Dr. Quinn Capers IV discusses Implicit Bias and the #DropAndGiveMe20 campaign

One of the focuses of my blog is STEM (Science, Technology, Engineering and Mathematics), and my most central principle is “Creating Ecosystems of Success”. While we tend to think of clinical medicine as strictly a ‘healthcare’ profession, its foundations are actually rooted in the ‘Basic Sciences’. In late 2017, I discovered Dr. Quinn Capers IV on Twitter one day by chance and started following him when he was tweeting about medical education at the Ohio State University. The hashtag he used in most of his tweets, #BlackMenInMedicine, further piqued my curiosity.

Last year I had the honor of interviewing Dr. Capers about his path and #BlackMenInMedicine. To see our 2018 interview go to Dr. Quinn Capers, IV discusses his path, #BlackMenInMedicine, and the present landscape of medical education. Dr. Capers recently granted me the opportunity to interview him a second time. In this follow up interview we discuss the concept of ‘Implicit Bias’, why it’s important, and the hashtag, ‘#DropAndGiveMe20’. The images in this interview were graciously shared by Dr. Capers himself. Click on any of the images to enlarge them.

Anwar Dunbar: Hello, Dr. Capers and happy New Year. I want to thank you for the opportunity to interview you again. As the Dean of Admissions at the Ohio State University’s Medical School, your words are very, very valuable, especially for students aspiring to attend medical school. Before we get into ‘Implicit Bias’, the last time we spoke we spent quite a bit of time on the hashtag #BlackMenInMedicine. I now see you using a second hastag, #DropAndGiveMe20. Where did this hashtag and the whole push-ups piece come from? Did you start that?

Quinn Capers: The #DropAndGiveMe20 campaign is a great story. I’m a big fan of Ohio State University (OSU) Football. For years, while watching the games on television, I’ve had a fun routine of doing 10 push-ups every time they score a touchdown. I picked push-ups because they don’t require equipment or much physical space. They’re a good measure of overall upper body strength and they get your heart rate up. Mostly, I wanted to feel like I was exerting myself while the players were on the field exerting themselves. It’s just fun.

I’ve done it at sports bars and experienced both strange looks and strangers joining in! In November 2017, my wife recorded me doing this after an OSU touchdown and I thought it’d be cool to put it on Twitter to spark excitement among OSU football fans. I got a few responses, but the best one was from an interventional cardiologist at UCLA, Dr. William Suh (he is now a great Twitter friend or a “Tweep”), who said he could top that; and would do 20 for every UCLA Bruin touchdown. So he did 20, then when OSU scored another touchdown, I did 20.

AD: Ohio State Football. Yes, you all beat my Michigan Wolverines yet again (laughing).

QC: Well, we both had Twitter followers who are cardiologists and since heart doctors love promoting exercise, they joined the fun and challenged other cardiologists. I guess you could say that Dr. Suh and I are the “co-founders” if you must, but it has grown so fast and so many are responsible for spreading it that it really is a group effort now. It grew quickly to include other specialties, non-physicians, and even patients. In fact some of the most regular and awesome participants are patients; one a heart transplant survivor. They’re simply incredible.

It grew fast under the hashtag “#DropAndGiveMe20” and it’s now international with participants all over the world posting clips from places like the following: Sydney (Australia), London, and Lagos, Nigeria. We post daily and give each other positive feedback, hold each other accountable, and promote wellness and exercise. One of my main goals is to promote exercise as a way to improve heart health and to show that you don’t have to wait to go to a gym, since it can be hard to work a full day and plan to go to a gym afterwards. I’ll usually post clips of myself doing push-ups during my work day in the cardiac cath lab, in my office between meetings, or even in an auditorium after giving a lecture. Others have posted clips in unusual settings, like at dinner parties.

AD: Nice.

QC: I’ll tell you about two of my favorite clips. There’s a very famous female cardiologist who posted clips of herself doing push-ups at the airport terminal awaiting her flight. A prominent British cardiologist topped that by doing his on a moving walkway at London’s Heathrow Airport (not recommended, by the way)! We have great fun adding humorous wrinkles to it, like adding more and more people in a clip. I suppose I took it to new heights recently when I concluded a live simulcast lecture to a group of medical residents in Cameroon by asking them to do push-ups with me! They complied and we completed what might be the first, simultaneous, international push-up session!

