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AAP Bulletin December 2012

LCME Institutional Standard-16 on Diversity

Francis Lu, MD, 11/30/2012

Diversity and Cultural Competence Caucus

With Toi Harris, MD, and Joan Anzia, MD, I co-chair the AAP Diversity and Cultural Competence Caucus, founded in 2008, whose charge/responsibilities include: 1) To recruit, retain, and promote culturally diverse and underrepresented academic psychiatrists so as to increase their representation in both AAP and academic psychiatry, and 2) To foster cultural competence in medical students, residents and fellows, faculty, and staff of academic psychiatry departments so as to reduce mental health disparities.

We welcome your participation!

Consistent with the first charge, we wanted to publicize an important LCME Accreditation Standard for medical schools known as “Institutional Standard-16” that became effective July 2009. While this LCME standard is relevant directly to medical school accreditation, its implementation should include medical school departments including psychiatry. Of the first 25 medical schools that were site visited by LCME reviewers, 20 were cited as deficient on this standard. At, there are the Standard and Annotations that are quoted below. In addition at this webpage, there are materials to help medical schools prepare for the site visit on this standard, some of which would be relevant to medical school departments.

“IS-16. An institution that offers a medical education program must have policies and practices to achieve appropriate diversity among its students, faculty, staff, and other members of its academic community, and must engage in ongoing, systematic, and focused efforts to attract and retain students, faculty, staff, and others from demographically diverse backgrounds.


The LCME and the CACMS believe that aspiring future physicians will be best prepared for medical practice in a diverse society if they learn in an environment characterized by, and supportive of, diversity and inclusion. Such an environment will facilitate physician training in:

• Basic principles of culturally competent health care.

• Recognition of health care disparities and the development of solutions to such burdens.

• The importance of meeting the health care needs of medically underserved populations.

• The development of core professional attributes (e.g., altruism, social accountability) needed to provide effective care in a multidimensionally diverse society.

The institution should articulate its expectations regarding diversity across its academic community in the context of local and national responsibilities, and regularly assess how well such expectations are being achieved. The institution should consider in its planning elements of diversity including, but not limited to, gender, racial, cultural, and economic factors. The institution should establish focused, significant, and sustained programs to recruit and retain suitably diverse students, faculty members, staff, and others.”

This standard is at the “must” level of mandate (as opposed to “should” or “may”). It asks for specific “policies and practices to achieve appropriate diversity among its students, faculty, staff…” (as opposed to just policies involving just students). The annotation gives the rationale for the standard including physician training in both “culturally competent health care” and “recognition of health care disparities and the development of solutions…” Certainly this has relevance to our training of medical students and residents! Finally, diversity is defined as “including, but not limited to, gender, racial, cultural, and economic factors”; more on this definition can be found at the website below.

The AAMC Group on Diversity and Inclusion (GDI) has helpful resource materials and professional development conferences: As a member of the GDI National Steering Committee (2009-2012), I would be happy to serve as a resource person for further information:

AAP Bulletin – December 2012, Page 2 of