Training Activists, Not Physicians: The Impact of DEI on Medical Schools

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The committee will please come to order. A quorum is present. The committee meets today pursuant to notice. Without objection, the chair may recess the committee at any point. Last August, uh the Education and Workforce Committee opened investigations into three medical schools before us today. We had received re- repeated complaints of severe anti-semitism from students and faculty on these campuses and we wanted to under- understand what was causing it. It soon became clear that the pervas- pervasive anti-semitism we were investigating was a result of a deeper problem. It was a result of the activist infrastructure that these medical schools themselves had constructed. This infrastructure puts people into categories based on race, an identity rather than judging people as individuals. It also incites anti-semitism among other hatreds by labeling Jews as white and therefore privileged and oppressors. That same ideology has shaped admission policies, hiring practices, and even curricula. For example, in May the Justice Department found that UCLA Medical School intentionally admitted applicants based on race, trading merit for DEI. UCLA is not alone. On now removed web pages, UC San Francisco touted its increasing numbers for residents who they claim are, quote, "underrepresented in medicine," end quote. Similarly, departments across the University of Illinois College of Medicine have pledged year after year to increase their proportion of certain medical students, residents and faculty. But admissions were only the beginning. DEI became part of the curriculum at these medical schools. For example, UCLA Medical School and the University of San Francisco School of Medicine require students to take classes indoctrinating them in settler colonialist, anti-oppression nonsense. These classes are filled with propaganda. They do not prepare medical students to become qualified, skilled physicians. And I repeat, these courses do not prepare medical students to become qualified, skilled physicians. They're focused on topics that have nothing to do with medical science because they seek to make medical students not into competent doctors but into far-left activists. UCLA and UCSF have admitted as much to the committee. UCSF told the committee that its required DEI class, and I quote, "did not meet UCSF standards," end quote. Specifically, The course did not meet, and I quote, " benchmarks for student reviews" and did not align with graduation competencies or milestones. UCLA also told the committee that its DEI course is, quote, " no longer offered after a review of the first year curriculum," end quote. Both schools are now offering replacement courses, which I worry will be just more of the same. It's clear that we need to spend some uh time today learning how those courses made their way into the curriculum in the first place. Today's hearing is about accountability. Today's hearing can be emotional, frustrating, encouraging, discouraging, all of the above, dep- depending on how we, the committee, work it out together. And I put that emphasis on together. Even with the differences and the viewpoints. We'll be asking some difficult questions about the, about uh these medical schools and the choices that they've made. We'll be asking things like why are you prioritis prioritizing politics over medical education? Why are you perpetuating anti-semitism and discrimination? Why are you turning doctors into activists? We look forward to hearing your testimony. With that, I yield to the ranking member for an opening statement.

Thank you, Mr. Chairman. Mr. Chairman, today the full committee is holding a hearing entitled Training Activists, Not Physicians. of DEL on medical schools. The three medical schools appearing for the committee today were initially asked to respond to concerns about anti-semitism on their campuses, yet somehow somewhere along the way uh the majority has shifted its focus from addressing allegations of anti-semitism in medical schools to attacking diversity equity and inclusion in medical education. It may be clear, illegal discrimination in any form against any person should not occur. in our medical schools, teaching hospitals, the health care system, anti-semitism is r- is real and is rising, as are claims of Islamophobia, racism, sexism, and other forms of discrimination. Our nation's educational civil rights laws are put into place to ensure that students, residents, and faculty in in medicine have safe learning environments. The Democrats have stood ready to meaningful address hate and discrimination. However, I'm doubt um dubious about my colleagues' commitment to addressing discrimination when they have abandoned good faith efforts to do so, especially given the fact that they've turned a blind eye to people within their own party who have actively normalized bigotry and are dismantling the very offices created to fight illegal discrimination. Promoting diversity, equity and inclusion is how we combat bigotry, hatred and illegal discrimination. And enforcement is by the Office of Civil Rights, uh, at at the Department of Education, an office that's already lost about half its staff and has been bounced around from what out of the Department of Education a- as we speak. We do not defeat prejudice by eliminating exposure to people different from you, or by erasing the training that teaches future doctors to recognize and confront bias. You defeat it by building familiarity, understanding and respect. Gutting D I programs in the name of fighting anti-semitism simply doesn't make sense. Worse, it makes medical schools less equipped to care for Jewish students and other students who face discrimination. For example, earlier this year, uh my colleague, our colleague from Pennsylvania, uh Ms. Lee, reminded the Health and Human Services secretary that his own department had directed staff remove nearly two hundred words and phrases, including the word black, from funding applications as part of the Trump administration's war on DEI. So the congresswoman posed a simple question. How are we going to solve the black maternal mortality crisis if we cannot say black? Uh, she did not get a coherent response. That contradiction is at the heart of the administration's a a approach. we cannot address health disparities if we're discouraged from even acknowledging how different communities uh are impacted. Another way this administration has dismantled programs that would address students experiencing discrimination has been the illegal dismantling of the Department of Education's Office of Civil Rights. According to a report uh the Health uh Education and Labor Pensions uh Committee in the Senate, In twenty twenty five, OCR reached zero resolution agreements involving sexual harassment, sexual violence, seclusion or restraint violations of students with learning or behavioral issues, racial harassment, or discriminatory school discipline. To add a finer point, OCR reached zero resolutions in those categories in twenty twenty five, despite having more than twenty seven hundred pending cases. The Gov- the Government Accountability Office also reported that while all discrimination claims went unaddressed, the federal government pla- paid employees at the Office of Civil Rights, up to thirty-eight million dollars, for not working. This is in part thanks to Doge. The very office that could and should be protecting students from illegal discrimination has effectively been hollowed out. The majority in this committee is complicit. because you have refused to conduct any meaningful oversight over the plans by this administration to decimate OCR or critique the actions of HHS that are counter to evidence data science or even common sense. Instead of seeking accountability and change, my colleagues have chan- have chosen to hold endless hearings that may be in good faith may be good for uh grabbing headlines but are not very effective and in enacting any positive results to improve health care in this country. This he- this hearing will not address access to affordable care, gaps in medical care, or communities uh that need to be served, won't address the alarming decline in medical school enrollment among key demographics necessary to serve this country's diverse communities and population centers nor will it s- ensure that our medical school, faculty, students and residents are equipped with the best technology to improve services to the public. Sadly, this hearing is yet another example of weaponized grievances against D against DEI dressed up as a concern for anti-semitism. Now real inclusion in health care requires a multi-pronged approach. First, medical schools should be teaching best practices, which include training future doctors to recognize biases in their field of practice. That includes institutionalized biases based on race, gender, religion, ability, socioeconomic standing, and others. Second, the medical school settings was fostered in inclusive environment that produces better prepared doctors. You cannot claim credit for the second step if you spent the last two years dismantling step one. Health care is among America's most diverse workforce sectors. When students entering the field feel safe and they perform better as providers. When patients feel seen, they have an increased trust and can better engage in their own care. Inclusion just isn't fair, it's more effective medicine. That includes making sure that everyone feels safe and respected too. Lastly, health, equity and affordabil- and affordable uh care are the same fight. A system that tolerates discrimination does not just fail individuals, it drives up costs for everyone, Healthcare should work for everyone, no matter who they are, who they worship, or how much money they have. Thank you, Mr. Chairman. I yield back.

I thank the gentlemen. Uh, pursuant to committee rule eight C, all members who wish to insert written statements into the record may do so by submitting them to the committee clerk electronically in Microsoft Word format by five p m fourteen days after this hearing. And without objection, the hearing record will remain open for fourteen days to allow such statements and other extraneous material noted during the hearing to be submitted for the official hearing record. I'll now turn to the introduction of our four witnesses. Our first witness, uh, Doctor S- uh, Doctor Steve Dubinette, uh, Dean of the University of California, Los Angeles, David Geffen, School of Medicine in Los Angeles, California. Our second witness is Sam Hogood, Chancellor of the University of California, San Francisco in San Francisco, California. Our third witness is Doctor Roger A. Mitchell, Junior, President of the National Medical Association in Silver Spring, Maryland. Our last witness is Doctor Enri Enrico Benedetti, uh Interim G. Stephen Erwin, Executive Dean of at the University of Illinois. College of Medicine in Chicago, Illinois. We thank the witnesses for being here today. Pursuant to committee rule, I would ask that you each limit your oral presentation to a three-minute summary of your written statement. The clock will count down from three minutes as committee members have many questions to ask you. However, pursuant to committee rule eight D and committee practice, we will not cut off your testimony until you reach the five-minute mark. I would also like to remind the witnesses to be aware of the responsibility to provide accurate information to the committee. And so now I will now first recognize Doctor Dub-Innet for your testimony.