I also take the opportunity to share my love and knowledge of jazz, hip-hop, and R & B/Funk music. My clips are always accompanied by a musical selection from my collection. I always credit and tag the musicians (if they have a Twitter handle), hoping to spark curiosity about certain hidden gems and send my Twitter followers “digging in the crates” to support the music. I was beyond thrilled when two different artists supplying the soundtrack to my push-ups responded to my tweet, the hip hop group “Digable Planets” and saxophone legend Branford Marsalis!

It’s great fun, and a very friendly Twitter community has grown around it. We now arrange to meet up at conventions (cardiology or otherwise) and do a “#DropAndGiveMe20!” Regarding the health benefits, doing push-ups can provide positive reinforcement in a relatively short period of time. Last November I could barely do 25 at one time, now I can max out at 43. Anyone is welcome to join the fun. If you can’t do 20, start with 1 or 2 push-ups! By the way, Dr. Dunbar, you and your readers are welcome to join anytime. Just record yourself, post it on Twitter with the hashtag “#DropAndGiveMe20” and tag your colleagues to get them involved.

AD: Okay, Dr. Capers. I haven’t done push-ups in a while, but now I may have to see if I can crank out 20 (laughing).

I noticed that after starting to follow you, ‘Implicit Bias’ became something you started addressing. How did this come about? What should the general public, and particularly those looking to get into medical school, understand about it?

QC: Implicit bias is a negative or positive attitude towards a person or group that occurs outside of our awareness, intention, or control. Although these biases occur outside of our awareness, they can influence behavior, possibly resulting in well-meaning people treating others differently based on race, gender, age, etc. I came across the concept as a cardiologist interested in racial healthcare disparities. Disparities have many causes, like social determinants of health, housing discrimination, unequal access to the best care, outright racism (explicit bias) of practitioners, structural bias in the healthcare system, etc.

I became intrigued with the notion of implicit or unconscious bias and its potential role in unequal treatment. Several studies have shown that a physician’s unconscious association of negative thoughts or words with a particular race or gender can be associated with therapeutic decisions that are harmful to persons in that group. For instance, one widely quoted paper had physicians take the computer-based implicit association test (IAT) that’s designed to uncover implicit associations or biases (free, available at implicit.harvard.edu) and then review case vignettes of a black or white male suffering from a heart attack.

Doctors were asked if they thought the symptoms of chest discomfort were indicative of a heart problem and if they’d treat the patient with a life-saving drug to terminate the heart attack. Physicians whose IAT showed “implicit white race preference” or an unconscious association of a white person’s face with good words (love, joy, warmth) and a black person’s face with bad words (danger, misery, trouble) were less likely to treat the black patient with the drug despite the black and white patients having identical presentations (1). It is important to note that this is not racism, which is a conscious, explicit bias. But implicit bias can potentially have life-and-death consequences in healthcare. While not all studies of implicit bias show an association with a doctor’s decision-making, enough do to cause alarm.

AD: That’s interesting.

QC: In addition to being a cardiologist I have the great privilege of serving as the Associate Dean for Admissions at the Ohio State University (OSU) College of Medicine, and I’m responsible for overseeing the recruitment, interview, and selection processes for our incoming medical students. When I reviewed a paper that showed that approximately 70% of a large group of physicians taking the IAT have implicit white race preference (2), I immediately pictured our medical school admissions committee and the fact that it is composed largely of physicians, and I had several questions: Do the physicians charged with the awesome responsibility of deciding who will become a doctor have implicit racial biases? If so, to what extent? If so, might it influence their decision-making and put black and Hispanic applicants at a disadvantage?

We set out to answer these questions and had our entire committee take the race IAT in 2012. Aggregate results revealed that a significant portion of the committee (between 50 and 70%) had an implicit white race preference. Next, Dr. Anthony Greenwald, implicit bias expert and one of the inventors of the IAT, led the committee in a discussion of implicit bias and how to reduce it. In the very next cycle we matriculated the most racially diverse class in the history of the college, suggesting that we are able to overcome implicit biases. This was the first paper to document the presence and extent of implicit racial bias in the medical school admissions process (3).

Our results indicated to us that we could have what we thought was a fair, objective process, on the surface, but that unconscious biases could put certain groups of candidates at a disadvantage. Since then we’ve had robust discussions about implicit bias and annual workshops on bias mitigation. I recently completed a training program leading to certification to moderate implicit bias workshops, and I do so twice a month. This goes beyond admissions and is open to the entire medical center. So far we have trained over 1,000 physicians, nurses, staff and students in bias mitigation strategies. It is a real passion and we are trying to make a difference.

AD: Thank you for that in depth explanation. Is there anything new at the Ohio State Medical School?

