The field of retina—as is the case in all of health care—has a long way to go before its members adequately represent the populations it serves. With so much left to do, it can be easy to overlook all the hard work that’s already inciting change. Improving diversity, equity, and inclusion (DE&I) in retina remains a top priority for leaders in every setting, whether that’s academia, private practice, industry, or continuing education. Here, we highlight the many efforts underway that are advancing retina toward a better, and more inclusive, future.
DIVERSITY IN PROFESSIONAL ORGANIZATIONS
American Society of Retina Specialists
Ad-hoc committee. The pandemic has been instrumental in exposing the wide disparity in health care for underrepresented minorities. The American Society of Retina Specialists (ASRS) DE&I ad-hoc committee was formed to develop an actionable strategy to increase diversity in its membership and leadership. Many citations in the medical literature report improved patient outcomes when there is a concordance of ethnicity between patient and physician. The committee recognized that more effective and lasting diversity in the ASRS requires ongoing programming and support.
The long-term goal of the committee is to increase the number of underrepresented minorities (URMs) practicing retina by 50% by 2030. Several programs have been developed, including for mentorship, research, clinical trial development, and communication and education on diversity and inclusion.
“The mentorship program is the centerpiece and differs from many other mentorship programs in its structure and implementation,” said Keith A. Warren, MD, head of the committee, in an email to Retina Today. “Instead of one-on-one mentorship, this program is composed of mentor ‘families.’ Physicians at all levels of experience serve as mentors to both the mentees and each other. The more senior physicians advise the midcareer, early career, fellows, residents, and medical students.”
Likewise, younger physicians are encouraged to assist senior physicians on use of current technology, such as the Intelligent Research in Sight registry or artificial intelligence. This helps the mentorship family develop lasting connections, while taking the pressure off of one-on-one relationships.
Women in Retina. At the 2021 ASRS meeting, the Women in Retina (WinR) section cohosted a luncheon with the DE&I ad-hoc committee. The luncheon was attended by more than 100 individuals virtually and in-person.
WinR also offers a thriving mentorship program and is committed to providing opportunities for personal and professional growth. In 2021, the ASRS’s mentorship and educational events included:
- A webinar about creating a personal press kit, which includes CVs, resumes, and bios;
- A virtual training session on personal branding, including how to improve presentation, communication, and leadership skills;
- An online mentoring and career guidance session that offered career and job search advice; and
- Case conferences at the ARVO and AAO annual meetings, providing an opportunity for young physicians to present their work and receive supportive feedback.
The AAO’s Minority Ophthalmology Mentoring Program (MOM) is working hard to improve access for underrepresented minorities in ophthalmology.
The AAO’s Young Ophthalmologists group held a program at AAO 2021 titled “Why Representation Matters: A New Era of Equity,” which featured discussions about caring for members of the LGBTQIA+ community, eliminating health care disparities, and increasing diversity in clinical trials. The 2020 and 2021 winners of the Artemis award for exemplary care of patients shared their insights, as did Michael F. Chiang, MD, the director of the National Eye Institute, pictured here with program chairs Meron Haile, MD, (left) and Viraj J. Mehta, MD, MBA, (right).
The ARVO Foundation for Eye Research partnered with Genentech to promote diversity in retina through an award program that provides the recipient with a 2-year grant to support research and personnel costs. The collaboration is an effort to provide underrepresented minority investigators with an opportunity to explore novel and innovative research projects.
Women in Ophthalmology
In January, Lisa Nijm, MD, JD, CEO of Women in Ophthalmology (WIO), and Lejla Vajzovic, MD, a director in the society, participated in a joint WIO/Ophthalmic World Leaders networking reception at the Hawaiian Eye conference in Waikoloa, Hawaii. WIO also held an event at the Association for University Professors in Ophthalmology (AUPO) in the same month, partnering with the AUPO’s new Women Professors in Ophthalmology group to support mentorship of women in academics.