Good morning, Chairman Wahlberg, Ranking Member Scott, and members of the committee. The mission of the David Geffen School of Medicine is to improve health through education, research, and patient care. We have trained generations of dedicated physicians and made scientific advances that have saved lives. For example, this has included major advances in cancer, heart and lung disease, as well as neurologic disorders. We are committed to educating future doctors who will improve health care across California and the nation. We prepare our medical students to deliver high quality, evidence-based care grounded in science, clinical judgment, and professionalism. Effective medical care requires understanding how a patient's background and circumstances can affect health. As a critical care physician who has cared for veterans at the West Los Angeles VA, I have seen firsthand how much medicine depends on compassion, respect, and trust. Teaching medical students how a patient's life circumstances can affect health is consistent with accreditation standards and is a necessary part of medical education. This was the intent of a now discontinued course, structural racism and health equity. But well before the committee's inquiry, we determined that some of its content was not appropriate for a medical school curriculum. To address these concerns, we took the following concrete actions. One, we eliminated the course and replaced it with a new one that emphasizes evidence-based medicine and relies on clinical case studies. Two, at my direction, only UCLA faculty may lecture in our medical school courses. Three, we instituted training on University of California policy twenty-three O one, which limits the use of the classroom to relevant course content. We are committed to a scientifically rigorous medical education that prepares students for the realities of patient care. One of our core values is fostering a welcoming and inclusive medical school environment. Some of our Jewish community members have confronted painful moments since October seventh, twenty twenty three. This resonates with me personally. Not all of my family made it out of Europe during the Holocaust, and I have experienced, personally experienced, anti-semitism growing up. Our medical school condemns anti-semitism and all forms of hatred. We are committed to sustaining an environment where all community members can learn, work and care for patients with safety and respect. I welcome the opportunity to discuss the importance of medical education with you today. Thank you.

Thank you. I now recognize uh Doctor Hoggard for your testimony.

Good morning, Chairman Wahlberg, Ranking Member Scott, and all members of the committee. The UCSF School of Medicine consistently ranks among the top US medical schools in education research and patient care. As a public university, we are committed to serving the health care needs of all the people of California and indeed the nation. This mission is deeply personal to me. I came to UCSF more than forty years ago as a research fellow and have practiced newborn intensive care medicine for thirty years, and run a federally funded research lab to understand the basic science of medicine. Patient-centered care is at the very center of what the School of Medicine's curriculum is all about. We teach students the fundamentals of medicine through a rigorous, science-based curriculum grounded in biology. In compliance with accreditation standards, we also teach future doctors that delivering compassionate, high-quality care requires an understanding of how a patient's background and life circumstances may affect their health outcomes. The Justice and Advocacy in Medicine course, or JAM, was designed to address these social drivers of health. JAM account- counted for roughly two percent of the entire classroom experience of our medical students. Although much of JAM meant the school's expectations, portions did not meet our standards for relevance and scholarship. In the fall of twenty twenty five, our standard curriculum review process indicated the need to discontinue the course. We have implemented three remedial actions. First, in early twenty twenty six, the decision was made to replace JAM with an entirely new course. Second, we have implemented required training to reinforce the importance of Region's Policy twenty-three O one, which limits the use of classroom to relative course content. Third, all mandatory courses will be taught by U- university faculty who will be held accountable for meeting these standards. We strive for an educational environment that is respectful and supportive of our entire community. Anti-semitism or any other form of discrimination have no place at UCSF. Since twenty twenty four, we have provided professional training about anti-semitism to faculty, staff and students. As Chancellor, I have spoken out against anti-semitism and held accountable those who violated our policies. I appreciate the opportunity to speak about UCSF's commitment to educating outstanding doctors prepared with the latest science and technical skills. Thank you.

Thank you. I now recognize uh Doctor Mitchell for your testimony.

Chairman Wahlberg, Ranking Member Scott, and members of the committee, I greet you on behalf of the National Medical Association as its hundred and twenty-sixth president. Founded in eighteen ninety-five, we are the nation's oldest and largest organization of black physicians dedicated to ensuring access for our patients regardless of race, creed, religion or gender. NMA stands in the lineage of undeniable scientific excellence, the moral conscience of medicine. With a long history of working alongside Congress, and presidential administrations to advance the health for all Americans. Members like Doctor Daniel Hale Williams, a pioneer in open heart surgery, Doctor Charles Drew, whose blood banking science saved countless lives, Doctor Montague Cobb, who's led in the establishment of Medicare, and Doctor Patricia Bath, whose laser cataract innovation restores sight. Excellence stands as the legacy of diversity, equity and inclusion, for all of American medicine. Allow me to be clear, diversity in medical admissions does not lower standards. We need physicians who are able to meet rigorous academic and clinical expectations mastering anatomy, physiology, pathology, pharmacology, and diagnostic reasoning. In a diverse nation, we also need physicians who can communicate across differences, recognize bias, understand the lived context illness and serve rural and urban communities that have too often been marginalized. Effective communication is clinical competency, not political ideology. Diversity as a component of medical education benefits every student regardless of race or gender. The goal is not to replace science with radical doctrine. The goal is to make sure biomedical expertise reaches every patient accurately, and with equity. A physician who cannot understand the human experience is not fully prepared for modern medicine. Just as it is important for learners to understand technology and AI in medicine today, so it is for them to understand cultural differences. A diverse, lastly, we are now facing a physician shortage, a shortfall of up to eighty-six thousand physicians in twenty thirty-six. We cannot be mandating racial concordance or supporting separate but equal doctrine of the Jim Crow past. We must expand medical schools, seats, and resident training positions now. But the expansion without diversity will reproduce the same problem it leaves today, access to rural, health, and in marginalized communities. Diversity must be a central part of a comprehensive workforce policy. So I reject this false choice. We don't have to choose between excellence and equity. We don't have to choose between innovation and inclusion. We must agree that creating an inclusive workforce that can heal every patient, every family, and every community must be our goal. This is a uniquely American value. And together we can strengthen American medicine. So members of this esteemed committee, Let me say it again. Diversity in medical school admissions, as content in medical education, and as a component of patient care improves patient safety, quality care, and enhances the physician workforce, and improves financial outcomes. On behalf of the National Medical Association, I urge this committee to protect policies and systems that broaden opportunities to strengthen our physician workforce and the future of health of an entire nation. Thank you and I'm here for any questions that you may have.

Thank you. I now uh lastly recognize Doctor Benedetti for your testimony.

Good morning, Chairman Wahlberg, Ranking Member Scott, and all member of the committee. I'm Doctor Enrico Benedetti, Interim Dean at the University of Illinois College of Medicine. a role that I held since January two thousand twenty six. Our university mission is to provide the broadest access to the highest level of educational research and clinical excellence. I spent more than thirty-five years in our College of Medicine as a resident, transplant surgeon, and head of surgery. I have dedicated my career to advancing organ transplantation. The college primary goal is simple, to train excellent physician who provide the best care to all patients, regardless their own background, the background of those they serve. We provide a medical education that focus on science, evidence-based medicine, and the professional competency required to care for patient. We are here to train physician. We cannot allow anything to displace rigorous medical training or interfere with our core educational mission. Nothing should undermine the trust and relationship that must exist between patient and their daughters. The college is commit to ensuring that these policy and practice comply with federal law. We are commit to providing a learning environment where all student, including Jewish student, feel safe, respected, and ready to learn. I'm pleased to share that the college is taking concrete step to advance our mission. First, we will enforce our professional code to hold student accountable for hate speech and other misconduct, including conduct that occur outside the classroom or clinic. Second, we discontinued an internal communication channel that had become a forum for inappropriate and offensive commentary. Third, we have changed our senior leadership structure to ensu- ensure clear lines of accountability. The new Vice-Den of Education will now have oversight over student complaints regarding misconduct. Fourth, we are updating our curriculum to better ensure that all our physician are trained to effectively treat patients from all communities. Fifth, uh I've instituted an open door policy so students, staff and faculty can bring concern directly to me. I'm pleased to report that Jewish student and faculty in particular have told me, as recently as last week, that I feel safe and supported under my leadership. In the coming weeks I will personally speak to our entire class of incoming medical student to make sure they understand the college expectation for professionalism and respectful engagement within our diverse community. This step, among others, reinforced the college's focus on its core mission of training exceptional physician, and then the score of the college will not tolerate any form of hate, including antisemitism, or any behavior that undermines a professional and respectful learning environment. It is our collective responsibility to leave the college's value on inclusivity, tolerance, respect and excellence. I'll train the next generation of physician. Thank you.

I thank the witnesses. And uh, under committee rule nine, we'll now question witnesses under the five minute rule. And so I'll recognize myself for five minutes of questioning. I listened carefully to each of you as you spoke. And I think there needs to be a a a a clear statement right from the beginning of my questioning that we certainly agree with the concept that there ought to be merit within organic diversity. And I think if we keep it in that order, there will be diversity. But there will be merit and the quality of medicine that we need for all communities. That's our concern. And that is versus uh merit flexibility with manufactured diversity. That's our concern. I hope that is stated clearly. I'd also like to remind our witnesses that it is a felony to lie to Congress. And so that's the beginning of our questioning as well, because we are taking this seriously. For each witness, uh, I ask you to respond. Does your school treat student applicants of different races differently, whether for admission or for opportunities such as fellowships, yes or no? Doctor Dubenet.

My understanding that a race is not considered, uh, in applicants, uh, to a medical school.

Doctor Hogood.

No, for thirty years under California law, race has not been a factor in admissions to medical schools.

Doctor Enrico Benedict.

No, we do not consider race when we choose the best student that we can to attend our medical school.

Secondly, does your medical school have race-based diversity goals that it seeks to achieve through admissions, including um using holistic review? Doctor Benedetti.

Our process exclude the the reviewer from knowledge of the race of the applicants. Therefore, I believe that we are in compliance.

Doctor Hoggart.

Similarly, we are unaware of the race until the actual in-person interview. We do not set any quotas uh uh at all.

But it is part of the the interview, and and the interviewers are making the decisions? In the end?

I said that race was only visible to the interviewer when they saw the person in front of them they don't use race in the interview process.

Mm-hmm. Doctor Dubonnet?

