Building a Diverse and Inclusive Biomedical Workforce with Susanna McColley, MD and Matthew Fete, PhD

Erin Spain, MS [00:00:03] Welcome to Science in Translation, a podcast from NUCATS, Northwestern University Clinical and Translational Sciences Institute. I'm your host, Erin Spain. NUCATS and Chicago State University are working together to help develop a diverse and inclusive biomedical workforce by fostering across institution biomedical collaborations in research, training and education. Here with details on this initiative is Dr. Matthew Fete, Dean and a professor of pharmaceutical studies at Chicago State University College of Pharmacy, and Dr. Susanna McColley, a professor of pediatrics in the Division of Pulmonary and Sleep Medicine at Northwestern University Feinberg School of Medicine. Dr. McColley is also director of the NUCATS Institute's Multidisciplinary Training Program in Child and Adolescent Health, or the TL1 program. Welcome to you both.

Matthew G. Fete PhD [00:01:01] Thank you.

Susanna A. McColley, MD [00:01:02] Thank you. 

Erin Spain, MS [00:01:03] There is a shortage of diverse professionals in the biomedical field. Can you each talk about this issue a little bit and the current state of diversity in the field?

Matthew G. Fete PhD [00:01:14] Certainly in health care right now, we're seeing patients in our communities are not receiving care from representative community health care practitioners. And there's also a need to graduate more scientists who do research related to health care and specifically clinical and translational research, which ultimately increases patient care.

Erin Spain, MS [00:01:34] Dr. McCauley, Can you add on to that? Tell us what you're seeing from where you sit at Northwestern.

Susanna A. McColley, MD [00:01:40] I want to really emphasize the reasons that it's important to have a diverse scientific and biomedical workforce, and we come together here with biomedical research. First is that diversity of thought, which comes from different backgrounds, different upbringings and different perspectives, is essential for innovation and for success. And that's not just in science, that's been proven in all kinds of businesses. Second, and as Dr. Fete reflected on, diversity in the biomedical workforce is essential for representation so that people have health care providers and scientists who look like them, who have some shared culture and background and experience. And that is essential to advance science, but also to assure that all science is conducted with an equity lens. Scientific advances should be applicable to everyone who could benefit from them. And so coming together for workforce development and scientific partnerships between Northwestern and Chicago State Universities is an important initiative that we can bring to our community here in Chicago and the region.

Erin Spain, MS [00:03:08] Dr. Fete, maybe underscore a little bit more for us the unique position that CSU plays in the Midwest in producing graduates that are traditionally underrepresented in the field of biomedical science, specifically at your school, the School of Pharmacy.

Matthew G. Fete PhD [00:03:22] Where a predominately black institution on the far south side of Chicago. We're the only predominately black institution in the country that actually has a pharmacy program. Now we have five sister schools that are HBCU's, historically black colleges and universities that have pharmacy programs. So there's really only six dedicated pharmacy programs in the country for graduating diverse pharmacists. 

Erin Spain, MS [00:03:44] Underrepresented minorities were awarded 11% of research doctorates, despite making up 27% of the population. That's really low number.

Susanna A. McColley, MD [00:03:54] I know that statistic, and I will also comment in my own field of medicine. Not only has there always been disproportionate representation, but it's actually gotten worse. And so we are not creating opportunities for very talented people to come into the workforce in biomedical science. We know that there are many structural barriers for people who want to enter these fields. The metrics at which we look for entry into M.D., Ph.D. programs or combined programs can include things like where you went to college and test scores and research experiences. And there are a lot of barriers for people who come from minoritized and marginalized communities. Some of them are financial, some of them are connections. But the talent is there and the energy. And the creativity is there. And so we need to disrupt some of these systems and give people opportunities to come into settings where there are intensive research resources.

Erin Spain, MS [00:05:15] So that is what is happening right now. This partnership. Dr. Fete, Tell me a little bit about the background here and how the two schools have come together. 

Matthew G. Fete PhD [00:05:24] Well, we've had a program called the Science Immersion Program together for some years now. Dr. McColley is the lead at Northwestern University Feinberg School of Medicine. And we collaborate to identify students who have research aptitude and desire. It's worth noting that in the College of Pharmacy, you typically have two departments one a pharmacy practice and one or pharmaceutical sciences. And so that can set students up for all sorts of opportunities in both patient care and research. So students very interested in the pharmaceutical sciences are interested in doing research, bench research, translational research and clinical research. And so we have partnered to identify students that would be a good match to do a summer internship program within the labs at Northwestern Feinberg School of Medicine. And we have found that students who engage in that program go on to do really interesting things with their careers or their post graduate education. That was the start, and we have grown quite a bit to do other things with faculty in a program called Science in the City where and we share research across Chicago. Our scientists gather with Northwestern scientists and we talk about equity driven research.

Erin Spain, MS [00:06:33] Take me back to the genesis of the Science in the City program and the science immersion program. Dr. McColley. 

