Frequently-Asked Questions

This is the most common question we are asked, and it highlights some important misunderstandings about the history of this work at YSM.

• The conversations have been had. As we have highlighted elsewhere, every 2-3 years for at least the last decade, there has been a major report by a group of faculty and/or students making recommendations very similar to those now demanded. These demands are the most comprehensive such report in recent institutional memory, and they are the result of dozens of hours of conversations.

• The demands are a statement of goals, but we are providing them along with an associated list of action items, in order to kickstart the process of institutional planning and to clarify what is meant by each demand.

• The work is urgent. Black students are exhausted by years of halting progress, by endless messages of “support,” by committees and reports and bureaucracy. Now, at this unusually stark political moment, is the time for action.

• This is the beginning of a new conversation. As should be clear from the demands, a major goal is ongoing conversation about systemic racism and oppression in many avenues—in the medical student and graduate medical curriculum, in the clinical and basic science departments, in a newly-established research center, and beyond. The “old” conversation was typically confined within committees and reports, and disproportionately occurred among individual underrepresented students and faculty. This “new” conversation must permeate to this entire institution, reaching all the policies, procedures, social norms, and individual beliefs.

Yes. Anyone affiliated with Yale, New Haven, or the broader medical and scientific community is welcome to sign the demands.

Please consider signing the demands even if you disagree with a few specific action items, in order to express solidarity with the overall goals. Please consider signing the demands even if you do not have the time or energy to read the entire action plan.

If you disagree with or feel ambivalent about the overall goals as articulated by the demands, we implore you to introspect seriously on why that is and what allows you to feel that way. Perhaps your experiences with the police have been positive, and you object to the abolition of the Yale Police Department; please consider that this may be a consequence of a privileged position; many in our community are not able to share those feelings of safety and belonging.

You are signing the 9 core demands as summarized here. The full action plan should be seen as clarifying and elaborating on the scope of these demands. Please consider signing the demands even if you do not have the time or energy to read the entire action plan.

These are not demands of Dean Brown personally—they are demands of the Yale School of Medicine, Yale-New Haven Health System, and Yale University. Dean Brown is the leader of YSM, and therefore the demands are being sent to her and she is being asked to direct their implementation. However, every faculty member, administrator, staff member, and student will have some role in fulfilling the vision of an inclusive and equitable YSM.

Systemic racism at YSM is not Dean Brown’s fault, but it is now her responsibility. We believe she has a historic opportunity to make lasting and long-overdue changes to this institution.

It is true that Yale School of Medicine, a school within Yale University, is nominally a separate organization from Yale-New Haven Health System (YNNHS) and Yale-New Haven Hospital (YNHH). However, these organizations are intimately linked and could not exist without one another. It is not meaningful to ask for change at one and not the other.

• Many YSM clinical faculty practice at YNHH, and increasingly, faculty at other hospitals within YNHHS receive YSM appointments.

• Leadership is explicitly shared: the chairs of YSM’s clinical departments are also the chiefs of YNHH’s clinical departments (a role known as “chair-chiefs”). The Dean of the Medical School is listed as a Trustee of YNHH.* The President and Provost of the University serves on the Board of Trustees of YNNH and YNHHS.**

• Students at YSM receive their clinical training largely at sites operated by YNHHS. In this sense, YNHHS is an extension of the training environment of YSM

We are asking for change at YNHHS and YNHH, in addition to YSM. In some cases we have recommended that a position be explicitly created with roles at both YSM and YNHH, much like what is done now for the chair-chiefs. This will require thoughtful collaboration and open communication between the organizations.

• Sign the demands.

• Spread the word about the demands. Please consider posting to your social media (Twitter, Facebook, Instagram) in addition to signing onto the demands with the following message or something similar:

  • "We demand a Yale School of Medicine, Yale New Haven Health System, and Yale University that is anti-racist and a YSM that actively dismantles its complicity in systemic violence against Black people. ysmdemands.org @Yale @YaleMed @ynhhealth #ysmdemands #NextYale #NextYSM"

• Contribute ideas and feedback.

• Stand in solidarity with the many other groups working for change at Yale, in New Haven, and beyond

An anti-oppressive curriculum is meant not only to make students aware of inequity but to teach them to actively resist systems of oppression.

Two core parts of such a curriculum are structural competency and anti-racist pedagogy. Structural competency is the ability to recognize and articulate how structural forces—laws, policies, companies, economies, the built environment—affect health, and to imagine and observe structural interventions. Anti-racist pedagogy is a method whereby students learn to critically reflect on oppressive power relationships; by examining issues from multiple perspectives and confronting—often emotionally—their own biases, students can work to overcome them. We highlight anti-racism here but this methodology can be applied to resist other systems of oppression.

This is the general philosophy, but a curriculum which is anti-oppressive will have to make many other changes and additions, which are described in more detail in the demands. This includes (but is not limited to): debiologizing race; disentangling sex and gender; teaching presentations of disease in diverse patients; providing historical context; and critically evaluating formulations of race and gender in the medical and scientific literature.

Wear, D., Zarconi, J., Aultman, J. M., Chyatte, M. R., & Kumagai, A. K. (2017). Remembering Freddie Gray: Medical Education for Social Justice. Academic Medicine, 92(3), 312–317. https://doi.org/10.1097/ACM.0000000000001355

Metzl, J. M., & Hansen, H. (2014). Structural competency: Theorizing a new medical engagement with stigma and inequality. Social Science and Medicine, 103, 126–133. https://doi.org/10.1016/j.socscimed.2013.06.032

Wagner, A. E. (2005). Unsettling the academy: Working through the challenges of anti-racist pedagogy. Race Ethnicity and Education, 8(3), 261–275. https://doi.org/10.1080/13613320500174333

Restorative justice (and “restorative practices” more broadly) seeks to repair harm caused by negative behavior. Often this is done by helping the two parties meet and agree on a way to repair the harm—but not always. The overall goals of such as process are:

• Empower the person who suffered harm

• Allow the person who caused harm to take responsibility and commit to change

• Repair the harm caused, in a manner agreeable to the person who was harmed

This process can be transformative and lead to lasting change in behavior. In the context of a medical school, this can also be an opportunity for education; publicly acknowledging and accounting for harm—intended or otherwise—can teach the community how to be more inclusive in the future.

Acosta, D., & Karp, D. R. (2018). Restorative justice as the rx for mistreatment in academic medicine: Applications to consider for learners, faculty, and staff. Academic Medicine, 93(3), 354–356. https://doi.org/10.1097/ACM.0000000000002037

Racialized equity labor is a term coined to describe the “often uncompensated efforts of people of color to address systematic racism and racial marginalization within organizations.” We use this term to call attention to the fact that the burden of addressing racism within institutions falls disproportionately on people of color, while the fruits of their efforts are often eventually appropriated by those institutions or institutional leadership.

Lerma, V., Hamilton, L. T., & Nielsen, K. (2020). Racialized Equity Labor, University Appropriation and Student Resistance. Social Problems. https://doi.org/10.1093/socpro/spz011

Title VI of the Civil Rights Act of 1964 protects against discrimination on the basis of race or national origin in programs or institutions receiving federal funds; it is intended to work similarly to the more widely-known Title IX. Successful litigation has created expectations about what Title IX enforcement should look like (hence the proliferation of Title IX offices), but the same has not happened for Title VI.

In May of 2018, following a racially charged incident, black graduate students and their allies wrote an open letter (An Open Letter to the Yale Administration from Black Graduate Students and Allies) requesting the establishment of a Title VI at Yale, among several other important changes. The University’s response to this letter has been lengthy and complex, involving multiple committees and a report written by an outside expert. In summary, this response has included several administrative changes, expanding implicit bias and resource training, a new website, additional programming, and an expanded scope for the (now renamed) Office of Institutional Equity and Access (OIEA).

In our appraisal, many of the problems identified in the original 2018 letter and the outside evaluation remain. The Office of Institutional Equity and Access (OIEA) remains opaquely-named and there has been little communication (at least to medical students) about its function for responding to Title VI complaints (Title VI is not mentioned on the OIEA website). The only method listed to file a formal complaint is to directly contact the Senior Director. There is no formal complaint resolution process described. It remains unclear how many instances of race-based discrimination and harrassment have occurred, because there is evidently no formal reporting process. And of course, we remain frustrated with the way University leaders communicate in response to major crises. But most fundamentally, the massive disparity in resources for Title IX compared to Title VI is itself inequitable, unjust, and unacceptable. Today, we re-focus on and amplify the moral clarity in the message of our allies over two years ago—Create a Title VI Office.

Siyonbola, Lolade; Williams, Alexia; Williams, Teona; Hall, Amanda J.; Brown, Charles D. II; McMillon-Brown, Lyndsey; Kothor, Marius; Barrera, Pablo N.; Lewis, Demar F. IV; Jean-Louis, Reneson; Okafor, Ifeanyi; Dromgoole, Ambre. “An Open Letter to the Yale Administration from Black Graduate Students and Allies.” May 26, 2018. http://www.conversationx.com/2018/05/26/an-open-letter-to-the-yale-administration-from-black-graduate-students-and-allies/

On this issue, we stand in solidarity with Black Students for Disarmament at Yale (BSDY) and endorse their petition to defund and dismantle the YPD.

Attempts at police reform have long been attempted in the United States, without much success at reducing violence committed by the police. This has led many groups to, for years, call for abolishing the police. We stand with this ideology. To quote a recent, widely read editorial:

Why on earth would we think the same reforms would work now? We need to change our demands. The surest way of reducing police violence is to reduce the power of the police, by cutting budgets and the number of officers.

But don’t get me wrong. We are not abandoning our communities to violence. We don’t want to just close police departments. We want to make them obsolete.

We should redirect the billions that now go to police departments toward providing health care, housing, education and good jobs. If we did this, there would be less need for the police in the first place.

Additionally, we object to Yale Police on separate grounds—they are redundant, unnecessary, and unaccountable. New Haven already has a public police department; Yale has an extensive security force. We are forced to ask, "why does the YPD exist?" In keeping with the broader movement for police abolition, we demand that Yale devote resources of the YPD to community accountability protocols and structures, and other alternatives to policing—including to studying the efficacy and consequences of those alternatives.