Mm-hmm. First I would say uh to make it clear is that I'm not uh involved uh with the admissions process at UCLA by design because of uh appearance of conflict of interest uh but it is my understanding uh that race uh plays no role uh, in decisions about applicants.

Thirdly, does your admissions office obtain information about the race of applicants before making admissions decisions? Doctor Hoggard.

As I stated earlier, the only time that the race becomes known is at the time of the in-person interview.

Doctor Benedetti.

The final committee does not have information about the race of the candidate.

Doctor Dubenet.

It's my understanding that race plays no role in the process.

If you had to pick only one thing, such as GPA or MCAT score, what's the best indicator of an applicant's future success in medical school? Doctor Dubenet.

Um, there are a a broad array of factors, uh, that predict, uh, success and, uh, certainly, uh, MCAT scores and and GPAs are important.

Doctor Hoggard.

Yes, we take GPA and MCAT scores seriously and set a lower boundary below which we do not, uh, uh, interview or - or accept students, uh, it is not the only, uh, measure of the, uh, long-term professional outcome of our students.

Doctor Benedetti.

Yes.

We we do do not uh in any way um um admit to the committee student that are below a certain academic standard. So we have a limit for uh the score, the grade point average, and therefore the student are not even considered for the final determination.

And finally, uh does your medical school obtain information about the race of job applicants prior to making hired decisions? Doctor Dubenet?

Uh, not to my knowledge, no.

Doctor Haugood?

No.

Doctor Benedetti?

No.

My time has expired. Uh, thank you. I yield back. And now I recognize the gentleman from Connecticut, Mister Courtney.

Thank you, uh, Mister Chairman. I want to thank all the witnesses for your testimony this morning. Um, uh, like the chairman, uh, I listened closely and I know all of, uh, my colleagues on the panel uh listened closely. In each case of the three medical deans it's pretty clear that um you all responded to issues and complaints that were presented to you and made uh intelligent, sincere, meaningful adjustments in terms of curriculum uh to to address the the concerns that uh people raised. Uh Doctor Mitchell in my opinion uh pinpointed what really this committee oughta be focused on which is America's healthcare workforce again, you cited the statistics of shortages for If anything, I think you understated the numbers. Uh, the Trump administration's own Bureau of Healthcare workforce at eight at HRSA in the Department of Health and Human Services actually says that there'll be a shortage of a hundred and thirteen thousand three hundred and eighty full-time equivalent physicians by twenty twenty eight so actually the looming cliff the shortfall that we are gonna be experiencing in our healthcare system which affects everybody um is actually uh coming at us uh very quickly. Unfortunately, a year ago, on July fourth, my colleagues on the Republican side um participated in a fast-track legislation, HR one, the one big beautiful bill. That's a term they don't use anymore because the American public has found it so toxic uh over the last year. But it radically changed the student loan structure, particularly for graduate students, putting a cap in terms of what students can actually borrow, uh a total uh universal cap. for graduate students of two hundred thousand that includes undergraduate student loans as well as uh loans that uh being incurred in medical school. The average student loan debt for a medical student graduating uh last year was two hundred and forty six thousand six hundred and fifty nine, so already the cap is below what the actual real lending is. And and that cap by the way is not indexed, it's not gonna adjust in future years. So we we are really seeing um a change in the system that is really gonna put tremendous pressure on low income students who really have very little options in terms of how to actually pay for tuition room and board during medical school. So, Doctor Mitchell, can you talk about, you know, what that change, uh, could do potentially, uh, again in terms of just recruitment of students of, you know, any race or gender or part of the country who, again, uh, comes from a family that can't foot the bill, for higher education and particularly graduate school education.

Well you've you've stated it uh quite quite clearly. It's gonna have a chilling effect on those individuals that have the grades, that can achieve the MCAT scores, that have the GPA, um that have the the social skills to treat patients, uh have the love of their community and the support of their community where They wanna be doctors and everybody that saw them when they were children growing up said, hey, you should be a doctor one day, and they worked hard for it. Um, got all As and graduated high school and then went on to a college and then they realized that they can't afford it. Um, we lose a workforce that way. Uh, and in those numbers that you've you've uh laid out, that's really the work. The work is how do we ensure that we widen the pipeline, widen the pathway towards becoming a physician in this country, American-born American service physicians. Uh, that's the work that we need to be working on and ensuring that there are no barriers, um, to making sure that those can serve, um, in this country. So, uh, I think, I think it has a chilling effect and twenty twenty-eight is, is truly around the corner. Um, and we're not even talking about burnout.

Right.

I mean, a lot of that is is from a burnout, a physician attrition. Uh, we have an aging workforce as it relates to physicians. Um, and so, uh, we really need to be be be diligent, uh, and vigilant in in recruiting our physicians of the future.

The premise of which H. R. one was, uh, drafted was that putting these caps in terms of, uh, access to, uh, Stafford loans that the federal government has provided for uh low-in income, middle-income students going back to the nineteen sixties, um would somehow put uh downward pressure on the cost of tuition, that it would just magically reduce uh tuition costs. Uh again I only have a few seconds left, maybe Doctor um you know Dumaneti can talk about the fact that you know, there there is no magic uh wand in terms of um you know providing high quality medical education.

Uh no that's correct Congressman. Uh we uh cannot alter the cost of medical education uh because of that and we think uh what you've described will be a negative very negative impact for entering students.

I thank the gentleman and I recognize the General Lady from North Carolina, Miss Fox.

Thank you very much, Mister Speaker. I have a lot of questions, I need short answers. Doctor Dubonnet, in twenty twenty one, the UCLA School of Medicine had a curriculum titled Healer, Educator, Advocate, Leader, Scholar, Heals. Heals featured a required DEA themed course during students' first year known as structural racism and health equity, which focused on non-medicalized expertise and also strongly urged students to engage in activism. One class session entitled quote " Colonialism and the Role of Medicine and Race" end quote, included the theory that all capitalism is quote racial capitalism. Can you explain what racial capitalism is and why this theory was taught in a first year medical school course?

Um, no Congresswoman, uh as I stated, this course uh was stopped uh long before this committee's inquiry, in that we determined that some of the content was not appropriate for medical school curriculum. Um, and so

Why was it begun to start with?

Um, th- this, the intent of this was to address the social determinants of health, uh which, which are important, uh and required in medical education.

Well then, I'm gonna jump ahead. Do you believe the word obesity is a slur? Is the concept of obesity used to exact violence on fa-

Uh, no.

Well, the UCLA medical school's required first-year DEA class taught both claims in a required reading.

Uh

Do you still do that?

Uh, the course has been eliminated.

K. Well, can you explain how teaching first-year medical students about colonialism and race helps them provide the best health outcomes for their future patients?

Um, our goal, uh, is, uh, to have a content that is scientifically-based, uh, clinically relevant, uh, and important for the realities of patient care. Um, it is important that in - uh, amongst that, that the students understand the social drivers of health, uh, and - and be able to help their patients, uh, no matter who they are. Awesome.

So, Doctor Dubonnet, another structural racism and health equity course lauded the Young Lords and Black Panther parties both radical violent groups for being unique and extraordinary. It described both as role models for UCLA's structural racism and health equity curriculum. Are the Young Lords and Black Panther parties appropriate role models for medical students?

Well, as I mentioned well before this committee's inquiry, we

So, I answer the question. Are they appropriate role models for medical students? Yes or no?

Um, no, we think that our role is to focus

OK. So, how did teaching first year medical students about violent political groups help those future doctors provide the best health co- health outcomes for their patients?

Following our review of the course, we stopped the course and created a new one to address social determinants of health.

Doctor Hogood, um, I'm gonna go back to this issue of obesity. Um, is health independent of size or weight, yes or no?

Obesity affects health. Uh, for instance, uh, the incidence of type two diabetes is higher in obese patients. But obesity as an independent indicator uh is a more complicated story.

Okay. Uh, you said in your opening remarks that courses are grounded in biology. UCSF's required first-year DEI class taught that health is independent of size and weight. Another session of that class at UCSF taught that, quote, there is no standard definition of health or wellness. Do you agree with that claim?

I I would un- need to understand the context in which that statement was said. It was obviously within a broader lecture. The definition of health is a complex issue based on both populations and individuals. Uh, so I think teaching our medical students nuance is a very important issue.

So are you examining the curriculum there to make sure that all of your curriculum is consistent with courses grounded in biology?

We are, Congressman, uh we use uh standards that it must all of our curriculum must be evidence-based, grounded in science, and related directly to patient care or patient outcomes.

And when did you come to that epiphany?

Now the lady's time has expired. I'll have to move on. I now recognize the gentlelady from Oregon, Ms. Bonabici.

Thank you, Mr. Chairman, and thank you to each of the witnesses for all you are doing to improve health care, particularly to have physicians to meet the needs of our uh constituents. Uh I'm trying to figure out what we're doing here today. I I just want to comment on what Mr. Courtney uh talked about. Um we should be discussing breaking down barriers to access to higher education. That would be a conversation worth having. And I'll also note that The the message we got this morning here as the committee started is that somehow blaming diversity equity inclusion for anti-semitism which of course misses a whole lot of history and nuance of predating DEI for centuries, and using anti-semitism as a pretext to dismantle DEI programs is hugely problematic and also deeply disappointing. We're we're at a pretty critical time in American healthcare right now, I just have had conversations at home about concerns that are are across the the district I represent in Oregon, particularly about uh the Medicaid cuts, that's what we should be talking about today. But as we discuss the future of the medical workforce, we should acknowledge that diversity, equity, and inclusion in medical schools, that's not something to be criticized or or blamed. A coursework that focuses on the social determinants of health, including patients' racial backgrounds and socioeconomic status, fully equipped physicians to meet the needs of the communities they serve. So I wanna ask you uh, Doctor Mitchell to help set the record straight, what does diversity, equity and inclusion mean in a clinical setting and in training physicians?