Susanna A. McColley, MD [00:06:40] So I'll start with the Science Immersion Program, because that was really the impetus for the Science in the City program. This was originated by my dear colleague, Dr. Bill Schnapper. He had a big impact in terms of making the connections for the science immersion program with Chicago State and also Northeastern Illinois University, which is another minority serving institution in Chicago. We count on our partners at these institutions to identify students who are interested in research, and many of them have had some research experience that piqued an interest. But some come in saying, "This is interesting to me, I don't have that background." And we welcome those students as well, because that kind of interaction, both in labs with faculty but also as a group with specific learning activities, has spurred students on who really didn't think that research was going to be for them but were curious into research invested careers. And so that is really the magic of this opportunity. And the partnerships are very closely established now. We do interviews together and really talk about that and try to make sure that people don't feel in any way that they can't fit in. We want to meet them where we are because we know of the talent and drive there. A couple of years ago, we started to have conversations about how we could do more. So after some discussions, what we landed on is that the best way to build additional student opportunities was to have collaborations between faculty members. And one important thing is the Chicago State University College of Pharmacy is a long standing school that has a lot of terrific faculty. At Northwestern Feinberg School of Medicine we have a wonderful department of pharmacology, but we don't have a school of pharmacy. The pharmacology and pharmacy interact significantly together. They have resources and people with backgrounds that we need to do our best. And we have very well funded huge research opportunities that are also there for collaboration. And so we started this program and we've since had three different symposia bringing people together, even virtually and getting people to know each other is building a community. And we of course, invite students as well. And so it's been really effective and there's a lot of potential for future and further growth and collaboration. 

Erin Spain, MS [00:09:43] Dr. Fete, tell me about some of the success stories and some of the reactions from students who have participated in these programs.

Matthew G. Fete PhD [00:09:51] Yeah, it's really just been extraordinary and it's made me so proud. The students have gone on to do fellowships at Howard University. Postgraduate fellowships. They've gone on to do fellowships at Sanofi, which is a big pharmaceutical sciences company that has representation all over the world. And they've gone on to do research at Northwestern University. Feinberg School of Medicine opens up a whole nother career avenue for these students. We're really interested in graduating and educating students who can take advantage of the full opportunities, whether it be in community pharmacy, clinical, patient care at the hospitals or doing that incredibly important translational research that affects outcomes in pharmacology and pharmaceutics. These students end up working for pharmaceutical science companies, being involved in clinical trials and pushing the research frontier forward for us. Ending up in better patient outcomes for our communities, but also incredible career opportunities as they move through their futures.

Susanna A. McColley, MD [00:10:52] I'd also like to note that one of the opportunities that we give interested students is that we will place them in research pharmacies. So we do really large numbers of clinical trials here at Northwestern University and at Lurie Children's Hospital, and there is actually no specific training program for research pharmacists. So that's a huge need. And again, representation makes a big difference there. I'll also say that many people who graduate with pharmDs work at community pharmacies. Bringing the research background there to benefit people who come in is important, but there is a huge movement under way with some of the large pharmacy chains to actually conduct research within pharmacies. Drug research. And that's really, really important for another aspect of equity, which is facilitating participation in research studies, because minoritized and marginalized community members are generally underrepresented in biomedical research. So that is something that is in development that these students will have a great opportunity to take advantage of. And I think it's really important to keep that in mind as we continue working together.

Erin Spain, MS [00:12:26] These programs fall under NUCATS programing. Tell me how NUCATS is supporting initiatives like this for early career scientists with diversity, equity and inclusion initiatives.

Susanna A. McColley, MD [00:12:39] There has been a real sea change at NUCATS and elsewhere, so we have always had people who were interested in describing health disparities or doing research to overcome health equity. But foundationally, we need to be sure that everything in research has an equity lens and has an eye towards inclusive environments and a diverse workforce. Through NUCATS Center for Education and Career Development, we have embedded a lot of strategies and resources into programs. So in addition to the Science Immersion program, I and Evan Scott direct a program that combines pre doctoral and postdoctoral trainees who are looking at a future of translational science careers. And we embed content about inclusive environments, about the importance of designing studies that are generalizable, and all of the scientific, ethical and diversity knowledge that translational scientists need to know. This is also something that has been taken into the KL2 program, which is for early career faculty. And there's also a lot of content that goes, for example, to our clinical research community. Another strategy that we undertook a couple of years ago is to begin a course for the Master's of Science and Clinical Investigation program called Anti-Racist Strategies for Clinical and Translational Research. And Dr. Nia Heard Garris, who is a general academic pediatrician in our Advanced General Pediatrics division and a health equity researcher, co-directs that with me. And so we've done it for two years as an elective, and the feedback has been really extraordinary. And it's now going to be a core course, meaning everyone who gets that degree will be taking it. And so this gets people early in their careers to have the knowledge of their own power and privilege, the racism and how it affects health in the United States of America. Racism and both institutional and interpersonal in medicine and science and the health consequences of that. But more importantly, to take that foundational knowledge and think about developing research, whether it's in the laboratory, early translational or all the way out to clinical trials and implementation, that people have the foundational knowledge to not just be not racist, but to be really anti-racist in the way they develop their research. 

Erin Spain, MS [00:15:48] Is that pretty innovative? Our other folks doing this, or does this really set Northwestern apart?

