Healing the divide
A month after George Floyd’s murder, Stanford Medicine convened a Commission on Justice and Equity to study how it could fight systemic racism and curb health disparities.
The group’s findings, released a year later, were sobering. Underrepresented minorities made up less than 7 percent of faculty and around 5 percent of postdoctoral scholars. Some Black and Latinx patients found it difficult to access care. Meanwhile, the COVID-19 pandemic was inflicting outsized damage on disadvantaged communities.
None of this was news exactly. For years, a preponderance of evidence had made clear the insidious health effects of racism, both direct and indirect. From infant mortality and chronic disease to the availability of health care facilities and the prescription of pain medication, health care simply isn’t distributed evenly in the United States. But here the call was coming from inside the house.
“It was really hard tohear from members of our own community who said, ‘We don’t always feel safe or seen.’”said Dr. Terrance Mayes, who led the commission.
In 2021, Stanford Medicine launched the Racial Equity to Advance a Community of Health (REACH) Initiative with support from the Emerson Collective. The initiative is a set of six programs with an ambitious mission: diversifying health care and the biomedical sciences, while making a dent in health inequality nationwide.
“Once the REACH Initiative reaches maturity, it will be very difficult, if not impossible, to graduate without having received meaningful training and deep exposure to serving vulnerable communities,” says Mayes, who spearheaded and leads the initiative.
Partnerships that amplify impact
Mayes knew from the start that the REACH Initiative faced centuries of ingrained injustice. Making meaningful progress toward racial or health equity “is going to require us to fix foundational historical and structural harms. That’s difficult to do,” he says.
Rosalind Hudnell, a former Intel executive who had chaired the commission, described its mandate this way: “DEI work is not rocket science—it’s harder.”
Early on Mayes and the REACH leadership team made the decision to look outward. “Stanford Medicine brings a number of strengths, but we cannot address these long-standing issues in a vacuum,” Mayes says.
To that end, he and his team forged a first-of-its-kind partnership with historically Black colleges and universities (HBCUs) and historically Black medical colleges (HBMCs). For the latter, the team chose to scale a PRESENCE Center, Department of Medicine effort led by Dr. Abraham Verghese with one HBMC: Meharry Medical College. Recognizing the need to leverage existing relationships and efforts, the REACH-HBMC Summer Program grew this kernel into one that engages all departments and institutes across the School of Medicine. It is the nation’s only program that collaborates with all four HBMCs, adding Howard University College of Medicine, Morehouse School of Medicine, and Charles R. Drew University of Medicine and Science to the original Meharry Medical School. Each summer since 2022, a cohort of approximately 50-plus medical students from these schools spends eight weeks as paid research interns in Stanford Medicine labs.
“For many scholars, it’s their first time engaging in research, and for almost all of them it’s been transformative,” Mayes said. “They’re provided with experience and skills they take back to their home institution and are able to apply to more competitive residencies.”
Mayes’ team is also working with 17 undergraduate HBCUs to create opportunities for knowledge exchange and mutual support. Stanford Medicine has hosted leaders from 12 schools for a BioMedicine Think Tank, 16 science faculty members for grant writing workshops, and over the course of two summers nearly 100 students for R Data Science Courses.
“When primarily white and research-intensive, well-resourced institutions partner with minority-serving institutions, they almost always take a deficit approach: What can we give to them or do to help them become better,” Mayes says. “By building really authentic relationships with colleagues at HBCUs, we can both learn and gain from each other.”
Turning crisis into opportunity
Before coming to Stanford, as director of student affairs at UC San Diego’s electrical and computer engineering department, Mayes inadvertently found his calling. It happened when the dean asked him to oversee a new diversity push, following reports that a fraternity had hosted a “Compton Cookout” party, with invitations featuring offensive stereotypes about Black people. He said no to the dean’s request at first, fearing he lacked experience, but eventually he relented.
“I discovered this is work that truly aligns with who I am as a person,” says Mayes, who is now an associate dean at Stanford Medicine. He spent the next decade heading diversity and inclusion efforts, moving on to Stanford Biosciences, then the University of California, Irvine.
In May 2020, the news of George Floyd’s murder hit Mayes hard.
“I had a 1-year-old Black son at the time, so the murder impacted me deeply on a personal level,” he says. “I made a commitment that the work I did from that point forward would truly move the needle on equity and inclusion and justice.”
Mayes got his chance just a month later, when Stanford Medicine invited him back to help lead the Commission on Justice and Equity.
The power of support
In addition to his experiences with racism over the years, Mayes also encountered vital voices of support: A stranger in college, struck by his interest in reading, telling him, “You’re going to be a millionaire one day.” His grandmother saying, “You can do anything that God wants you to.” A supervisor suggesting he pursue a doctorate. A mentor encouraging him to promote his achievements.
These words were an antidote to what he felt every time a police officer was acquitted of murdering a Black man, or an advisor suggested a less ambitious career, or someone asked if he’d gone to college on a sports scholarship.
“Had it not been for those individuals who believed in me when perhaps I didn’t believe in myself, I would not be where I am,” Mayes says.
By extension, he says, “a vast amount of talent will go to waste” if people from historically marginalized communities never receive affirmation and support.
“Only by helping people reach their full potential can we make progress on health equity,” he says.
Cultivating a generation of health equity leaders
To broaden the pool of students building careers in medicine and science, Mayes and the REACH team launched a postbaccalaureate research program that invites 20 college graduates, primarily from underrepresented communities, to spend up to two years conducting research in Stanford labs and pursuing professional development. Further along the pipeline, they established a fellowship fund for students from marginalized communities to pursue a PhD in medicine.
“The ‘myth of meritocracy’ suggests that if you work hard enough, you can succeed. The reality is that not everyone has bootstraps to pull themselves up with,” Mayes says. “We’ve found that some students just need an extra boost to transition to the next stage of their academic training and career.”
Last year, Mayes and his team launched three other programs that train Stanford Medicine students to become health equity leaders. A four-week clerkship places students in clinics that serve vulnerable patients such as farmworkers, refugees, and unhoused people; the medical school is working to make the rotation a universal requirement. A scholarly concentration in Health Equity & Social Justice Research includes courses on the theory and practice of social change, while an MD/Master's Program in Health Equity covers tuition for students who are earning a master’s degree in a related field.
Apoorva Rangan, who will start a master’s program in epidemiology this fall, hopes to further her passion for improving geriatric care by researching the health effects of housing and compassionate release for older adults. So far, she has found support and inspiration in the program’s community events.
“Academic medicine has a history of work that has been harmful to marginalized communities,and I think only through early exposure in medical training and through a cohort model where we’re supported by really thoughtful mentors can we start to unravel and heal some of that.”Apoorva Rangan, MA ’25, MD ’26
‘A hub for change’
Mayes is proud of what his team has achieved—Reena Thomas, clinical associate professor in neuro-oncology, has been a thought partner in launching REACH—but they’re just getting started. The hope is to expand the scope of the initiative, eventually bringing in more students, faculty, and partners; the program will be rigorously evaluated, its lessons shared with other institutions. “We have no interest in keeping our momentum to ourselves,” he says. “We view ourselves as a hub for change across the country.”
Mayes knows no program can effect change overnight, but he believes the REACH Initiative is making a difference. “It has reaffirmed my commitment to this work, because I see the real difference it’s making in individuals’ lives,” he says. “I see the confidence that improves in each and every one of our participants.”