Thank you for that question. Um, I'll give a, I'll give an example. Um, I have a, a colleague, his name is Doctor Ed Chapman. He works here in Washington DC, right on Benning Road. Um, he was educated at, at Howard University. And he treats those men that are suffering from substance use and abuse, treats them with buprenorphine. Um, and the - his treatment model is not just to treat them for their substance use and abuse, but to also stabilize them because invariably they have chronic diseases that they're trying to handle. Hypertension, diabetes, high blood pressure, diabetes.

Mm.

And so when we talk about training the future physician group, the future physician group, the new physician, must understand how those substance use and abuse issues connect with the chronic diseases of those individuals how their homelessness or their imprisonment when they get out how that affects um their their future health. And so DDEI and having those types of social determinate case studies within uh schools of higher learning are extremely important.

I I appreciate that, Doctor Mitchell, and I was gonna ask you what a patient provider interaction looked like when a physician is aware of the social factors that affect a person's health, cuz you read my mind and answered that next question. But I wanna move on and and and say, Doctor Mitchell, the majority's title for this hearing suggests that diversity, equity and inclusion in medical schools are somehow compromising physician training have you heard anything here today that supports that conclusion and I wonder if you could talk about how In fact, diversity, equity and inclusion in medical schools actually strengthens physician training.

So there is um no, I have not heard anything that suggests that it diminishes it. Uh again, I think the the chairman has laid out that getting into medical school admissions based upon proper biomedical scores, the ability to be a physician and be able to absorb that information is critically important and is at baseline for all of the institutions that are here today. Now we have to treat the actual patient. And that actual patient is showing up differently. They're showing up as the rural farmer that has a substance use issue. They're showing up as the black woman professional, uh, that is pregnant. And if we don't understand the human condition as physicians, trained physicians, then it's hard to treat that particular patient and the population that they come from.

I appreciate that. We heard that, my reference this morning in ranking members Scott's uh remarks about how, you can't address black maternal health if you can't say black. I mean it's just, w- w- the the expectations that th- th- this conversation is ha- that we're having today uh is completely unrealistic with uh our our population and the needs of our population and again dismantling DEI programs and course work in medical education would compromise patient safety and physician

Mm-hmm.

quality and if our goal Our goal should be to have the highest standard of health care for every American, regardless of their zip code, race or background. We must defend, not condemn, diversity in medical training. I thank you all for the work that you're doing in your communities. I hope that we can get back to having conversations about how we improve health care in this country, uh not micro-managing what your students are are learning. Uh thank you again for your work and I yield back.

I thank the gentle lady and I recognize the uh subcommittee chair of Health, Employment, Labor and Pensions. The gentleman from Georgia, Mister Al- Mister Allen.

Uh, thank you, Mister Chairman, uh, Chairman Wahlberg, and uh, this is an important hearing. Uh, obviously uh, this country uh, is celebrating two hundred and fifty years and of course, uh, that two hundred and fifty years is based on merit, hard work, and uh, and certainly education. And uh, we built an incredible health care system in this country. uh on that basis. Uh the Constitution also guarantees uh lots of uh of liberties, uh freedom. And uh Doctor Ha- Ha- Hauger, d- uh do you recall that during the COVID-19 pandemic there was controversy about restrictions on public gatherings at your medical school?

Yes, we had a uh stay in place order um First by the mayor of San Francisco and then by the governor of California.

Uh, do you recall that religious services wa- uh, under severe constraints at the time?

No, I I lead a a health care university. Um, I s- don't stray into political issues that are unrelated to health care. I w- I'm superficially aware of the controversy, but not in any detail.

Um, are you aware in twenty twenty that UCS School of Medicine appeared to sign an open letter supporting the large scale Black Lives Matter protest during this time. UCF's current Executive Vice Chair, Chancellor and Protest uh Provost, Catherine Lucey also appeared to sign onto this letter by name. Did UCSF make any statement at the time about the need to also relax restrictions on other gatherings?

I don't have the document that you are referring to in front of me and I would need to see it to make a dis- uh a a specific answer to your question.

Uh Well, I hope you can see why the average American would lose trust in medical institutions like yours when they discover that these institutions are calling for one set of rules, for one political group, but another set of rules for church services.

w- without the documents, I can't make that connection.

Um, when you get briefed on this, I think an apology from your institution will be in order. Uh, again, our Constitution requires freedom, particularly religious freedom. And, um, you might wanna apologize to -

Uh, I - I understand the Constitution requires religious freedom and implied knowledge

Yeah.

uh there's nothing that we have done now or in the past that would be in contradiction to that.

OK. Well, like I said, when you get briefed on this, then uh uh uh for the record, uh I would ask you to respond appropriately. Thank you, Mr. Chairman, I yield back.

Gentlemen yields, and I recognize the uh gentleman from California, Mr. Ticahino.

Uh, thank you, Mr. Chairman. I see we have many medical schools from California represented today. Um uh I'm I'm sure all of you are aware uh as uh administrators from medical schools in California that California excludes race as um a consideration for admission. Do you have that understanding, Doctor Dubonnet?

Yes, I do. Proposition t- uh two O nine,

No.

and we followed that uh sentence itself.

Do- Doctor Hargood?

Yes, it was passed in nineteen ninety six and for the last thirty years we have followed Mandate.

Doctor Benedetti, you're aware of that California law says that uh uh that race cannot be considered as part of admissions for medical schools?

I apologize, I don't, but I learned it today.

OK, so. But it's been long-standing uh for m for decades actually in California, we don't have race as a consideration. Um, forgive me, I don't but doc- uh you know uh Doctor Dubenet, you maybe can help me. I I recently remember that Ty Sacks disease affects a particular population, uh predominantly um can you tell me which population it affects?

Uh it's not in my area of expertise, uh so I I can't really

Is there any a d anyone can comment on that, which doctor before me?

It's it's more prevalent in Ashkenazi Jews.

An Ashkenazi Jews, very particular um part of the Jewish community. Um anybody familiar with um uh never, smoke or lung cancer?

Yes, I am. That's one of the areas of my own research.

Can you tell us which, which population groups seem to be affected by this predominantly?

Um, uh, well, we have known for, um, s- some years now that, uh, particularly young Asian women may have, um, uh, an increased propensity for,

Increase, yes.

uh, n- uh,

But not exclusively.

mental

They don't, uh, it's not exclusively to that population, but it, there's an increased um, uh, among young Asian women.

That's correct.

And the fact that they can't get, uh, the, the current guidance doesn't allow insurance companies to pay for, uh, screenings at that age because they've never smoked, because that's what the guidance says, you have to have, you have to have, uh, uh, several years of, uh, smoker history. Uh, they're in this conundrum that they have to pay extra. And so that could be kind of conser uh, considered a determinant, a social determinant of health there. Is that right?

Correct, and and there are ongoing studies now to actually evaluate this uh prospectively, um and the early results suggest that there will be a scientific fact to help make the decisions about that uh reimbursement.

So so there is in fact science that could drive this. Is research in this area p- gonna potentially have out, you know, uh impacts beyond young Asian women to understand why young Asian women, maybe predominantly uh impacted. Could could inquiry into this area also have benefits to the broader population?

Um, yes it will, and I think one of the very important things we're doing is beginning to use what we now consider to be diagnostic tests to be prediction tests. And what we're finding is uh that for example small parti- particle air pollution uh is a very important risk factor and studies have found if I live in a high uh a polluted area with that kind of pollution for more than three years, it can be equivalent to heavy smoking. And I'm sorry to say that seven of the top ten cities with small particle air pollution in the country are in California.

Um, it, so, I'm also hearing stuff about young people. Um, there's a troubling trend among young people, uh, um, can, are getting cancer, so it's not young Asian women that I'm talking about, but young people in general. Does it cut across all races?

Yes, we're um finding that we need to learn more about uh the genetic underpinning of uh early uh uh cancer in in younger people. Um and the all of that is actively under investigation. I'm hopeful that we'll be able to use the new tools that are being developed to predict risk in a way that we would be able to treat risk sometimes called prevention but I call it treating risk because prevention has not worked out well because of the inability to discern risk at a high level.

Well, so it is the case in California that race is excluded as far as admission to medical school, but it turns out that being able to say " young Asian woman", to be able to say " young people", to say " this particularly affects women", to say " this affects Ashkenazi Jews" in particular, that these are very important things to be free to talk about. and to be able to write and grant applications. Would you agree with me, Doctor Dubenay?

I do.

Uh, Doctor Hargood?

I do.

Uh, Doctor Mitchell?

Yes.

Uh, Doctor Benedetti?

I do.

I I wish I could talk about sickle cell anemia. I wish I could talk about all different forms of very specific medical conditions that require diversity, equity and inclusion and not an attack on them. I yield back.

The gentlemen Yales, I now recognize the gentleman from Utah, the uh subcommittee chair in higher education and workforce, uh, Mr. Owens.

