DEI Network founders: Let’s work together to increase diversity across all cancer centers in America

Christopher Li and Wendy Law, both of Fred Hutchinson Cancer Research Center, have a message for leaders of DEI programs in oncology: 

Join our Cancer Center DEI Network to develop diversity, equity, and inclusion metrics, and share best practices on recruitment and diversity programs.

“There’s a new emphasis on the part of NCI to really try and promote increasing diversity among the scientific workforce, in particular, at our nation’s cancer centers,” said Li, DEI associate director at the Fred Hutch/University of Washington Cancer Consortium. “We’re all trying to work through the new guidelines and figure out how we will approach them.”

NCI’s new “Plan to Enhance Diversity” is a component of the institute’s Cancer Center Support Grants, which means cancer centers looking to maintain or achieve NCI designation need to implement plans for increasing diversity in their faculty and workforce. 

A story on the new guidelines appears here.

“I would say that, first of all, the survey that AACI and The Cancer Letter jointly completed around cancer center leadership was very helpful to get the conversation started,” said Law,  associate director of administration at the Fred Hutch/University of Washington Cancer Consortium. “I mean, it’s not like we didn’t know that cancer center leadership wasn’t very diverse, but I think always, because we’re all scientists, having the data behind it is very powerful.”

Together, the Fred Hutch associate directors created the DEI Network to fulfill the need for effective DEI interventions in oncology.

“I think it was just an idea that Wendy and I had as we were talking about, how are we going to approach this?” Li said. “I was named our associate director for DEI, and we’ve done a lot in terms of our strategic plan, but we’ve also become engaged with a number of different centers through this process of, as I’ve come into this role, trying to learn what other places are doing and sharing information. 

“Just in those conversations, there seemed to be a real eagerness to try and have a broader group, a larger group where we could really hear from people across the nation.”

To become a member of the Cancer Center DEI Network, email cancerconsortium@fredhutch.org.

Li and Law spoke with Matthew Ong, associate editor of The Cancer Letter. A video of the conversation is available here.

Christopher Li: Thanks for the question, Matt, and thanks for this opportunity to speak with you. 

I think as everyone is probably aware the PAR for the CCSG new guidelines came out recently, and as part of those guidelines, there’s a new emphasis on the part of NCI to really try and promote increasing diversity among the scientific workforce, in particular, at our nation’s cancer centers.

And so, many institutions, as I know you’re aware, are starting to name associate directors for diversity, equity and inclusion to help fulfill the mission and the different requirements that are now part of the CCSG program. 

We thought it was really a great opportunity, really, to try and network with these individuals who are also new to these positions, as we’re all trying to work through the new guidelines and figure out how we will approach them. Also, to share best practices across institutions as a way of trying to develop more collegiality and really share different strategies that our institutions are using.

So, that was really the idea. It was really to just get to know the individuals who are doing this work across our cancer centers and have an opportunity to really be engaged in dialogue and discussion as we try to work together to really realize the vision of increasing diversity across all the cancer centers in the country, since it’s really something that I think can really be done most effectively through collaborative efforts, rather than single institutional efforts.

Wendy Law: I think another opportunity is that as we’ve seen with the community outreach and engagement section of the CCSG, there is an opportunity for us at the cancer centers who are in the weeds to provide some feedback to NCI about how these efforts are going and how we might work collaboratively, and what resources are needed to do this work. 

I think we’re grateful that the NCI is open to hearing the recommendations. So, I think that helps us to do our work also to be able to share amongst us, the people who are in the weeds doing this.

CL: Yes, I mean, it looks like for this initial cycle, the main emphasis is on developing a concrete and compelling plan around trying to increase diversity at the cancer centers. So, that seems to be a major focus. 

But I think paired with that is this more aspirational goal of the program, which is that the expectation really is that the faculty, the leadership of cancer centers should reflect the diversity of the nation.

So, it’s not limited to trying to reflect the diversity of your catchment area or your region, but really, all cancer centers should be reflecting that broader national diversity. Depending on where you are in the country, that can be a bigger challenge or maybe a smaller challenge. 

