For this year’s Marvin R. Dunn Keynote Address, Ala Stanford, MD, a pediatric surgeon and founder of the Black Doctors Consortium and Center for Health Equity, shared her incredible journey to provide testing and vaccination services to more than 140,000 people in an underserved part of Philadelphia, and discussed how the graduate medical education (GME) community can help reduce and even eliminate injustice in the health care space.
Dr. Stanford spoke about her own path in medicine, describing how her motivation to effect change was sparked during medical school when she learned about lower life expectancy rates in certain communities. She cringed at some of the reasons given for health care disparities in the Black community, which she felt did not apply to her.
Dr. Stanford’s preferred framework for creating change is called, paradoxically, BIAS: Believe, Identify, Act, Share. She encouraged attendees to believe the data about inequality in medicine and the lived experiences of their patients and to dispel any myths that patients are parroting back to clinicians.
“Lean on qualitative and quantitative data,” she said. By believing truths backed by data, the GME community can use that information to identify areas in which they have the power to improve patients’ lives.
“Whatever you can do in your space, you act on it. If you act on it and it doesn’t work, you don’t have to share it,” Dr. Stanford said.
The COVID-19 Pandemic: A Turning Point
In 2020, Dr. Stanford took her own advice to heart and acted, as Black people in underserved areas of the Philadelphia were dying and contracting COVID-19 at rates significantly higher than in other communities. She felt she had to do something about it, and went to the areas where the disease was most pervasive, connecting with Black churches and setting up testing sites in their parking lots at no cost to the patients.
Dr. Stanford and her team worked tirelessly in their privately run, publicly available clinics. They held 24- and 48-hour vaccination drives, even vaccinating people at 2:00 a.m. when clubs closed. The result? The clinic vaccinated more than 4,000 people in 24 hours.
“We started by going to the people that were the least, the lost, the forgotten, and then turned it into something for everyone,” she said.
Dr. Stanford's efforts have now extended well beyond the pandemic. When the CARES Act passed, she received reimbursement for those vaccines and used the money to build an ambulatory care center in the same neighborhood where she was providing vaccination services. The clinic offers barrier-free care with wraparound services. In January 2025, Dr. Stanford opened a second location, a recovery home for the unhoused where she and her team are providing medical care and vocational services.
“It can’t be the same way we’ve always done things,” she explained. “Why and how we were so successful is that we stepped outside of the four walls of the hospitals.”
Turning Action into Advocacy
Education, economic stability, social and community support, and health care access are all critical factors in improving health outcomes, but that doesn’t mean clinical care can’t do more. Dr. Stanford believes that everyone, from educators to practitioners to patients, can advocate for change.
“’First Do No Harm’ includes the eradication of substandard treatment of our patients,” she said. “We are and you are the answer to improving livelihood and life expectancy in our nation.”
Integrating Advocacy into GME
Following her presentation, Dr. Stanford sat down with ACGME Senior Vice President, Accreditation Nikhil Goyal, MD for a discussion that covered more about her story; her book, Take Care of Them Like My Own; and how those in GME can make strides to reduce health care disparities in their own communities.
Dr. Stanford said she grew up “working poor” and had distinct memories of how her family was perceived.
“I watched people look down on us when my mom took us to the ER to primary care because that’s when she could get us to get our physicals,” she recalled.
Instead of allowing these experiences to cultivate bitterness, Dr. Stanford uses them to cultivate motivation in others.
Dr. Goyal asked Dr. Stanford how GME institutions and programs could help residents and fellows get more involved in community outreach work. Her answer was surprising.
“There will be plenty of time for you to do this,” Dr. Stanford said, addressing the learners in the room. “When you are a trainee and a resident and a fellow, your focus is to complete your residency, to become the best clinician you can be so you can [then] do all of this.”
Dr. Goyal also asked for advice on navigating complex public policy changes, as the current federal government administration looks to dramatically shrink its footprint and decrease spending in a variety of areas, including diversity, equity, and inclusion.
Get creative, Dr. Stanford advised.
“We can’t just not work with whomever the administration is. You have to figure out what their focus and their goals are, and something will have to align,” she said.
Dr. Stanford asked the GME community to “believe what I told you today,” and to believe that inequity and injustice in health exist, and that the community can help.
“The next time you have a resident in front of you that’s struggling… give them another chance.” If they’ve gotten to the GME level, she reasoned, they’ve already proved themselves capable. Rather than looking for their flaws and failures, she said, advocate for their success.
“Health disparities exist in America,” she said plainly. “Who and how we train the future of medicine is integral to improving health outcomes [for all].”