Thank you. Thank you so much for this. Um, I think it's important as we go through this to highlight the historical need for this for this committee's um hearing. Uh, I'm it's exciting to see that we're making changes. Uh, the goal is, though, we should have a test of time that never do we get here, because of pressures from non-scientific sources. Um, so I, and with that being in mind, I do wanna highlight that we are gonna uh, we're trying to make sure we don't, don't go back to this, this ever again. Let me just let me just say this, uh, I believe the most important consideration for the student in medical school is medical competency in achieving good health outcomes. Time spent in medical school focusing on subjects that do not improve patient outcomes not only is a disservice to the student to the potential doctor, But it's dangerous depending on the uh for those depending on the medical knowledge and expertise of uh these future doctors. Uh doctors uh Har Hargood and and Dibinet uh Dibinet. Dibinet. I'm sorry if I've m- missed that out. Would you both agree that medical science knowledge is the most important competency for medical schools uh to part to impart on and uh and to the students, yes or no?

Yes, we are very focused on the scientific basis of medicine. I would rem would uh repeat that the course that we are discussing represented less than three percent.

OK. OK. I I just want a very quick yes or no, because I have a couple of questions here.

Uh, I agree with my colleague.

OK. Um, Doctor Dubenet, uh did UCLA's structural s uh racism and health equity course prepare students for licenses exams, yes or no?

Uh, not that I'm aware of.

OK. Doctor Hogwood, uh Hogwood, good. Did uh US UCFS Justice and Advocacy and Medicine course prepares students for licensed exams.

There were no grades given in that course, so it had no influence on the uh

But it w- the course was given then.

Doctor.

OK.

Sorry?

The course was, it was given then. I'm correct.

The course was given, it has been discontinued.

OK. For both uh, both of you, were all the sessions uh in the classes I just mentioned based on peer review evidence?

Um, well, we, sorry, go ahead, go ahead. We evaluated uh the course and and based on our task force uh examination uh of the results uh we eliminated the course and began a new course in its place.

That's okay. Okay. Okay. Okay, good.

The lack of uh evidence base was one of the reasons the course was discontinued.

Okay.

I would like to make the point though, with treating the course as a holistic issue, there were classes in the course that were concerning. Treating uh teaching students the uh social drivers of health, including structural racism, I believe is a very important part of our curriculum.

Okay, all right, that, all right, that's okay, kind of drifting back into the point of saying are we gonna teach medicine, uh are we teaching social concepts, so um I'm going to list subjects that were taught previously in these classes. I'd like to know whether uh UCF uh CSF or UCLA UCLA medical schools still teach these subjects today. Again, answer yes or no. Settler uh colonism, colonization.

Today, no.

Uh, white fertility, fertility.

Today, today, no.

Uh. Both, both of you?

No.

OK. Uh, fat fat phobia.

I'm not aware that that was in our curriculum, but we certainly don't teach it today.

OK.

No, no.

The black, we talked about this earlier, the Black Panther Party. Uh, thi- this, uh, we're - we're talking about medical school, by the way. I just wanna make sure I re-emphasize that again. The Black Panther Party, is that still being taught?

No.

Queer liberation.

We teach uh LGBTQ health specific issues in our course and we'll continue to. Not necessarily using that particular term.

Yeah, the same thing applies for UCLA.

Uh, prison uh abolition.

Again, we will continue to teach uh uh prison health because our students uh

Prison abolition, not health.

Not abolition, no.

Uh not abolition, no.

Border abolition.

No.

OK. Um Uh it's uh I I I think we just, and I'm glad we're getting here, uh we have to figure out how to make sure we never ever get delinked. from common sense. Um, I have a cousin as a physician, have a son-in-law that's ER doctor. I was studying to be a marine biologist one day, uh, to - to see what we're now teaching for those who are trying to understand how to help the human body, help the human person. Uh, it is - it is - I'm glad we're getting - are getting away from that at this point. So, that being said, uh, um, thank goodness we're - we're moving on from that. Uh, I'll - I'll go back.

Gentleman yields. I now recognize the gentlelady from North Carolina, Miss Adams.

Thank you, Mr. Chairman, and thank you to the witnesses uh for being here. Uh and I've got several questions too, so if we can get some quick answers that would be good. Doctor Mitchell, uh I wanna start by grounding this conversation in the patience that that that future positions w- will actually serve. According to the National Council on Disability, individuals with physical, intellectual, or developmental disabilities are more likely to be obese and have unmet medical, dental, and prescription needs. Uh, additionally, people with disabilities are three times more likely to have arthritis, diabetes and a heart attack, and five times more likely to report a stroke. Disabled women receive poor maternity care and are less likely uh to receive regular screenings such as pap smears and mammograms. Uh, in response to these findings, the National Council on Disability uh created a framework to end health disparities of people with disabilities. And I'd like to - to uh enter that into the record, Mr. Chairman.

Without objection, we proceed.

Thank you. Now one pe- uh key piece of - of this framework is requiring comprehensive disability clinical care curricula in all US medical nursing and other health care professional schools and requiring disability competency education and training of medical nursing and - and other health care professionals. So, Dr. Miller, Uh Mitchell, uh in your experience, why is it important to ensure that medical training addresses the healthcare disparities of vulnerable populations, such as people with disabilities? Give me a quick answer, that'd be good.

Thank you so much. I was the Chief Medical Examiner here in Washington DC, and in that role I served as the chair of the Disabilities Fatality Review Committee, where we reviewed all of the deaths surrounding disabilities, those that died um surrounding that. It's extremely important for us to understand the unique environment that our disabled Americans face. Um, and physicians have to understand that if they're going to treat them properly.

Thank you. Uh, uh, Doctor Mitchell, as I'm sure you are aware, our country faces a maternal health crisis, and this crisis disproportionately affects black women. Let me say that again, black women. Black women are three to four times more likely to die. than white women from pregnancy related causes. Uh, we have the worst maternal uh rates compared to all of the wealthy countries and over eighty percent of these deaths are preventable and that is absolutely unacceptable. We've received relentless criticism on uh on medical school education involving diversity equity and inclusion from my colleagues across the aisle. While ignoring this indisputable fact, education that includes DEI teaches doctors about implicit racial bias, culturally competent care, and expands their knowledge of the patient populations that they will be serving. But most importantly, it saves lives. The omnibus, which I co-lead with uh Congresswoman Underwood, is a comprehensive approach to this crisis and would get uh at the heart of of these issues. And that package includes my bill, the Kira Johnson Act, which would fund implicit bi- racial bias training, respectful maternity care and compliance programs within hospitals. So social determinants of health are really important. But we need a strong partnership with medical schools if we can hope to to really address this crisis and empower the doctors of tomorrow. So, Doctor Mitchell, could you speak briefly more about this this crisis as well as the role of DEI in medical education and what it plays in addressing it?

Well, similarly, I served as the chair of the Maternal Mortality Review Committee. uh where we've seen this firsthand and your point is well taken. I met Kara Johnson, I know I know her. Um and so these issues are extremely important for us to understand the particular social construct. I'm I'm saying the same thing over and over again.

Yes sir.

The the the the uh the importance of diversity, equity, and inclusion curriculum in our medical schools is a patient quality issue.

Okay, let me move on.

It's a patient safety issue.

So, for my colleagues across the aisle to suggest that teaching doctors about the social determinants of health or structural racism, is political activism, completely ignores the data on maternal mortality. A physician who cannot accurately accurately address how systemic barriers affect their patient's health, is fundamentally unequipped to provide quality, high quality care. A physician who is unaware of their own personal bias, is one who can unintentionally cause significant harm. So could you explain briefly, yeah, ten ten seconds, how medical school can fully prepare future physicians for the realities of modern clinical practice?

Through skills-based cultural competency curriculum.

Thank you, sir. I yield back, Mr. Chairman.

I thank the gentlelady. I now recognize the gentlelady from Illinois, Miss Miller.

Thank you, Mr. Chairman. The Hippocratic oath states that physicians will, quote, " do no harm or injustice to their patients." Unfortunately, many medical schools have abandoned this oath, not only by advocating for abortion and child mutilation, but also by allowing political activism into the exam room in the form of DEI and anti-semitism. Medical schools should be teaching the next generation of doctors and nurses to save every life and protect all those under their care, even the unborn, which, thanks to technology, we have a window into the womb. They are babies. This committee will continue to investigate these schools to ensure they are complying with federal law, and reserves the right to withhold funding from any institution in violation. Doctor Benedetti, the University of Illinois College of Medicine is one of the largest medical schools in the country. And with that, you have a profound responsibility to properly train our next generation of providers. Has UICM complied with President Trump's executive orders to eliminate federally funded DEI programs?

We, uh, in personal

Just yes or no? Have you complied?

To my knowledge, we did everything we could.

UICM affirmed that it will quote, I quote you, not react preemptively to actions made by the current administration, insinuating that the medical college does not intend to comply with directives issued by this administration. Also troubling, Doctor Benedetti, it appears that DEI has not left UICM. On your school's about page, clear as day it says, and I quote, At the University of Illinois College of Medicine, we are committed to diversity and inclusion. We have a number of programs and initiatives in place to promote diversity and inclusion. It's clear that UICM is just hiding the fact that DEI is still its core mission. Doctor Haygood, UC UCSF's Classroom Guide, titled Framework for Gender and Sex Concepts in Teaching, advises against using the term pregnant women. Instead, it says to use pregnant people. Who are pregnant people compared to pregnant women? Just curious.

So that is a part of our curriculum to help our students, uh, who are facing a wide diversity of patients. Of course, the vast majority of pregnancies are in women, and I have absolutely no problem with using the word pregnant women. I use it myself.

Has a non biological woman ever had a baby?

A transgender person can.

That's that's not a biological woman. Has a non-biological woman ever had a baby?

I I would reiterate we take care we take care of transgender patients.

No. It's ridiculous. Okay, Doctor Hoggard, the UCSF guide I mentioned earlier also advises using a child's self-reported gender identity even if it conflicts with the parents' wishes. Say a seven year old boy comes into your doctor's office and reveals he believes he's a girl is UCSF advising physicians to explicitly violate parents' moral values and have the doctors address this boy as a girl?

Our programs are consistent with federal and state law. Uh, we do undertake comprehensive psychological mental health evaluations, and work with the parents on these issues.

OK. And I hope that you are consistent with the law because, like I say, we reserve the right, we have the right to withhold funding from any institution in violation. Lastly, Doctor Dub- Dubonnet, a required course at UCLA Medical School, advises OBGYN students not to, and I quote, " assume gender identity." OK, from another class in May of twenty twenty six, it included a disclaimer that while it uses the term she and women, it does not intend to exclude, and I quote, those who have a uterus but do not identify with these terms. What does that even mean?

Uh, I'm not familiar with that announcement and I'd have to read the entire thing.

OK, I hope that you go back and check it out. Can someone have a uterus but not be a woman? Because it seems like your school is promoting that ridiculous idea.

Uh, I think again, as Doctor Haugert has described, uh we're uh treating uh pe- transgender uh people um but we're doing that in compliance with state and federal law.

And you do teach biology?

Yes we do.

Yes, this is curious. So you I I'm gonna ask you again, can someone have a uterus and not be a woman? Just say yes or no. Can they?

Um again I would ha- I would need an actual

Cuz that's what your that's what your medical

Yeah, and children ladies have an absolute The gentlelady's time is

Mister Chairman, it's clear these medical schools are hiding DEI curriculum under the guise of medical access.

Gentlelady's time has expired.

Thank you and I yield back.

Thank you. I now recognize the gentlelady from Georgia, Miss McMath.

Thank you so much, Mister Chairman and ranking member Scott, and I just wanna say up front, it it it it today it appears that my colleagues are throwing around the terms diversity and inclusion as if they're dirty words. Uh, this caucus is very, very diverse. This caucus, the United States House of Representatives, is the mosaic and represents people from all demographics, all nationalities. America is diverse. It is inclusive. And these are not dirty words. Before I start, I wanna make sure to extend my sincere gratitude to our witnesses here today for the work that you do um to help train generations of eager and very talented doctors. We need your help and assistance in doing so. Our nation is facing a very critical shortage of physicians with my home state of Georgia of course being on the top of the list and while I loved uh uh to be here today for a meaningful discussion I hope that we would have on how to address health care shortages, Republicans are using this time to attack curriculum designed to help doctors meet patients.

Thank you for that question.

Thank you for that question.

I you know, with disparities, we talked about the disparities surrounding maternal mortality within black women we've also know that prostate cancer has a higher risk in black men, we know that triple negative breast cancer is killing uh black women um at a higher rate than than their counterparts um cardiovascular disease, hypertension, diabetes, obesity uh these areas of disparity require us to engage with our patient population in communities where they come from in order to ensure that we have the best outcomes for health and safety of our patients. And so DEI uh there will never be a time in medical education that you should not be teaching cultural competency to the medical students and ensuring that that medical student is meeting or that future physician is meeting their patient exactly where they are.

Well, thank you for that, Doctor Mitchell. Um, social determinants of health have a very profound and intimate consequences for my constituents and Americans across the country. And I too sit on the Black Maternal Health Caucus for the the very reasons that you just espoused. So our work has to continue to understand how social determinants impact our health and how to use our resources to ensure everyone can live very long and healthy lives here in the United States. Doctors are tasked to not only treat the medical case in front of them, but to treat the whole person and to understand the circumstances that lead patients to their care in the first place. Patients from all walks of life, they are not one size fits all. Neither should the delivery of their care be one size fits all. And when we are proactive and thoughtful about how we approach medicine, we find solutions that ultimately benefit every patient. The curb cut effect is a phenomenon where strategies originally designed to help a smaller group of individuals ultimately improve accessibility for everyone the curb cut refers to the curb ramps at intersections originally designed for people with limited mobility to navigate sidewalks safely and independently. But this design also benefits the rest of us, parents. are pushing strollers, vendors that are pulling food carts, and tourists who are wheeling luggage. That same effect can be seen in medicine. To address black maternal mortality, one program gave all postpartum women blood pressure cuffs as they were discharged from the hospital. And as a result, all mothers benefited from greater health monitoring. When researchers sought to address gaps in lung and breast cancer, which I am a two-time Treatment completion rates for black patients, they increased training for providers, strengthened care tracking, and deployed more patient navigators, improving completion rates for patients across the board. Telemedicine technology, which was expanded to address critical gaps in care for our rural patients, now provides broader flexibility for all of us. reducing overall wait times, and improving access to care. Instead of spotlighting policies that will help the most vulnerable, expand health care access, and improve affordability for all, Republicans are using this hearing to distract from the legislation that they authored, and greenlit last year, policies that made health care far more expensive, kicked millions off their health care insurance, and created barriers for students to afford medical school and I yield.

Gentlelady yields, and now I recognize the um medical doctor uh on our, resident medical doctor on our committee, uh the gentleman from Missouri, Mr. Ronder.

Thank you, Mr. Chairman. Uh, Doctor Benedetti, the University of Illinois uh in August of uh health system and in August of twenty twenty five, suspended transgender surgery on minors. Can you share with us what led to that decision?

We followed the directive of the presidential order immediately without any delay.

Excellent. Now, did the University of Illinois Health System also um stop prescribing puberty blockers and cross-sex hormones to youth experiencing gender dysphoria?

That was my recommendation.

Okay. Has the University of Illinois done so?

I will uh check on it and let you know.

Okay, thank you. Yeah, if you could get back to us on that,

Yes.

um that would be excellent. Um because yes, uh I I think we knew about the pausing surgeries on minors, but it is equally critical to end puberty blockers and wrong sex hormones in these children, and that was also the subject of executive action uh by the president very early, in his in his term. In fact, in, you know, in doing so, and I commend the University of Illinois at least in pausing the surgeries, um, because we know these these procedures can cause long-term irreversible effects. The girl who has her her breasts removed will never be able to breastfeed her children. Uh, puberty blockers can lead to bone problems and - and of course, you know, osteoporosis. And of course the plan, when a child is launched on this path of puberty blockers is generally then cross-sex hormones, which lead, can lead to infertility, to numerous urogynecologic problems, metabolic problems, cardiovascular problems, long-term. All with very little to no evidence of any psychological benefit. In fact, the best study to date as I see it is the Finnish study that showed that girls who are transitioned have two point five pers- two point five fold higher serious mental health problems after transition than before, and boys who are transitioned have six times me- serious mental health problems than boys who are not transitioned. So, you know, again, uh, yeah, please do get back to us on where the University of Illinois stands right now on - on

Absolutely.

puberty blockers and wrong sex hormones for these poor children, who need our psychological and - and em- emotional support. Often they're victims of abuse. They're their children on the autism spectrum, they have depression, they have anxiety, they need support, and they don't need to be permanently mutilated. Um, uh, Doctor Haw- Hawgood, uh, the University of California, San Francisco offers a clinical rotation for residents and students on quote transgender medicine, where, uh, learners are placed at a transgender clinic that provides cross-sex hormones. Your website boasts that the um program teaches medical students to prescribe cross-sex hormones and refer for transgender surgeries. Does this training program instruct uh i- i- i- i- i- i- di- does this i- i- i- Yeah, does this training program instruct medical students and residents to uh do these things and to uh and to make surgery referrals on minors?

No, the program doesn't instruct medical students. Uh, or residents to do anything. It teaches them uh transgender health. Roughly one percent of the American population is transgender, and we take it as a strong responsibility to provide the best possible health care for that population.

And from your web site, this this this talks about transgender, but it doesn't talk specifically about pediatric and adults. Is it pediatric and adult both?

We have uh transgender programs for both pediatrics and adults. We do not do uh surgery under the age of eighteen and we abide by federal and state law,

OK.

as well as the uh recommendations of thirty-five professional associations in North America.

Well then you are ignoring the PR the HHS, you are ignoring the UK, you are ignoring Finland, ignoring Sweden, ignoring

We we I'll I'll it's not a program that I am an expert in

OK.

uh but those clinicians that focus on this area are continuously evaluating international literature in this field.

But you are involving medical students.

I'm sorry,

Uh, you're you're a medic-

I my my eyesight is,

Okay.

even with glasses, is not very good,

Okay.

but

But this is this i- your transgender clinic does continue to give puberty blockers and wrong sex hormones to children.

Correct.

Okay, that is in violation of federal law.

Not law.

It is i- in violation of multiple administrative policies. Do you bill Medicaid for the same?

It is my understanding that CMS

Gentlemen's, gentlemen's time has expired.

Thank you, Mr. Chairman.

I I now recognize the gentlelady from Connecticut, Miss Hayes.