QC: We’re always tweaking the curriculum to help produce physicians who are ready to advance healthcare. We’re on the cusp of a new expansion with blueprints for a new hospital building and a health professions education building. And finally, we are continuing to leverage the fact that we have one of the most diverse medical student bodies in the country to enhance medical education and community outreach. In other words, we are continuing our forward progress.

Thank you for the opportunity to share some thoughts with you and your readers. Best wishes for a happy, healthy new year!

AD: Thank you, Dr. Capers. I look forward to talking again and trying the push-up challenge.

Thank you for taking the time to read this interview. If you’ve enjoyed this, you might also enjoy:

Dr. Quinn Capers, IV discusses his path, #BlackMenInMedicine, and the present landscape of medical education
The story of how I earned my STEM degree as a minority
How my HBCU led me to my STEM career
Researching your career revisited: Wisdom from a STEM professor at my HBCU
A look at STEM: What is Pharmacology?
A look at STEM: What is Toxicology?

If you’ve found value here and think it would benefit others, please share it and/or leave a comment. I’ve recently started a YouTube channel, so please visit me at Big Discussions76. To receive all the most up to date content from the Big Words Blog Site, subscribe using the subscription box in the right-hand column in this post and throughout the site, or add my RSS feed to your feedreader. You can follow me on the Big Words Blog Site Facebook page, and Twitter at @BWArePowerful. Lastly, you can follow me on Instagram at @anwaryusef76. While my main areas of focus are Education, STEM and Financial Literacy, there are other blogs/sites I endorse which can be found on that particular page of my site.

Dr. Quinn Capers, IV discusses his path, #BlackMenInMedicine, and the present landscape of medical education

One of the focuses of my blog is STEM (Science, Technology, Engineering and Mathematics), and my most central principle is “Creating Ecosystems of Success”. While we tend to think of clinical medicine as strictly a ‘Healthcare Profession’, its foundations are actually rooted in the ‘Basic Sciences’.

I discovered Dr. Quinn Capers, IV on Twitter one day by chance and started following him when he was tweeting about medical education at “The Ohio State University”. The ‘hashtag’ he used in most of his tweets ‘#BlackMenInMedicine’ further piqued my curiosity. After seeing more tweets and pictures of himself and his medical students, I reached out to Dr. Capers, the Dean of Admissions of the Ohio University’s Medical School, and he agreed to do the following interview. In our interview which coincided with Black History Month, Dr. Capers discussed his own educational path, the ‘hashtag’ #BlackMenInMedicine, and the current landscape of medical education for prospective students.

Anwar Dunbar: Thank you for the opportunity to interview you Dr. Capers. I stumbled across one of your tweets one day which included the hashtag you often use; ‘#BlackMenInMedicine’. It caught my eye, in addition to the pipeline of black male doctors, you’re training there at Ohio State University. Even though you’re at The Ohio State University and I’m a University of Michigan alumnus, I thought interviewing you would be very beneficial to my audience as I’m a STEM practitioner and an advocate myself. Also even though we typically don’t think of medicine as a science, it very much is. With that, can you talk briefly about yourself? Where are you from? What got you interested in medicine?

Quinn Capers: Thank you for the honor of being interviewed Dr. Dunbar. Speaking of Black History Month, your last name reminds me of my high school in Dayton, Ohio. It’s named after our hometown hero; the first black poet who made a living with poetry, Paul Laurence Dunbar. I actually was born in Cleveland, Ohio and moved to Dayton when I was two or three years old which is where I grew up.

My answer to the question, ‘What do you want to be when you grow up?’ was always, ‘a Doctor,’ even as a toddler. I didn’t have any doctors in my family and to be honest, we didn’t see doctors regularly. It was only on an ‘as needed’ basis – i.e. if we were injured or got really sick. I’m not really sure where the thought came from, but I now assume God planted that seed in my heart and mind, as I truly feel I was ‘called’ to this profession.

AD: What is your family’s background?

QC: Though I was born and raised in Ohio, my parents and both sets of grandparents are from Talladega, Alabama. My parents moved to Cleveland, Ohio before I was born, and as stated earlier, we relocated to Dayton before my third birthday. My father is a retired police officer and my mother is a retired postal worker. They divorced when I was very young, and my mother raised my sister and myself. My sister and I were the first in our family to attend college.

AD: Are you the first medical doctor in your family? If not, who inspired you?

QC: Yes I am, but I have a cousin who was studying Pre-Med at the Tuskegee Institute when I was in elementary school. We spent many hours talking about our shared dream of being physicians, and she was always very loving and encouraging. She is now a successful Physician Assistant in New York City.

