Faculty Impact: Combining social justice with clinical practice
Firstly, I acknowledge the land on which I work, study, and learn, Detroit or Waawiyaataanong is the original homeland of the Anishinaabe, and commit to learning to be a better steward of this land and the indigenous peoples to whom it belongs.
My name is Dr. Ijeoma Nnodim Opara, assistant professor, Internal Medicine-Pediatrics, Wayne State University (WSU) School of Medicine and attending physician, Wayne Health. I’m a woman of purpose and passion. I describe my purpose in the modified words of President Barack Obama regarding the late congressman John Lewis, “I’m a woman of pure joy and an unbreakable commitment to justice.”
My ability to keep up with my commitments is grounded in my strong sense of purpose, as I try to ensure that my commitments are purpose-aligned and passion-driven. It also helps that I have a supportive spouse, three amazing little girls, a loving family who live close to me, and awesome colleagues, trainees, and mentees who help make all this possible. My faith tradition is also a great source of strength.
My life is not in balance because I don’t believe work-life balance exists. Instead, I aim for work-life dexterity or work-life integration and take it one day at a time to ensure my top priorities are addressed each day, particularly my self-care and wellness. This requires that I set and protect boundaries around my time and energy, which often means saying “no” to certain opportunities. I also work hard to actively reject perfectionism and people-pleasing by regularly telling myself that I am more than enough just as I am, warts and all.
There is no one way to be a physician to serve humanity. The options are abundant and varied. I am a physician-scholar-activist and my intersectional positionality as a Black, woman, first-generation Nigerian-American immigrant, with fiery red dreadlocks or jet-black afro (pre- and post-pandemic), tattoos, and nose-piercings, allow me the access to meet diverse people where they are, especially if they are BIPOC or of minoritized/oppressed/excluded identities. It allows me to have unusual perspectives and insights that lend themselves to innovative solutions in the face of seemingly impossible problems.
I center the voices, faces, and brilliance of Black and African peoples in my justice work which is woven into my clinical practice, teaching and mentorship, research, and advocacy/activism. In these various capacities, I have founded and co-founded multiple programs which have flourished within the WSU community and beyond, such as the Wayne State University Global Health Alliance (GHA) and Global Urban Health Equity (GLUE); Health Equity and Justice in Medicine (HEJIM); Healing Between the Lines (HBL); Black Healer Network (BHN); and the Coalition to Advance Antiracism in Medicine (CAAM). I also hold various leadership roles on several international, national, state, and local organizations focused on health equity, justice, antiracism, and decolonization.
An equitable and just society is a healthier society. People like me belong at decision-making tables and halls of power. Our voices, talent, and brilliance are needed in all spaces if humanity is to survive itself. Although comprising 13-14% of the population, Black physicians only constitute 5% of American physicians, and Black women constitute <2%. The reasons are plethoric and all rooted in structural racism, which shows up in every system of society in a mutually reinforcing manner, including within medicine and healthcare itself. This matters for many reasons, one of which is that health outcomes improve when Black physicians and women physicians are involved in patient care.
The Health Equity and Justice in Medicine (HEJIM) was born four years ago out of the WSU Department of Internal Medicine and Internal Medicine-Pediatrics to address some of these issues. It was overwhelmingly apparent that we needed a structured curriculum to address the social determinants of health that we know impact most health outcomes and about which physicians are inadequately trained.
I am honored to be the founding director of HEJIM. HEJIM’s vision is to develop the best physician leaders in systems transformation to realize health equity and justice in the communities we serve. Its mission is to educate and equip physicians in training and practice to 1. Understand and navigate the structural and social determinants of health, including structural racism and health system bias. 2. Partner with patients, communities, multi-professional colleagues, and stakeholders to promote health equity. 3. To effectively advocate for justice through multi-level transformative strategies in clinical practice, medical education, quality improvement and research, and policy.
A steering committee comprised of Internal Medicine and Internal Medicine-Pediatrics faculty, departmental leadership, and resident physicians has been pivotal to the program’s success. The HEJIM curriculum includes monthly didactic sessions covering various topics from structural racism to physician and health system bias and the history of Detroit. It is taught by community leaders, interprofessional guest speakers, resident and attending physicians, and faculty. It also includes small group critical reflection activities, written reflection, quality improvement projects centered on social determinants of health, and community engagement opportunities. We recognize resident and faculty excellence in role-modeling a strong commitment to health equity and justice through an annual award ceremony during graduation where we bestow awards of distinction. We also give a legacy award to the faculty member who has demonstrated a lifetime commitment to realizing health equity and justice and recognize our community partners’ work. We celebrate the diversity of our residency community with an annual multicultural potluck.
Due to the COVID-19 pandemic, we had to pivot to holding our sessions virtually, including our award ceremony and multicultural celebration. This provided a lot of opportunity for innovation in online pedagogical techniques and learning from speakers from all over the country.
The American Medical Association and the Detroit Medical Center Medical Staff Operations Committee have recognized HEJIM through a grant to support our curriculum. Last year, we spun off a smaller, more specialized program, Healing Between the Lines (HBL), funded through a grant from the American Association of Medical Colleges. HBL is a radical reimagination of medical education that pairs medical residents and medical students with community advocacy and activist groups in a partnership we call “Justice Circles.” The Justice circles identify an area of priority for the community partners and work together to address upstream determinants of that problem through the lens of justice and using policy interventions. HBL recognizes the role of “Redlining,” the state-sponsored racial housing segregationist policy from the 1930s that continues to impact the pathways and mechanisms of health disparities today. Our Juneteenth celebration was a symposium – Equi-D: Reimagining a Healthy Detroit Together - where our Justice circles shall present the policy recommendations to policymakers and community stakeholders for feedback and implementation strategizing.
Again, an equitable and just society is a healthier society. Many systemic interventions are needed to address this problem – correcting the legacy of racist policies, practices, and norms in housing, criminal justice, education, economic opportunity, foodways, media, and healthcare. In addition to these systemic interventions to eliminate the structural barriers that discourage the success of BIPOC students and trainees in the sciences, a straightforward idea is for institutions to invest in systematized opportunities to increase the visibility of BIPOC physicians and physicians-in-training, just like in this faculty impact newsletter. That means increasing diversity and ensuring belonging – which are by-products of equitable and just spaces – but it also means supporting the existing BIPOC physicians (including faculty, staff, and students) and ensuring their success, including funding, supporting, and promoting their work and achievements and protecting them from the “minority tax,” or crediting that extra work towards their promotion and/or compensation.
Increasing BIPOC physician visibility in a meaningful, respectful manner in line with overall institutional transformative practices towards non-performative true equity, justice, and antiracism will go a long way to demonstrate what is possible, for one cannot be what one cannot see.
For more information, questions, comments, and collaboration, you can contact Dr. Ijeoma Nnodim Opara at the following: