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October 3, 2007, ST. LOUIS - Barnes-Jewish Hospital''s commitment to diversity is quickly paying off.

Sixteen new medical residents from the Barnes-Jewish Hospital house staff were accepted into the Residents and Fellows Diversity Initiative in July.

The Residents and Fellows Diversity Initiative is a program established by the Barnes-Jewish Hospital Center for Diversity and Cultural Competence. Its goal is to encourage underrepresented minority medical students to seek their residency and fellowship training at Barnes-Jewish Hospital. Following training the program hopes to retain these physicians to serve in faculty positions at Washington University School of Medicine or encourage them to establish their practice in St. Louis.

Historically, minority students have been recruited by equally prominent medical centers outside St. Louis that have placed a stronger emphasis on diversity.

The program started with only 19 members; now there are 26. Members represent multiple ethnic groups, all interested in the same goal - to increase diversity on the medical center campus and to eliminate health disparities for diverse populations of patients. For the first time in the history of Barnes-Jewish Hospital, underrepresented minorities comprise 20 percent of its medical resident staff.

Selecting the 26 members out of a pool of 55 outstanding applicants was not an easy task for the selection committee. The selection committee was comprised of Lee Kling, president of the Barnes-Jewish Hospital Foundation Board; Jonathan Gottlieb, MD, chief medical officer, John Beatty, vice president of human resources and Brenda Battle, director of the Center for Diversity and Cultural Competence. Members are selected based on their ability to demonstrate commitment to efforts in promoting diversity, a commitment to actively mentor and recruit medical students and to perform community service to underserved populations in St. Louis. Members are awarded a grant from a pool of $200,000 each academic year through 2008.

"The response we''ve gotten so far is very encouraging," says Battle. "It''s evidence of the interest in increasing the presence of diversity on the medical center campus as well as supporting and sustaining this program."

Battle credits both the Washington University Medical Student Association and the Office of Graduate Medical Education in helping spread the word across the country that Barnes-Jewish Hospital places a premium on diversity.

Understanding subtle cultural cues

Corey Foster, MD, a third year internal medicine resident and a member of the Residents and Fellows Diversity Initiative, says cultural competence makes a huge difference when providing health care. When he was a medical student at Louisiana State University in New Orleans, Dr. Foster saw a lot of patients that didn''t have primary care physicians, went to the emergency room for minor care and didn''t take their medications as prescribed.

"Many people may not understand it, but for these patients it''s their reality," says Dr. Foster. "Some patients can''t read, and some have to make a choice between keeping their lights on or keeping up with their medicine."

Dr. Foster learned to look beyond a patient''s medical condition. "We would normally label such patients as non-compliant, but I was taught that if you don''t investigate past that assumption, you don''t give them what they really need."

Arghavan Almony, MD, a third year ophthalmology resident, knows all too well the importance of cultural competence in health care. At age 7, she came to the United States with her family as a religious refugee from Iran.

"As a member of the Baha''i faith, as a woman, as a Middle-Easterner in the United States, and as someone in an interracial marriage, I know firsthand the importance of the recognition and appreciation of diversity in all aspects," she says. "The Residents and Fellows Diversity Initiative is the kind of program that shows where Barnes-Jewish Hospital''s priorities are."

As a physician, Dr. Almony has seen how racial disparities affect healthcare decisions. When she was a medical student at University of Southern California, she did her rotations at the Los Angeles County Hospital, where most of the patients only spoke Spanish. She recalls a time when a parent brought in her child with an ear infection.

"It made a world of difference that the physician could speak Spanish and that the physician understood the parent may not have a refrigerator at home to keep certain liquid antibiotics for the child," she says. "Sometimes it''s the big issues, but often it''s understanding subtle cultural cues that allow for the best care of patients."

Residents and Fellows Diversity Initiative Members

• Anesthesiology – Takia Oglesby

• Dermatology – Chynna Steele

• Diagnostic Radiology – Yihua Zhou, Calvin Barnes, Kevin Johnson

• Emergency Medicine – Jose C. Vega, Dana Hendry

• General Surgery – Elbert Kuo, Tricia Moo-Young, Oluwadamilola Fayanju

• Internal Medicine – Sara Cross, Nasreen Ajmal Ilias , Chanda K. Ho, Corey Foster, Patrick White

• OB/GYN – Traci Johnson, Matrika D. Johnson

• Ophthalmology – Shu-Hong (Holly) Chang, Arghavan Almony

• Orthopaedic Surgery – Charles Toman

• Otolaryngology – Osarenoma U. Olomu

• Psychiatry – Juliet A . Glover, Cynthia Rogers

• Radiation Oncology – Elesyia Outlaw, Kenneth Biehl, Ryan M. Tierney