Susanna A. McColley, MD [00:15:54] That's a great question, Erin. And we looked for courses that were similar when we were starting. Didn't really find any. You're starting to see other courses in the literature. Some of them are more based on community-based research, which is also incredibly important. We haven't found anything exactly like ours that has been promoted in literature and things like that, but I expect other people have been developing such things. And one of the reasons we wanted to publish our experience was so that people could read it and think about what they could do in their own environments. 

Erin Spain, MS [00:16:33] Dr. Fete, what is your hope for the future of this collaboration between Chicago State University and Northwestern University NUCATS' institute.

Matthew G. Fete PhD [00:16:42] Thank you for that question. I'd really like to see it continue as is and grow. One of the things that we've been working pretty hard on, particularly the Department chair of Pharmaceutical Sciences, Michael Danquah Chicago State and the chair of pharmacology, Dr. Al George at Northwestern have been working on a pharm.d the Ph.D. pathway. And so I'm really excited about that for the future, wherein students who graduate from Chicago State will have a pharmD, but they can also engage with Northwestern to work on a Ph.D. in pharmacology, really setting them up for opportunities in the future. There are other things that we plan to do within our logic model, which includes more health science students involved in the summer internship program. So I would be very excited about that as well. Chicago State has a Public Health Health Service Administration, nursing, occupational therapy, and so there are more needs that Dr. McCauley and I are investigating together to see how we can meet the needs of a broader health care population, not just pharmacy and pharmaceutical sciences. I think the sky's the limit to growth. Northwestern has done an amazing job growing the program from their side, identifying funding and recently even expanded the opportunities to include cancer research opportunities for students in pharmacy and the other health sciences. So I would love to continue to see that grow in a very positive direction because the students absolutely benefit. And I would say that the nicest part of the program is sitting back a few years after it started and seeing where these students end up in our communities, whether it be in community pharmacy or the pharmaceutical sciences and the impact they're having broadly on health care and outcomes.

Erin Spain, MS [00:18:19] The title of this podcast is Science and Translation, and having an anti-racist lens and fostering an inclusive environment and science is so important to this translation part of science as we're wrapping up today. Why, when we're thinking of translating science, do we need to have this lens?

Susanna A. McColley, MD [00:18:38] Every person deserves to have the best health that they can. Every society needs the healthiest population that is possible. Our biomedical research structure in the United States, in addition to other structural issues, have not allowed for that to be achieved by having anti-racist lenses in all of our activities now, our research, but also our patient care. If you're someone like me who sees patients also, our education is critically important to overcome barriers and help that have grown up over hundreds of years in our country, and to be frank, in other countries. And so these initiatives to be very intentional with assuring that the great talent in our entire community, the great collaborations and diverse perspectives and really thinking about how to be anti-racist in all the practices. It could be your pharmacy practice, could be your medical practice, and in your research is the way that we can march forward to improve health equity and to achieve excellence in all of the scientific and educational outcomes. 

Matthew G. Fete PhD [00:20:11] Another thing worth noting is that we all have different genetics, and so it's important to pay attention to how we do research and what libraries we use. Typically, a lot of the research has been done on a predominantly white or European genetic pool where in life began in Africa. And so if you don't pay attention to the appropriate genetic poles, the outcomes will be geared towards a certain part of the population, not the whole population. 

Susanna A. McColley, MD [00:20:36] Sub-Saharan Africa has the most genetic diversity in the world, but the research efforts have not included people from many ancestral backgrounds. You can't look at a person and then assume their ancestry based on the way they look, that that's actually racist itself. But if you don't have diverse participation by populations, if biomedical researchers are not trustworthy, if the institutions that they work in are not trustworthy to people with different ancestral backgrounds, different cultures, then we can't overcome that issue. And it's not just lack of benefit, but harm can be done when you don't have diversity in genetics. And pharmaco genomics has been a big emphasis of prior symposia that we've held together. So it's a really important point.

Erin Spain, MS [00:21:33] Anything else either you would like to add today?

Susanna A. McColley, MD [00:21:35] I'm just going to say from my perspective, I am so fortunate to be in a position where I can work with Dr. Fete and his colleagues, but also amazing students who come in with great perspectives and curiosity. And to have that talent in a room and in these labs is just an absolute joy. So I just want to say it's absolutely my favorite part of my job to work with these young people who are so inspiring.

Matthew G. Fete PhD [00:22:10] I absolutely agree with Dr. McColley, and it's been such a pleasure to work with Northwestern. We have such a value based partnership, really seeks to understand where can we educate students together to put them into a really great position to make a difference?

Erin Spain, MS [00:22:26] Well, thank you so much, Dr. Matthew Fete and Dr. Susanna McCauley for coming on the show today and sharing details about this partnership. It's very exciting.

Susanna A. McColley, MD [00:22:34] Thank you, Erin. And thank you, Dr. Fete. 

Matthew G. Fete PhD [00:22:37] Thank you.

Erin Spain, MS [00:22:42] Subscribe to Science in Translation wherever you listen to your podcasts. To find out more about NUCATS, check out our website. NUCATS.Northwestern.edu.