Thank you to all of our witnesses for testifying today. This hearing follows a pattern of Republicans attacking diversity, equity and inclusion initiatives on this committee. And I can't help but notice that once again San Francisco, a representative from San Francisco is at the dais to respond to curriculum decisions made in that part of the country. Studies have shown that addressing racial disparities in healthcare reduces both health disparities and improves outcomes in all populations. I have to tell you I had prepared questions, but I couldn't write fast enough as I was listening to my colleagues I am incredibly disappointed that as academic deans you could not immediately answer the question about teaching colonialism in healthcare. Colonia- teaching colonialism directly addresses the systemic roots of healthcare inequities. It exposes how historic power structures dictate who receives quality care. It's important for future doctors to have that education to recognize how that historic a legacy promotes biases and and negatively impairs outcomes. That's why you teach colonialism in health care. I am equally as disappointed to hear that we have deans from California University specifically who can't immediately say that the Black Panther Party was central to health care discussions no matter how you feel about the Black Panthers they pioneered community-led health equity. They viewed health as a human right. They treated medical care as grassroots advocacy and opened up people's free medical clinics in the sixties and seventies. That would be the reason why that discussion would be introduced in medical programs. They have a lasting impact on the medical profession, on things like preventive care and screenings, sickle cell advocacy, on medical distrust and structural racism, things like historical medical experimentation. the Tuskegee experiment. I'm not a medical dean. I haven't gone to medical school. But that would be the reason why those conversations would come up in a medical program. It's very simple. So to come before this her- this committee, and I feel like witnesses get intimidated by some of the questions, that would be the reason why we have those discussions. So that medical professionals are properly trained and prepared for the communities that they will encounter. Uh, Doctor Mitchell, just really quickly, yes or no answers, just yes or no. I heard Doctor uh Debonnet, I'm sorry if I said your name wrong, talk about decisions are based on evidence-based medicine and clinical studies. Is this a political statement? Type two diabetes um impacts the black community.

No.

Is it a political statement that sickle cell impacts the black community?

No.

Is it a political statement that prostate cancer is more aggressive in black men?

No.

Is it a political statement to say that black individuals are three times more likely to die from asthma-related conditions?

No.

Is it a political statement to say that the BRCA one and two gene mutations are more prevalent in Jewish com um patients?

I don't know the answer to that.

Okay. Is it a political statement to say that Tay-Sachs disease is more prevalent? in some Jewish uh patients.

No.

I think you're making my point. We need diversity, equity, and inclusion in both the teaching of medical students, the diagnosis, the evaluation, all of these things, because I've heard many of you say, this is not my area of expertise, this is not my area of research. I don't know the answer to that. And that's an honest answer, and it's important. No one has all the answers to everything. which is why we need a more robust education experience, which is why we need to train and make sure that doctors are specifically prepared for the populations that they will encounter. You can't train doctors if you are not asking the questions, if you are being hyper- if you are not being hyper-specific and intentional about what they will face in different communities and in different medical diagnoses. That is not political. And the fact that we continue to have hearings on this committee, which are not talking about improving outcomes for patients or preparing the next generations of doctors. My colleague from Connecticut talked about how H. R. One put caps on professional loans, how it makes it so that only the wealthiest people can afford to go to medical school. Nothing that has been said here is helping us address that or improve outcomes for the patients who are the most marginalized. and the brilliant professionals who want to go into this into into this profession that is so lacking we see uh applications decreasing amongst uh marginalized black and brown communities that's just data and that's what we should be talking about

General Lady's time has expired

I've gone over my time but I think my comments were very important to this discussion I yield back

I thank the General Lady I now recognize the Gentleman from North Carolina Mister Harris Thank you Mister Chairman and I thank you to all of you who are serving on the uh the panel today. Uh, I appreciated the opportunity of reading your uh testimonies in advance, and of coming to the hearing today. Last year, the Department of Health and Human Services released a four hundred and ten page comprehensive review of medical intervention for children and adolescents with gender dysphoria. This report notes an increased reliance on so-called gender affirming care as the treatment for children questioning their sex despite known health concerns including infertility, adverse effects on bone health and cardiovascular function, and negative impacts on brain development. Along with HHS's report, we've seen the American Medical Association and the American Society of Plastic Surgeons actually shift from their earlier positions by issuing updated guidance, clarifying that the evidence for surgical interventions in minors is insufficient. Following HHS's report and and position changes by large medical associations, in the United States, I've got several really just yes or no questions for the medical school deans that we have sitting here before us today. So if you don't mind, if you'll indulge me with yes or no to these questions, regarding sex trait altering surgeries on minors, does your medical school teach that these procedures are ever appropriate? And I'll start with Doctor Dubenet, yes or no?

Uh, to the best of my knowledge, we do not.

Okay, Doctor Hall, good?

We do not provide surgery under the age of eighteen.

Okay, Doctor Beneditti?

We do not provide surgery under age of eighteen.

Okay. Does your medical school offer these procedures through its own clinics to minors, yes or no? Doctor, to my best of my knowledge, no, no.

To my knowledge.

We do not offer surgery.

You do not, Beneditti?

Uh, not to my knowledge.

Okay. Has your hospital or medical school ever offered these procedures to minors?

Uh, this is not within my area of jurisdiction in the health system, uh but uh I I actually don't know the answer to that in the historical past.

I I also would, uh if you're saying ever ever, I would need to uh confirm the answer to that.

OK, and Doctor.

We did perform before the presidential order. We stopped after the presidential order.

Oh, OK. So, another one. Has any provider at your hospital or medical school ever referred or provided letters of support or recommendation for minors for these procedures to other entities? Doctor Dubenet? Um, I have no knowledge of that. Okay, Dr. Halgood?

I also don't know the answer to that question.

Okay, and Doctor Benadidi?

Not to my knowledge.

Okay. Um, also for the record, in your view, are sex trait altering surgeries for minors ever medically necessary? Doctor Dubenet.

Uh, this is not within my area of expertise, um and UCLA has uh, uh as far as I know has completely stopped uh doing surgeries for minors.

OK. Doctor Hogood, in your view, or sex trait, altering surgeries for minors,

You know, my

ever medically necessary.

my view is not relevant here, cuz I'm not an expert and I don't treat these patients, but our policy is not to offer these procedures under the age of eighteen.

OK. And Doctor Benadidi, to you.

Yeah, we don't offer this procedure and I, of course, I'm not an expert of it.

Okay. Um, my follow-up to that was if so, do you believe that parental consent must be received before any sex trait altering surgery is performed on a minor? Doctor Dubenet?

Um, parental consent is always required.

Always required. Okay. Doctor Hawley?

We don't do the procedure, but yes, I'm a pediatrician, so I strongly believe in in con

Okay.

Parental consent.

Yeah. OK, Dr. Beneditti.

Illinois law uh mandate parental consent.

OK, very good. Um, let me come back to Doctor Dubenet with one quick uh question. When Americans need care for - for medical professionals, their first thought is not about a doctor's belief in woke ideologies or political activism. Their only concern is whether their doctor has the expertise to treat them when they have the flu a broken bone, as I'm dealing with, or ever even life-threatening ailments. Unfortunately, we've seen medical schools across the country put ideologues in charge of the medical school admissions. And these individuals put academic excellence and merit aside in favor of candidates who will further activism in the profession. Doctor Dubenet, the Justice Department's Civil Rights Division recently announced its findings at UCLA, illegally used race in medical school admissions. And they want to come to a voluntary resolution with UCLA on this issue. Is UCLA currently engaged in discussions with the DOJ about this agreement?

Uh, I'm not able to talk about, uh, ongoing litigation here.

Okay. Well, the - the DOJ indicated that UCLA's Medical Schools Associate Dean of Admissions Jennifer Lucero used intimidation and shaming tactics to pressure the admissions committee to

The, uh

unlawfully consider race and I - last question,

J- the gentleman's

I'm done. Is there ever a time when -

gentleman's time has expired.

Okay. I have to move on.

All right. Thank you, sir.

And I'll recognize the gentlelady from Pennsylvania,

I'll be right back.

Miss Lee.

Thank you, Mister Chair. Um, let me just start by saying it is absurd that in this committee, we are required to defend time and time and time again the humanity of marginalized communities, our right to education, our right to appropriate and proper medical care. The life expectancy for black people in my district is eight years earlier than white people. Black women are dying three times more during pregnancy than white women. Three in four black adults develop hypertension by age fifty-five. We still have no widespread cures for for uterine fibroids or sickle cell anemia. We have not solved health disparities in this country. Diversity, equity, inclusion, and accessibility programs exist because marginalized people are more likely to be un- or underinsured, unable to get an appointment or be misdiagnosed, to have their pain ignored, or to be discarded by the healthcare system altogether, disparities exist at every step of the process. This is just a fact. And conservative discomfort with facts is not grounds to overhaul the medical education or or a medical education system. Let me just say, I have a black doctor and I sought my black doctor out. In fact, black doctors are in high demand because black patients know that culturally competent care can be the difference between care and cure or life and death. That's just what it is. Uh, just really quickly, I don't know if some of my colleagues know some of the history of uh black care and mistreatment in the medical field. But for instance, gynecology procedures were developed from un-anesthetized uh non-consensual experiments performed on enslaved black women. Life-saving vaccines were developed using stolen cells from Henrietta Lacks, a non-consenting black woman. Modern health care was built using black bodies without our consent. And when there is even the mere suggestion that we should invest in cures for diseases disproportionately affecting black people or that there aren't enough black doctors Republicans uh cry DEI and say it's unfair. They say we should only rely on so-called objective standards for medical competence. But objective according to who? You cannot standardize test your way into empathy or taking people's pain seriously or cultural competency. Uh, MCAT scores don't translate to better care for black people automatically. Having all white male doctors is just as bad for the medical profession as having all white male congressmen is to our government. What if someone who lived in rural Pennsylvania their entire life, for instance, in an all white town matches to residency at a hospital in Philadelphia, where there are, there is a larger black population, without training in racial bias or cultural competence without learning to humanize their patient? That is different from them. That resident will be more likely to misdiagnose an episode of intense pain, for instance, from a sickle cell flare-up as a psychosis. Dr. Mitchell, can you speak to other examples like this and why it would be dangerous for medical schools to disregard training on special on social and cultural factors, or devalue lived experience?

