dr. Shah named the development and support of emergency medicine trainees as one of his key priorities as chair. This is another way in which retention and not just recruitment is front of mind.

We recognize that we are stronger together when we are a diverse group of individuals with mutual respect for one another. We deeply value the concept of cultural humility. We hold many events to ensure that we continuously have dialogue around our unique and often intersectional identities; this includes a DEI journal club and book clubs, inviting grand rounds speakers and speakers from our community.

Residents can also connect with others across UW through employee resource groups. Some of the most active groups are for individuals identifying as Black/African/African American, Latinx, Asian/Asian American/Pacific Islander, LGBTQ+, Women in Leadership, and Military Service Members.

This is a very important, high priority issue for both the department and GME programs. We follow many best practices that recognize the barriers that are frequently encountered in academic medicine by those with URiM backgrounds. We are proud to be among the first EM programs providing a funded away rotation for URiM medical students – a practice that has since been modeled nationally.

Recruitment strategies range from holistic review to individualized outreach, but we know that it’s just as important to help individuals thrive and be successful while they’re here. To ensure residents find personal and professional success, we provide mentorship and individualized guidance to support residents in becoming leaders in emergency medicine. Our unique resident coaching program pushes this to the next level, as we are always find ways to improve our program.

We are committed to recognizing our unique differences, leaning into uncomfortable situations and conversations, standing up for what’s right, and making our department an inclusive and welcome space for everyone.

The Department of Emergency Medicine also benefits from UW-Madison’s extensive array of resources aimed at recruiting the best and brightest talent from all backgrounds. The UW’s Faculty Diversity Initiative includes many funding sources, such as the Centennial Scholars Program, which provide financial support for hiring faculty from URiM backgrounds who may serve as visible role models and mentors to our student body while offering them protected time to advance their careers.

UW, UW Health, and the Department of Emergency Medicine continue to make dedicated efforts to increase the diversity of our faculty, trainees, and staff, including offering significant financial resources for faculty from URiM backgrounds.

We are proud that both our founding and current chairs are members of the BiPOC community and that all of our vice chairs and chief administrative officer are women.

Our department is very engaged in DEI efforts and conversations, and we are rapidly growing our efforts in this space. We are actively involved in research, clinical care, community outreach, and education efforts related to DEI. Our EDI Committee bridges important conversations and connects people from all levels of our clinical and administrative departments.

In the education space, we award multiple scholarships each year to underrepresented in medicine (URiM) medical students to support them completing visiting rotations with our department. Our faculty hold leadership roles in the EDI space, including our EDI Committee Chair, Dr. Ryan Tsuchida. Dr. Tsuchida was recently appointed the Interim Assistant Dean of Multicultural Affairs for Health Professions Leaders at the UW School of Medicine and Public Health; he is also a faculty mentor for the UW SMPH’s BEAM (Building Equitable Access to Mentorship) program for medical students and holds leadership through the Society for Academic Emergency Medicine’s DEI Academy.

Dr. Mary Westergaard, vice chair of education, has also been influential in DEI efforts through the UW Health Graduate Medical Education Diversity and Inclusion Task Force and as the founding chair of our school’s Group on Women in Medicine and Science. Her efforts helped to establish our local chapter and its annual Women in Medicine and Science Symposium, which occurs each fall.

Dr. Marin Darsie, assistant professor of emergency medicine and neurosurgery, successfully advocated for DEI contributions as consideration in faculty promotions at the school level and is a staunch support of civic health and supporting access to voting for all eligible people. And Dr. Sara Damewood, director of ultrasound, recently received an Impact Award for her efforts to advocate for women in medicine across the institution.

Additionally, Dr. Andrea Gilmore-Bykovskyi, associate vice chair of research, conducts extensive research into understanding the needs of diverse, vulnerable, and underrepresented communities in research populations.

These are just a few examples of the work being done in our department to challenge the status quo and to advance health and health equity for all.

Our faculty and residents are involved with many Madison-based groups, including MEDiC Clinics (free health care clinics affiliated with the UW), street medicine, food pantries, and supporting Native American communities. We support providers and staff to attend conferences and activities that either connect them with the community or provide education around health care disparities in our region.

Bringing the community to our didactic conferences is also a priority for us, and invite community organizers and patients to share their stories with our group throughout the academic year.

Across our research and knowledge translation activities, we continually work to sustain and strengthen our practice of critical reflection and active engagement with systemic and structural drivers of inequities. We recognize this effort as an essential component of our commitment to conducting transformative and innovative research—which extends to the way we engage and value the diversity of backgrounds and perspectives among our teams, trainees, and the populations we serve. Much of our research centers on understanding how the current healthcare system does not sufficiently support vulnerable populations and identifying ways to address these shortcomings.

We utilize research and discovery to address health disparities by:

• Engaging in research focused on promoting effective, meaningful, and equitable care and research for people living with and at risk for Alzheimer’s disease and related dementias, and which stewards new areas of investigation surrounding care delivery patterns and outcomes and established frameworks to advance research equity and inclusion.
• Addressing these priorities among vulnerable populations at high-risk points in the health and care continuum, such as during and after emergency department care and hospitalization and in advanced disease stages.
• Understanding and addressing how vulnerable populations are disproportionately affected by substance abuse and child sex trafficking, and implement ED-based interventions to improve care for these populations.

“It is incredibly important to identify where and why these patients are being managed and treated differently, and to ameliorate these healthcare disparities.” – Allie Hurst, MD, MS, medical director for pediatric emergency medicine and co-PI on a study in collaboration with UW School of Pharmacy utilizing game-based learning to teach opioid safety