I think it’s a challenge for everyone, because we know that there’s persistent underrepresentation, particularly of racial, ethnic minorities in cancer center faculty as well as leadership.

But I think it can be a particular challenge for those parts of the country where there is just inherently less diversity. So, I think that is certainly one major piece of focus. And then, I think the other is being able to develop the infrastructure to be able to track metrics and progress in this space.

When we had the first meeting of the group, we did some brainstorming around what were the topics that people most wanted to start with or to discuss. And that was the number one priority, in terms of, we did a little poll and asked people to rank their choices. 

The one that got the most votes was around, how do we collect DEI-related metrics? How do we track them? How do we report them as a way to have accountability for the work that we’re doing, and also be able to report that to NCI?

What’s the genesis story of the DEI network? I mean, it’s your brainchild; right? And how many cancer centers showed up for your first meeting?

CL: I think the first meeting we had about 30 different cancer centers represented. I can say on a weekly basis we add more. 

I don’t know what the current total is. It’s probably about 40 centers and maybe 50 or 60 individuals, because some institutions have more than one person who’s interested in participating.

So, I think it’s something that is continuing to grow. We’ve had two meetings so far, and after each meeting, we’ve seemed to get a bolus of new people who are interested in joining, as people hear about this and connect with other colleagues. 

Again, I think a lot of cancer centers are just in the early stages of even figuring out how they’re going to approach this. And so, either people are being named or ideas are being generated of people who might be engaged in different centers to be involved in this activity.

So, I think it was just an idea that Wendy and I had as we were talking about, how are we going to approach this? I was named our associate director for DEI, and we’ve done a lot in terms of our strategic plan, but we’ve also become engaged with a number of different centers through this process of, as I’ve come into this role, trying to learn what other places are doing and sharing information. 

Just in those conversations, there seemed to be a real eagerness to try and have a broader group, a larger group where we could really hear from people across the nation.

WL: Yes. I think for cancer centers it’s always been really helpful to have peer networks to collectively figure out some of these things that we’re all trying to do. And I feel lucky because many of our cancer center colleagues are very willing to share ideas and their efforts. 

And so, it’s worked in the education and training space as well as the COE space. We thought that this might be a good opportunity to start the conversation around this newer component of the CCSG.

This is perhaps a bit more of a philosophical question, but what does a day in the life of a cancer center DEI director look like for you?

CL: Well, I think for us this is something that is certainly a priority for Fred Hutch, as something that we have been engaged with over the past few years in a variety of different ways, which culminated in the formation of an office of DEI for the first time at Fred Hutch, the naming of a chief diversity, equity and inclusion officer, my colleague, Dr. Paul Buckley.

And one of the first things that we did as we were building this office and wanting to launch this effort was to really understand what was the experience of employees at Fred Hutch in the area of DEI. 

I had one-on-one conversations with a number of our faculty, particularly those from underrepresented backgrounds.

Paul Buckley, my colleague organized a series of listening sessions with people from different demographic identifications throughout Fred Hutch to really understand what are people’s experiences, so that we could use that information, too, as a primary input to developing our first Fred Hutch DEI Strategic Plan, which we announced back in the summer of 2020.

And so, I think now that we have that plan a lot of the effort has really been focused around trying to execute that plan. There are a number of different pillars to it. 

One was very focused on increasing the recruitment of diverse faculty. We, I think, are one of the only cancer centers to have done a “cluster hire” search. I know many universities have done cluster hires, but I think we’re probably one of the only cancer centers that I’m aware of.

We did a specific cluster hire within the cancer center. And so, that took a lot of my time in terms of I chaired that search and we were successful in recruiting eight new faculty to Fred Hutch, all from underrepresented backgrounds. We put a lot into that recruitment and now we’ve really shifted into career development and retention and support for the new faculty who have joined us and are doing that in a variety of different ways.

So, that has been one major piece. Another is really around supporting our existing, in particular, Black, Indigenous, people of color faculty and staff at Fred Hutch. 

We started a BIPOC affinity group, which meets once a month, which has been, I think, an important space for both creating community, as well as discussing a variety of different emerging topics. Both Wendy and I participate actively in that group.

And then, I think the other piece that I’ve been particularly engaged with is really trying to take the principles of anti-racism and apply those to our institution. 

So, one of the major activities that I have been engaged with is taking a very careful look at all of our academic policies through an anti-racist lens to identify what are ways that we can really both change specific aspects of our policy, so that we’re not perpetuating these different sources of structural racism at our institution.

So, we’re in the process of implementing a variety of changes to our academic policies as a result. I think every day is different, as a short answer to your question. 

It depends on what we’re working on. Those are some of our major activities, I would say over the past year that I’ve been engaged with.

What are your programmatic plans for the network? Are you going to be meeting regularly at regional or national gatherings? What is it going to look like?

CL: I think we’re all taking advantage of everyone’s increased comfort with just being in the Zoom environment. 

And in some ways, it has opened up the opportunity to have monthly meetings where we have pretty high attendance across the different cancer centers. 

Like I said, at that first meeting, we brainstormed a number of different topics that people were interested in discussing. So, the first one from last month was focused on the DEI metrics. 

The second most important topic to people was around faculty recruitment. Our December meeting will focus on that topic. 

And then, we’ll just continue down the list of the different topics that people identified, once a month inviting volunteers from different institutions to speak on their experience related to that topic. 

So, the first meeting on the metrics, we talked about what work we’ve done here at Fred Hutch, and then our colleagues at St. Jude’s also talked about how they’re approaching metrics.

Similarly, at this next meeting, I think we have three different volunteers who will talk about their experiences with faculty recruitment. So, the idea is to not just be hearing from the same institutions over and over, but to really hear from a variety of different places, and then limiting the presentations to about 10 minutes each. 

About the first half is on presentations, the first 30 minutes. And then the second half is more Q&A, discussion, trying to dig into the topics a little bit more and get more details so that people can get information that they can use and bring back to their centers.

WL: The only thing to add is that I know that our Office of Diversity, Equity and Inclusion has done a really great job of launching learning modules for us. Both faculty and staff are taking these modules. And I feel like it’s not just an online training that you breeze through, you answer the questions and you’re done.

But it does require each person to do some introspection and think about, what is your position or position of privilege within the workplace? I think we all have multiple roles in which sometimes we have more privilege than at other times. 

It’s an ongoing, evolving conversation with other people who are also taking the same training as well as ourselves to have that self reflection. So, I really appreciated that piece of the work that the ODEI has been doing.

In these early stages of plans the cancer centers are making, based on what you know about how cancer centers are building these programs, what do you think are some of the heaviest lifts, so to speak, that DEI teams have to make to meet these new guidelines?

CL: I think there has to be an emphasis. That’s something different that we haven’t talked about, an emphasis also on pipeline programs to really increase the diversity of the cancer research workforce. 

And I think that is something that we tend to think about really in the researcher and scientific space, but also thinking about that on our administrative staff and our other support staff for the research that we’re doing and trying to have a more holistic approach to really trying to diversify our workforce very broadly, not just on the faculty level and the leadership level, but throughout the institution.

This is obviously a challenge, just because the numbers of people being trained from diverse backgrounds often, for many fields, remains quite small. 

And so, how do we really think creatively about developing these programs, learning from each other in terms of what has been successful to reach different communities?

And so, I think that will certainly be a challenge because it is, I think, an ambitious goal to have both faculty and leadership at cancer centers reflect the nation’s diversity. 

It’s not something that is readily achievable overnight, for sure, just in terms of the numbers, but as an aspirational goal, I think it really requires us to be thinking about the longer term. How can we get there—hopefully, not in decades, but maybe in years—to achieve some of this diversity?

CL: I think the way that we’re thinking about it, and one thing that we have started is to really think about our work, as the Office of DEI, not in a vacuum, but one that really requires, in this case, a very close partnership with our Office of Community Outreach and Engagement, because that’s focused more on clinical trial enrollment, our community partnerships, as well as our Office of Education and Training.

We can also help support the pipeline so that it’s not something that each office is doing in isolation, but that we have a plan together to try and realize the goal, because it requires a multifaceted approach and not something that probably a single office is really even suited to do all by itself, but that we can. 

And so, now we’re starting monthly meetings of the leadership of our three offices, so that we can try and engage around these different opportunities and do some strategic planning in that space where there is sort of a natural overlap between our work and responsibilities.

WL: I would just say that for a long time we’ve focused on the recruitment piece, and now, I think there’s more emphasis around the retention piece, because you can get someone to your cancer center, but keeping them there and keeping them well resourced to do the research that they’re there to do, is another thing altogether. 

So, I think continued support of our trainees and faculty to keep them in cancer research is something that we’re looking to do in the long term.

On the flip side of that, based on the first meetings that you’ve had, what are some of the takeaways that you maybe can communicate to our audience, about what your average cancer center can most easily do when it comes to initiating a DEI plan?

CL: I don’t know if there’s a simple answer to that. I think part of it is that every institution is at a different phase of their development and their readiness around these topics.

I think, and also because of the nature, of the heterogeneity of cancer centers themselves, where you have the freestanding vs. matrix vs. ones that are really embedded in the university that might have an Office of Diversity that has been in existence really for decades and been doing a lot of work that they engage with.

So, I think every cancer center, as we know, is different in their structure. I think it’s really about trying to identify and prioritize. 

It’s not limited to trying to reflect the diversity of your catchment area or your region, but really, all cancer centers should be reflecting that broader national diversity. Depending on where you are in the country, that can be a bigger challenge or maybe a smaller challenge.

Christopher Li

How are you able to advance, given your particular circumstances? I think that’s at least how we’ve approached it at Fred Hutch, where we didn’t really have any metrics related to DEI that we could readily report.

We did put a lot of emphasis on, how can we get the data? How can we have hard numbers regarding diversity in different spheres of our organization? And then, we can use that to then inform, okay, well, what sort of programming, what sort of initiatives can we then take to try and address the major gaps that are seen? 

For us, our workforce is actually pretty reflective of the diversity of Seattle, but if you look at our faculty it’s certainly not as reflective. And if you look at our leadership, it’s even less reflective.

That was one of the major reasons why we started with the cluster hire as an important strategy, because there was a very urgent need around trying to increase the diversity of our faculty.

And that, I think, will now shift to thinking about, okay, well, how do we address the issues around diversity and leadership, which I think is, as you know, there have been recent publications over this past year that have documented the lack of diversity in leadership across cancer centers.

And so, this is not something that’s just specific to us, but I think is something that all cancer centers will be grappling with. I think that’s another area for collaboration around, how do we develop leadership development programs that will be effective in transforming the composition of cancer center leadership?

WL: I would say that, first of all, the survey that AACI and The Cancer Letter jointly completed around cancer center leadership was very helpful to get the conversation started.

I mean, it’s not like we didn’t know that cancer center leadership wasn’t very diverse, but I think always, because we’re all scientists, having the data behind it is very powerful.

And I think that knowing more about our relationship to our catchment area and how we plan to serve the people in our communities is also a very important step to make sure that that is part of the consideration of how we grow our workforce and how we grow our faculty, and how we grow our trainees to meet the needs of the communities. I think that’s a really important piece as well.

Did I miss anything? Is there anything else that you want to highlight?

WL: I think people were very open to hearing one another share about this because we all know, no one has the right answer. 

As Chris mentioned, every cancer center is a little bit different, and we just have to figure out what’s going to work at our cancer center in order to move things forward. 

That’s one thing that we’ve taken away from it is that everybody is willing to share, be in the room to discuss, and then we’ll take it back to our own cancer centers to make it our own.

CL: I’ve definitely appreciated The Cancer Letter’s emphasis on this topic throughout this past year in particular. I think that’s been really helpful in pushing the ball forward in many respects. So, thank you for your work.

WL: Matt, I’ll email you our cancer consortium email alias (cancerconsortium@fredhutch.org). If people want to join the network, we would welcome people to get in touch so we can add them to our network.