Boston Medical Center’s Pharmacy Department: “All-In” for Diversity

In early 2021, Boston Medical Center’s Pharmacy Department shared a historic announcement: It had just accepted two students into its first-ever All-In Committee Advanced Pharmacy Practice Experiences (APPE) Scholarship Program. The news was a “pinch me” moment for BMC’s All-In Committee—it marked a pivotal stride forward in the group’s mission to promote and build diversity, equity and inclusion in both the hospital’s pharmacy workforce and beyond.

Currently, the pharmacy profession is sparse when it comes to representation of minority groups. “Certain groups are significantly underrepresented in pharmacy,” emphasizes Jessica Fortune-Chery, PharmD, BCACP, clinical pharmacy specialist. “It hasn’t changed much since the 1980s.” A 2019 National Pharmacist Workforce Study indicated 78 percent of pharmacists are white, with the second-largest demographic being Asian. Then, the number drops off significantly, with Black and American Indian, Hispanic/Latino and “other” making up about 10 percent of the study’s respondents. “Having a diverse provider demographic is really important for optimal patient care,” notes Clinical Pharmacy Specialist Christopher Fagbote, PharmD, BCACP, about the implications of the unbalanced field. “That’s supported by the literature.”

Over the last two years, Fortune-Chery, Fagbote, Jason Mordino, PharmD, BCCCP, clinical coordinator for pharmacy education, and several colleagues have been hard at work creating a pathway to increase representation in their field, formalizing their work as the All-In Pharmacy Committee. “We have a diverse patient population [at Boston Medical Center] and it is important that our staff is diverse, inclusive, culturally competent and reflects the community we serve,” explains Fortune-Chery. “Our mission is to promote BMC’s core value, ‘Many Faces Make our Greatness.’”

Although it may seem daunting to spur change when the demographics have remained practically stagnant for four decades, progress comes by taking just one step in a new direction.

“I think one misconception is that in order to make a lasting change, it takes an extraordinary effort or a brilliant mind. It really just starts with a simple decision to, one, acknowledge that the status quo does not suffice and, two, act on it,” Fagbote notes. “This was a grassroots effort that started with taking an honest look and saying, ‘We can do better in this particular area.’ We have people from all different levels—pharmacists, coordinators, administrators, residents—who are eager to make a difference. There’s a James Baldwin quote that best describes our mentality: ‘Not everything that is faced can be changed. But nothing can be changed until it is faced.’”

And so the All-In Scholarship Program was born. The scholarship was developed for students enrolled in an accredited pharmacy school located outside New England who identify as an underrepresented minority such as African American, Hispanic or Latino, Native Hawaiian or American Indian.

For All-In scholars, they spend 12 weeks of their final year of pharmacy school—a time earmarked for participating in clinical internships to gain practical experience under the guidance of a preceptor—at Boston Medical Center. During that time, they take part in two six-week rotations, choosing from one of the following areas: internal medicine, inpatient operations, community, ambulatory care and electives (like critical care or pediatrics). Students are paired with a preceptor in their area of interest for each rotation.

The experience brings two unmatched benefits. First, students have the unique opportunity to work directly with a diverse patient population—people with whom they identify—and do so while practicing under BMC’s hallmark mantra exceptional care, without exception. “BMC is so special because we are here to treat the whole patient, no matter their socioeconomic status nor their past traumas,” says Fagbote. “Patients don’t just see BMC as a place for health care. They see it as a place of refuge.”

The second benefit is the opportunity to practice a specialized version of clinical pharmacy. “What we’re practicing is more progressive than many institutions,” says Mordino. “We’re not seeing patients from behind a counter, as many imagine. We’re at the bedside. We’re responding to medical emergencies. We’re seeing our own patients in clinic. We’re writing prescriptions. We’re providing a ton of education to patients.”

On top of gaining clinical expertise, students are paired with a minority mentor who provides a wide range of guidance and support, from helping them get acquainted to a new city to discussing professional goals.

The program’s concept is rooted in addressing opportunity gaps for advancement in pharmacy that could be served by increased institutional partnerships. To that end, the committee was strategic in how they spread the word about the scholarship. “We began outreach to pharmacy programs at historically black colleges and universities,” says Fortune-Chery. “We held several showcase presentations where we highlighted BMC, the committee and the scholarship program.” Fortune-Chery also notes that she often hears students saying they never heard of BMC, but once they have a chance to research it, they are taken aback by how it is well-aligned with their diversity- and inclusion-oriented career goals.

Despite the first year of recruitment taking place during a pandemic, the program thrived, bringing in applications from 16 schools of pharmacy. Eight candidates were invited for an interview, where the committee evaluated them based on their pharmacy achievements, pharmacy work, experience as well as their commitment to diversity, equity and inclusion. While the scholarship was offered to two students, five will be joining BMC’s campus this fall—three of the applicants elected to come to BMC on their own volition, a testament to the unparalleled career development offerings of BMC’s Pharmacy Department.

The ultimate goal of the program is to encourage underrepresented minority students to apply to BMC’s Pharmacy Residency Program, and then go on to build their careers at the hospital.

“We’re one of the top places in the nation to pursue postgraduate and graduate within pharmacy education,” notes Mordino. “We thought there was value in leveraging the strength we have in postgraduate education to bring more students from historically Black colleges and universities, and building diversity and equity within our residency programs.”

While the committee is thrilled at how the first recruitment year went, they are only just beginning to disrupt the field of pharmacy.

“When we started All-In, we didn’t know we’d accomplish so much [in such a short amount of time]. We just saw an opportunity to make a change. And we have,” says Fortune-Chery. And when it comes to the committee’s future plans? “We’re definitely thinking big,” she concludes.