AD: Describe your educational path.

QC: I attended public schools in Dayton, Ohio on the city’s west side – the ‘black’ side of town. I was always enamored with Black History and read voraciously about black heroes. Because of this, I knew I wanted to attend a Historically Black College/University (HBCU). I wanted to be taught by professors that were making Black History and I wanted to be in the same buildings, on the same campus, walking the same path as so many of the black intellectuals, artists, and revolutionaries that I had read about.

I chose Howard University in Washington, DC for my undergraduate studies – one of the best decisions I made in my life. For medical school I returned to my home state to attend the Ohio State University College of Medicine. Since I had attended predominantly black schools from K-12 and then Howard, medical school was my first time stepping foot into a Predominantly White Educational Institution (PWI). People have asked me if being at a PWI after having been cradled in majority black institutions my whole life led to my feeling out of place, or ‘inferior’, or if it gave me an ‘impostor syndrome’. No, it was actually just the opposite. Because I had seen so much black excellence, I felt invincible. After medical school, my residency and fellowship training in internal medicine, cardiovascular diseases and interventional cardiology, took place at Emory University in Atlanta, Georgia.

AD: Were there any particular challenges for you on the road to becoming a medical doctor?

QC: There weren’t any big challenges that stand out other than the need to prioritize studying, not over partying, and delaying gratification. Many of my friends were enjoying being finished with school, buying their first car, first house, and essentially living their lives while I was still in school and/or training. But since the opportunity to work towards an MD was a dream come true for me, none of it seemed like an inordinate challenge.

AD: What is your medical specialty?

QC: I am an ‘Interventional Cardiologist’, which is a heart specialist who specializes in opening blocked arteries and repairing heart abnormalities or defects with ‘catheter-based’ approaches. We repair the heart by accessing the circulation through an artery in the arm or leg, and then threading tubes and high-tech catheters, balloons, stents, and lasers to the heart.

AD: If I recall correctly, former Vice-President Dick Cheney had a series of those procedures. How did you ascend to become the Dean of Admissions at the Ohio State University’s Medical School?

QC: After spending the first eight years of my career in a private cardiology practice, I missed teaching and the academic environment, so I sought a position at my medical school alma mater. In private practice, nearly 100% of a physician’s time is spent taking care of patients. In what we call ‘academic medicine’, doctors work at medical schools and university teaching hospitals and have three responsibilities: caring for patients, teaching medical students and young doctors, and performing research. I thus left private practice to go into academic medicine.

After a short period of time I won several teaching awards from the students. When the Associate Dean of Admissions position opened, a colleague encouraged me to apply for it. My initial response was, ‘No that isn’t a part of my plan,’ which was to impact healthcare and improve people’s lives as the best interventional cardiologist and medical educator I could be. After giving it some thought, I realized that overseeing the admissions process at one of the country’s largest medical schools would allow me to have an even greater impact on healthcare than direct patient care. So, I decided to apply for the position and the rest is history. Now I perform both roles – Interventional Cardiologist and Associate Dean of Admissions, allocating approximately half of my time to each role.

AD: Let’s go back to #BlackMenInMedicine? Where did the hashtag come from?

QC: There are many black male physicians on Twitter. One day in 2017 some of us were having an online discussion about the landmark 2015 Association of American Medical Colleges publication entitled Altering the Course: Black Males in Medicine, which details the current severe shortage of Black males entering the medical profession. According to this publication, there were fewer Black males applying to medical school in 2014 than in the late 1970s and the downward trend continues. This portends a severe lack of Black male physicians in the future.

We discussed strategies to combat this trend and collectively came up with the idea of an online campaign to flood social media with images of Black male physicians at work, at play, and simply living their lives. The primary goal is to be role models for and inspire young men (and anyone) to pursue medicine. Other goals include changing the narrative about Black males – i.e. that not all are ‘dangerous’, but that many are physicians saving lives and serving humanity. We also wanted to speak out about injustice in any form against any group. The name of the campaign is thus ‘#BlackMenInMedicine’.

AD: This is an optional question, but based upon today’s climate, have you gotten any pushback because it acknowledges just men and not women?

QC: Very little that has been openly stated, but we are sensitive to the fact that there are likely some who feel it’s divisive and not promoting unity. We think that it’s possible to promote Black men in medicine while supporting many other groups. Many of us also tweet using other hashtags that preceded #BlackMenInMedicine, such as #WomenInMedicine, #ILookLikeASurgeon (which promotes images of women in surgery), and others. We took this on because the low numbers of Black men in medicine, in academic medicine, in leadership roles, and amongst medical school applicants has reached a crisis. I should also point out that we, the original creators of this campaign, do not feel that use of the hashtag is proprietary. Anyone who wants to promote diversity in medicine, and particularly encourage Black men to pursue medicine, is welcome to use the hashtag. In fact, we encourage it.