WIO consistently holds events and webinars throughout the year and engages in initiatives such as a clinical trials training program, a speaker’s bureau, a mentorship program, and several award and scholarship opportunities, all highlighting URMs in medicine.
WIO’s signature event is the Summer Symposium held every August. The 2022 Summer Symposium will be held August 25 to 28 in Monterey, California. WIO will also host their annual Charity Golf Tournament in August, which raises funds for Orbis International, an organization that supports the prevention of blindness and the treatment of blinding eye diseases in developing countries.
In 2021, Euretina launched its Women in Retina program, headed by Anat Loewenstein, MD. The program works to foster the professional development of young female retina specialists by creating more opportunities to speak at the podium, engaging in policy review to promote equal representation in meeting programs and society committees, and facilitating gender-related conversations through the Euretina Online Forum.
Vit-Buckle Society
The Vit-Buckle Society (VBS) developed a diversity action plan that includes the development of FOstering Careers for Underrepresented Stars (FOCUS), an educational and research-based mentoring program targeting URMs in medicine who are currently medical students and ophthalmology residents. The goal of FOCUS is to increase the pipeline of URM candidates by providing exposure, mentorship, and research opportunities. Participants in FOCUS will receive a travel grant to the VBS annual meeting, where they will attend lectures and small group sessions specifically designed for URMs, in addition to interacting with faculty during the core meeting. The FOCUS initiative will also provide ongoing mentorship, including career guidance.
“VBS will continue to work with industry partners to fund and develop additional programs to increase DE&I in ophthalmology and retina with the goal of decreasing health disparities,” said Basil K. Williams Jr, MD, in an email to Retina Today. “VBS is looking forward to its tenth Annual Meeting in Las Vegas in March and will be excited to welcome the first class of FOCUS program members to celebrate this anniversary with a Great Gatsby theme!”
At the 2021 AAO meeting, Carl Zeiss Meditec hosted students in the MOM program to foster their professional development in the field.
The Retina Society
At their 2021 annual meeting in Chicago, the Retina Society presented recent metrics for diverse internal gender representation, including growth in the percentage of female members. New members of the society are 55% women, and several of its committees have an increasing proportion of female members, including the Nominating and Fellow Awards (50%), Bylaws and Website (40%), Program (37%), Audit (33%), and Executive and Finance (29%) committees.
INDUSTRY EFFORTS
Alcon
This year, Alcon achieved a perfect score of score of 100 on the Human Rights Campaign Foundation’s (HRC) Corporate Equality Index (CEI). With this recognition, the HRC has designated Alcon to be among the “Best Places to Work for LGBTQ+ Equality” in the United States.
“Since first listing on the CEI in 2020, we showed continuous improvement in ranking year-over-year: first receiving a score of 90, then of 95, and now recognized in the third year with a top score of 100,” said Kristen Weirick, chief diversity and inclusion officer and vice president of Global Talent Acquisition at Alcon in an email to Retina Today. “This honor is attributable to the collaborative efforts led with the support of the Alcon executive leadership team, our D&I, HR, and Benefits teams and many others.”
Alcon reached this perfect score in part due to the high level of engagement and participation from their LGBTQIA+ employee resource group, Open Professional Employee Network, which works to examine and revise internal policies to drive positive change within Alcon.
The company also provides opportunities for employees to partake in discussions about what it means to be part of the LGBTQIA+ community in eye care. During the latest event, “Eyes on Inclusion—Being Out in Eye Care,” panelists discussed how being “out” in the office can enhance their relationships with others, and they shared some of their personal journeys to becoming comfortable in their own skin.
Alcon has also received recognition for its excellent work environment, including Top Employer 2022 certification in Brazil, France, Poland, Russia, Spain, and Switzerland; Best Place to Work 2021 certification in the United States and Malaysia; and Top Employer 2021 certification in Europe.
In collaboration with Genspace, Iveric Bio is working to support life science educational programs for URM youth and adults.
Regeneron
In 2020, Regeneron established a task force focused on evaluating patient diversity in clinical trials. The company examined patient diversity data in selected clinical trials and explored industry regulations, guidance, and best practices. The findings resulted in recommendations across four areas: education and processes, community/site engagement, patient engagement, and stakeholder partnerships.
