A board certified neurologist, Roy Hamilton, MD, directs the Penn Brain Science, Innovation, Translation, and Modulation (brainSTIM) Center and the Laboratory for Cognition and Neural Stimulation at Penn Medicine. He is Associate Professor of Neurology and Associate Professor of Neurology in Physical Medicine and Rehabilitation at the Perelman School of Medicine at the University of Pennsylvania.
When it came to inclusion and diversity in Penn Medicine's Department of Neurology, Roy H. Hamilton, MD, MS, Vice Chair for Inclusion and Diversity, was bothered by a specific concern. As he looked around the table at the small committee he chaired, he realized every member came from populations that were historically marginalized.
"While that seems intuitive, or at least normative, the people who are marginalized are not the ones who created the problems we were trying to address," he says.
"Also, I finally picked up on the fact that all our diversity efforts, like I imagine them to be in the vast majority of clinical departments, focused only on people whose last names ended in 'MD,'" he recalls. "That was a clear omission."
Such realizations likely would have altered the committee's agenda to some degree if everything had remained as it was. But it didn't: Video of George Floyd's murder last May created shockwaves around the world, igniting a summer of protests and the first largescale discussion of systemic racism in the United States.
"The events of 2020 showed us that what we were doing was inadequate for a variety of reasons," Dr. Hamilton says.
Amid the protests, he organized a Neurology Department town hall in the format of a Quaker meeting. There were no presentations, no host. Everyone sat in silence until someone in the audience felt compelled to talk.
"There was a long period of silence. Then the dam broke, and people started sharing their feelings and experiences," Dr. Hamilton says. "It was revelatory in so many ways. Afterward, there was a deluge of people asking what they could do to help."
Inclusion, Diversity, Anti-Racism, and Equity (I DARE) Program
In response, Dr. Hamilton scrapped the Inclusion and Diversity Committee and erected a new framework known as I DARE, or the Inclusion, Diversity, Anti-Racism, and Equity program in place of the original committee. He now chairs a new steering committee that oversees four new sub-committees with a more diverse composition, where trainees sit alongside faculty and staff members in non-physician roles.
The committees, the vast majority of which are comprised with volunteer members, include intradepartmental equity; recruitment and retention, which is focused on workplace diversity; equity education, which is responsible for education about health equity concerns and anti-racism; and community and social action, which is charged with ensuring the department is delivering equitable care to its patients and justice in society more broadly.
"We've increased our size by a factor of five," Dr. Hamilton says. "It's also a more inclusive way to pursue our goals."
Dr. Hamilton's vision for I DARE can be summarized by its title. But rather than fixate on specific goals, he's choosing to see it more of a constant pursuit of all those things.
"It's not something a committee is doing," he says. "It's that the whole department is animated by the notion of how critical it is in medicine and neurology to advocate for these principles because it's the best thing for our patients and each other."
Action for Cultural Transformation
At Penn Medicine, Dr. Hamilton’s goals in the Department of Neurology align with updated organizational efforts striving to eliminate structural injustice — known internally as the Action for Cultural Transformation, with leadership and faculty collaborating to develop strategies to ensure equity, mitigate bias and eliminate racism across Penn.
A Neurologist's Personal Quest for Inclusion
From the time he arrived at Penn 19 years ago as a resident, Roy H. Hamilton, MD, MS, has prioritized his participation in diversity and inclusion initiatives, first as Director of the Educational Pipeline Program and then, Dean of Diversity and Inclusion at the Perelman School of Medicine. Today he is the Neurology department’s Vice Chair for Inclusion and Diversity.
Dr. Hamilton's mother is a Japanese immigrant who grew estranged from her family after she entered a relationship with his father, an African American. Consequently, he was raised "largely with a Black identity," though he never truly felt like he fit in anywhere.
As he began submitting college applications, Dr. Hamilton also lacked a figure who could help prepare him for what to expect around the next corner. Among both his immediate and extended family, he was entering uncharted territory.
"I progressed along my path from high school graduate to college graduate to medical school graduate to resident to junior faculty member always sort of feeling like I was building the plane while I was flying it," he says. "So, I've always been interested in making sure that people have less of that experience."
That said, Dr. Hamilton admits there's a "more direct incentive" for improving inclusion at work: "I thrive in an environment that includes me," he says. "I cross so many lines with respect to my identity, so I really need to be in an environment that's accepting of all kinds of people. If it means taking the lead to make that happen, I will."