AD: Are there particular programs at The Ohio State University for minority medical students?

QC: Yes. At the Ohio State University College of Medicine we believe that diversity drives excellence in healthcare, and we have several strategies to recruit and support diverse students and women. We’re proud to be leaders in educating women and underrepresented minority physicians. The last four entering classes have been predominantly women, and according to 2017-2018 AAMC statistics, OSU ranks sixth of nearly 150 medical schools for the number of enrolled black medical students. We also have a post baccalaureate program called ‘MEDPATH’ that is focused on increasing the number of underrepresented and/or disadvantaged students entering medical school.

AD: When I was an undergraduate at Johnson C. Smith University in the late-1990s, many of us pondered practicing medicine, but few of us understood what it took to get into medical school – something a particular professor reminded us of regularly. Aside from the necessary academic credentials, what are some of the personal qualities aspiring medical students need to be successful?

QC: Today, most medical schools judge applicants using the Association of American Medical College’s ‘holistic review’ framework, which recommends balancing the applicant’s: experiences, personal attributes, and academic metrics (MCAT and GPA) when making a decision about their candidacy. While the MCAT (Medical College Admissions Test) and GPA are self-explanatory, it’s important that aspiring physicians understand the importance that past experiences and personal attributes will play when your application is being reviewed. You will need to have a track record of compassionate community service, healthcare-related experience (shadowing or volunteering/working in a healthcare setting), leadership, and often research.

Regarding personal attributes, medical schools desire students who are: compassionate, collegial, curious, and who are self-directed learners. While the exact attributes and experiences may vary by school, medical school hopefuls need to ensure that their experience portfolio is full and that their recommenders can speak to the attributes mentioned. Often the difference between the applicant who gets accepted to medical school and the one who doesn’t is not their MCAT score or GPA, but more so a matter of which applicant had the better strategy. Gaining acceptance to medical school is very competitive and applicants should have a well-thought out strategy. Some examples of strategic questions that students should think through include:

• Will I take a “gap year”?
• If I plan to take the MCAT in spring of my junior year, when should I take Physics?
• Which leisure-time activity will demonstrate the attributes that medical schools seek?
• Should I apply before my MCAT scores return?
• If my undergraduate grades are low, should I plan on graduate school? If so, what discipline? MPH or Masters Degree in a biomedical science?

I consider it part of my mission to provide the answers to these questions to students as early in the pipeline as possible. We do this via our OSU College of Medicine website (https://medicine.osu.edu/admissions/md/tips-and-advice/pages/index.aspx), by speaking to students via webinars (https://www.youtube.com/watch?v=Q_7B3qUjuJs), and via social media.

AD: Describe the landscape today in terms of getting into medical school versus when you were aspiring to study medicine yourself.

QC: I applied to medical school in 1986. At that time, the weight of academic metrics was definitely more than 1/3 of a candidate’s application. Community service was almost ‘optional’ at that time. Academic achievement is still very important, and always will be when evaluating medical school applicants. However, it is very unlikely that a student will be accepted to medical school today without a record of compassionate community service and healthcare-related experience. Also, many medical school curricula employ both group-based learning and independent learning, so schools look for evidence of collegiality and self-directed learning to provide evidence that a student will be successful.

AD: Okay, Dr. Capers, that’s all I’ve got. Thank you again for this opportunity to interview you, and also for providing the pictures to go along with this interview. I understand that your time is very valuable. Perhaps we can do follow up interviews at some point. Do you have any other parting comments or thoughts?

QC: No. Thank you again for giving me this opportunity, Dr. Dunbar. I’d be delighted to do this again, or even to make it a recurring feature. Good luck to all of your readers!

Thank you for taking the time to read this interview. If you enjoyed it, check out my 2019 interview with Dr. Capers.  If you’ve found value here and think it would benefit others, please share it and or leave a comment. Please visit my  YouTube channel entitled, Big Discussions76. To receive all of the most up to date content from the Big Words Blog Site, subscribe using the subscription box in the right hand column in this post and throughout the site. Lastly follow me on the Big Words Blog Site Facebook page, on Twitter at @BWArePowerful, and on Instagram at @anwaryusef76. While my main areas of focus are Education, STEM and Financial Literacy, there are other blogs/sites I endorse which can be found on that particular page of my site.