Novartis
The Beacon of Hope is a multifaceted initiative launched by Novartis in collaboration with Historically Black Colleges and Universities and Historically Black Medicine Schools to dismantle the inequities Blacks face in education and health care. Citing medical atrocities such as the Tuskegee Syphilis study and the story of Henrietta Lacks, as well as contemporary health metrics such as the lower life expectancy and higher mortality rates among Black patients with cancer, the initiative emphasizes the need for systemic change in health care.
Lack of diverse representation in clinical trial investigators and participants is another area the initiative is addressing, as well as the persistent lack of equitable educational opportunities for minority students. The Beacon of Hope began its initial 10-year plan with a focus on:
1. Investing $20 million in research grants and academic scholarships to support a goal of 1,200 students in partnership with organizations such as the Thurgood Marshall College Fund, including mentorship programs and internship opportunities;
2. Supporting the creation of digitally enabled clinical trial centers of excellence headed by URM researchers to foster trust in medical research among the Black community;
3. Researching and validating existing data on racial health disparities in diagnosis, treatment, trial endpoints, and population health policy to identify and remove discriminatory practices in search algorithms and technologies;
4. Establishing centers to research the effects of climate change and the environment on health, with the knowledge that pollution, natural disasters, and other environmental threats disproportionately affect URM communities.
“The Black, Hispanic, and Indigenous American communities have reason not to trust the health care system,” said Patrice Matchaba, MD, president of the Novartis United States Foundation in an interview with Retina Today. “However, to paraphrase Field of Dreams: If you are honest in seeking the truth and build a trusted and transparent program, ‘they will come.’”
Inclusivity at Meetings
The EnVision Summit, an ophthalmology CME conference held annually in Puerto Rico over President’s Day weekend, takes a unique perspective on what a scientific meeting can be. In many ways it’s a typical multispecialty ophthalmology CME program, but what’s special is that physicians are encouraged to bring their families.
The EnVision Summit includes a parallel track for children, according to Bonnie A. Henderson, MD, director of the program The program offers many age-appropriate activities, such as magic shows for younger children, or yoga classes and lectures on applying to college for teenagers. In addition, attendees with infants can listen to lectures from private nursing areas.
The conference also seeks to allow people to speak on the podium and be in leadership who oftentimes are not invited to be in those positions, Dr. Henderson said. This meeting is geared towards allowing those voices to be heard and providing people from underrepresented backgrounds the opportunity to present. The program committee is largely run by women, including retina specalists María H. Berrocal, MD; Audina M. Berrocal, MD; Judy E. Kim, MD; and Geeta A. Lalwani, MD, and the leadership strives to focus on diverse representation.
This meeting is geared toward all family-oriented attendees, not just women, according to Dr. Henderson. Male physicians are participating in the robust scientific program and are encouraged to bring their families. Everyone is invited to come learn and enjoy beautiful Puerto Rico!
Allergan
In 2021, Allergan, an AbbVie company, convened a Retina Health Equity Forum panel of esteemed retina specialists dedicated to improving retinal outcomes in underserved communities. Following the forum, AbbVie’s health economic and outcomes team developed a long-term research agenda leveraging real-world evidence to evaluate disparities in diabetic retinopathy and diabetic macular edema to provide robust evidence to inform ongoing discussions in the clinical and policy communities. Preliminary results from the first phase of the study were shared with the panel at an advisory board held at the 2021 AAO meeting in New Orleans. With the critical input of the panel, the research is being revised and expanded for future dissemination.
“At AbbVie, our commitment to science is a commitment to better our society,” the company stated in an email to Retina Today. “We value diverse perspectives, an inclusive culture, and treating all employees with dignity and respect. AbbVie believes that a diverse and inclusive culture strengthens our ability to innovate and is crucial to our ability to deliver now and into the future.”
Last June, Apellis celebrated Pride Month with a panel for LGBTQIA+ community members and allies and held an ice cream social event in lieu of the Boston Pride Parade, which was postponed due to the COVID-19 pandemic.
Genentech
Black, African American, Hispanic, Latin American, and Indigenous people are disproportionately affected by diabetes and are at higher risk of developing diabetic macular edema (DME). Recognizing this increased risk and the historical industry-wide lack of diversity in clinical trials, Genentech designed the Elevatum study of faricimab-svoa (Vabysmo), a recently approved injectable bispecific drug for the treatment of wet AMD and DME, in underrepresented populations. "Historically, ophthalmology clinical trials focused on diabetic eye disease have been lacking representation from different ethnic and racial groups. We designed the Elevatum study to specifically address this issue and evaluate treatment response to Vabysmo in patients with DME from underrepresented patient populations," said Manuel Amador, MD, a medical director at Genentech who is helping lead the study, in an email to Retina Today. Results from the trial are expected in 2024.
In addition to initiating this study, Genentech has modified its clinical trial protocols across therapeutic areas to enhance inclusivity and communicated this strategic focus to site investigators. It also formed the External Council on Advancing Inclusive Research to collaborate with innovative leaders in the field. More information on these and other corporate efforts can be found in Genentech’s annual diversity and inclusion report for 2021, released on March 30.
MedOne Surgical
DE&I education is important to create an environment where people feel valued and encouraged. For example, Bruce Beckstein, MBA, president and owner of MedOne Surgical, completed a certificate course on DE&I in the workplace at the University of South Florida. “The course gave me a good foundation for what DE&I means and how to foster an environment that is open and accepting of others,” Mr. Beckstein told Retina Today in an email.
SCHOLARSHIP PROGRAM
The Rabb Venable Excellence in Ophthalmology Program strives to foster interest in ophthalmology among URM medical students and those who desire to work in underserved communities. The program’s offerings include mentoring, career development, and volunteer opportunities, as well as an annual scholarship open to medical students and residents/fellows. The next deadline is coming up on March 31! See application details at www.rabbvenable.com/application.
Oculis
Riad Sherif, MD, chief executive officer of Oculis, has an acute awareness of cultural, demographic, experiential, and cognitive differences, such as understanding that there is a wide range of factors influencing how people present their accomplishments and skills. He commented in an email to Retina Today that “being aware of the differences in people’s backgrounds and ways of thinking enables leaders to better evaluate talent and make fairer comparisons when hiring. For Oculis, this awareness led to the hiring of exceptional talent from around the world, the building of a diversified leadership team and, ultimately, Oculis is becoming a more robust organization as a result.”
As part of its commitment to DE&I, Biogen publishes an annual report detailing the company’s four-pronged DE&I strategy: build awareness, capability, and an urgency to act; build a diverse workforce; improve health outcomes; and promote economic empowerment.
Bausch + Lomb
In its Fall 2021 Environmental, Social, and Governance Report, Bausch + Lomb listed several company activities that supported a diverse and inclusive culture, including:
- Hosting an interactive executive committee session on the topic of “Inclusion as a Strategic Driver”;
- Conducting listening sessions for employees to provide thoughts in the wake of protests in 2020, while engaging DE&I ambassadors to help lead and grow key initiatives;
- Launching an ongoing speaker education series on topics such as “Being Consciously Inclusive,” “Resilience,” and “Avoiding Burnout”;
- Sponsoring 28 leaders to participate in McKinsey’s Black Leadership Academy to help accelerate the progression of Black leaders in the organization;
- Creating a global DE&I intranet site and launching a newsletter to provide information, resources, and tools necessary to implement and advance DE&I goals;
- Launching Employee Resource Groups (ERGs) designed to engage employees more directly in DE&I initiatives. The first ERG, the Women’s Inclusive Network, focuses on the hiring, development, retention, and career advancement for women and assists in the achievement of women’s personal and professional aspirations.
If there is a DE&I activity your company or society would like to highlight, please reach out to abrodin@bmctoday.com to be added to the article.
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