There's some recent literature that talks about a study that looked at um black concordance with black PCP's in over sixteen hundred counties in the United States. And what they found was that life expectancy in those counties was higher when they had higher black PCP's. um, that mortality rates went down because they had higher black PCP's. Um, I went to medical school in New Jersey, in Newark, New Jersey, and I sat next to a diverse group of individuals. And I'll tell you, they learned just as much from me and my lived experience and how to treat the patients in Newark, as I learned from them and their experiences. Diverse workforce and admissions to medical schools creates a better better system for for this country.

Thank you for that answer, and it does beg the question. Do Republicans want black patients to die? Do we want women to die? Do we want trans kids to die? Because we know that a cultural competent education, that uh cultural competency and diversity in our education system, our medical system saves lives. Well, my life is on the line. The doctor I want in the room isn't the one who got there because their parents were able to afford them an elite private school education. and uh test prep courses and an admission consultant is the doctor who studied for the AP biology test during lunch when they're in high school didn't offer AP courses, or the one who had to work multiple jobs, or the one who had to wake up early to get their siblings on the bus and still made it, the one who recognizes me in my humanity because actually seeing people for who they are does matter in the medical profession. Um I have more questions and there are so many things and so many different avenues that we can go down. about how important it is that we have cultural, culturally competent education, that we have a culturally competent medical field. But I know that my colleagues already know that. This is another grandstanding attempt to deflect away from black advancement and care in an equitable society. I'm, it's a shame that we do that. Republicans care more about culture wars than culturally competent care. And as long as they get re-elected, they don't care who dies along the way.

General Leidy's time has expired. I now recognize the gentleman from Florida, Mr. Fein.

Thank you, Mr. Chairman. Um, Doctor Hargood, under questioning from Miss Miller, you said, quote, " the vast majority of pregnancies are in women," end quote. Who has the other pregnancies?

It's it's possible for uh transgender people.

So wait, so your testimony is that, t- a- again, so transgender people? I I thought a transgender woman was a woman. So you said the vast majority of pregnancies are in women. So who are the other pregnancies?

Who don't recognize themselves as a woman.

What?

You heard what I said. They don't recog- transgender.

So there are people who are pregnant, who are

It's a, it's a, it's a,

No, I ju- just use your, use your made-up language.

it's an extremely rare event.

Transgender, who, who are the other people who have, who are pregnant in your, in your kooky world view? You said the vast majority of pregnancies are in women. Who are the other pregnancies in?

A transgender person.

A transgender person. OK, so, uh, so, if you don't even understand this. By the way, the, the answer I pr- presume in your kooky language would be a transgender man. I don't know why you won't just admit that. Why won't you just say a tran- uh,

I don't

cuz a transgender woman would be a man who's pretending to be a woman. So why won't you even say the truth in your own screwed up view of the world, that the other pregnancies are transgender men? Why why won't you just say that?

I'm happy to say that.

OK, so say it.

Transgender men.

Transgender men get pregnant. That is that is your view. So, OK, that that that's insane. Um, Doctor Dubenet, um, I want to remind we learned last committee hearing lying under oath or lying while your Congress is against the law, so I'd point that out before I ask you these questions. Um, do you think that people dying in the name of DEI is OK?

What do you mean by dying in the name of DEI?

Do you think if d- if if instituting DEI leads to people dying, is that okay? I'm gonna assume your answer is no, this is an opinion question. Is it okay to kill people because we're so we're so determined to be diverse that we take unqualified people and we put them into our institutions. Is that okay?

Wait, I take exception to the premise of the question, sir.

All right, well then I'm I'm gonna move on. You said that it is against the law to use race as a form of admissions at your institution, correct?

In state of California.

Okay. And it you also said you don't it's your policy that you don't take race into into consideration in your admissions,

Uh,

correct?

I as f- as far as I know, I'm not directly involved with that.

Okay. So how would you explain in twenty twenty-three two races of students at your school were it had three point eight GPAs when they got in or in in the eighty-eighth percentile in terms of their MCAT scores and two other races of students are are twenty basis points behind and twenty points behind sixty-eight percentile in their MCAT scores. How can you explain that if race isn't taken into account?

Uh, s- sorry, you've concluded causality between two sets of facts and, um, I don't think we can do that.

Well, I'm asking what other factors could it be then? I'm asking for an explanation. Why would one group of people have dramatically lower MCAT scores and GPAs than another group of people, yet they're all admitted if you have a race-blind admissions policy. How could that happen?

Uh, because there are a number of other factors, uh, that, uh, that are involved.

So are you aware that Jennifer Lucero has been accused by other people in the admissions department for pushing unqualified minority candidates to diversify the school, have you heard these claims?

Um, I g- I will not be discussing things that are undercurrent, but if you

Have you heard the claim?

Um, and I will not be discussing individual faculty or students.

I just asked if you've heard the claim, not an opinion, not have you heard the claim. I presume the answer to that is yes. Would it concern you if the claim were true? Not asking you whether it is or not, would that concern you if the claim were true?

I'm not discussing individual faculty.

Okay, so you're gonna come here and not and not answer our questions. Look, uh, last question I'll have to you is this, at your institution, um, in another class that you have right now, after you changed everything, because of the previous baloney class. You've got race, science and hate, the case for anti-semitism. Students are appear to be taught that the birth of anti-semitism was relatively recent happening only two hundred years ago. Do you agree with that? Is anti-semitism a recent phenomenon or something that's lasted a long time?

That of course is not true.

OK, good. Thank you for saying that. And do all of you, final question, agree as it relates to anti-semitism, your institutions need to do a lot better job moving forward than they have in the past? I'll ask you, Doctor Dubenet, yes or no?

um, we're - we're doing a lot in the area of anti-semitism and we -

Better now.

uh, we stand against anti-semitism strongly. Um, and as I said in my opening statement, uh, these issues I take very personally, uh, as that all of the issues resonate with me personally and that my family, not all of my family, escaped Europe during the Holocaust.

Understood. And I'm out of time, so I'm not gonna ask the other two.

Yeah.

Mister Chairman, I yield back to you.

Gentlemen yields. I now recognize the gentleman from California, uh, Mister DeSaulnier.

Thank you, Mister Chairman, I wanna tell the witnesses, particularly the two distinguished gentlemen from California and as a California, how incredibly proud I am of you, all of you, uh, but particularly the two of you and the institutions that you lead, having been to both of them, as somebody who's a survivor of stage four cancer and uh infections of mercer and and sepsis, I'm not supposed to be here, but I'm here. uh because of providence and because of the medical professionals who treated me through those challenges. And a bunch of that research came from your researchers. So Mister Chairman, with with the state of health care in this country as the former chair of the health comm subcommittee, and the future chair of the We're forty-sixth in life expectancy, but we have the most expensive health care system in the world. Average American spends fifteen thousand per capita expense for health care in

You have uh uh quoted the statistics as I know them uh correctly.

Mm. Chancellor? I'm sorry. Go ahead.

Yes, to the - to the best of my knowledge, yes.

So, let's talk about what this administration's done. Why - why - I don't understand why the m- our - the majority is not having a hearing on what this administration's done between HR one and the budget, to health care and health care research. I'm alive because of, as my colleagues know, because of research that started at DARPA, but also was added to by UCSF. researchers that did blood work including on hiv aids but for leukemia uh patients like myself so chancellor augurth what has the nih cuts done to ucsf in the context also of forgive me for this but return on investment you your website says that your foundation calculates that your research has basically a multiplier of nine times out to the general public ucsf or ucla you measure it on societal outcomes Could you both speak to the - both of those things? Is what are these cuts and what are HL one doing to all the good work you do, as two of the premier research facilities in the world?

Well, um, thank you for the question. Uh, we have enjoyed uh unparalleled support, bipartisan support from uh Congress for uh w- almost eighty years since the NIH was created following the Second World War. That's allowed us to make unprecedented advances in the medical sciences. It's we have built one of the strongest uh medical research ecosystems in the world. The biotechnology industry spun out of UCSF and led to a revolution in new therapies for things like cancer and leukemia. One of our faculty received a prize this year for essentially curing the commonest cause of multiple sclerosis so the partnership between the Congress administration and the great research universities of this country for the last eighteen years has had a profound impact. We are concerned that that partnership is under threat. I've been to Washington multiple times in the last two years, and I really appreciate the bipartisan support for science that I have seen and received um I'm also uh relieved to see that the allocation of funds from the NIH this year is starting to catch up um some of the administrative difficulties they've had earlier in the year um we are seeing uh uh catch up this year i hope that the partnership uh between the great research universities of this country congress and the administration will continue because science is the future to attack the cost of medical educate medical care uh, and the issues of, uh, where we rank in the world.

And UCLA, one of the cuts most concerns me, I was down there recently and met with your staff to talk about the remarkable acute behavioral health center you're developing.

Yes, um, uh, as Doctor Horowitz had mentioned, uh, the importance of federal funding for biomedical research, uh, cannot be overstated. Um, and in particular, our ability to have the workforce of the physician-scientist workforce renewed, and have people continue to actually make the discoveries uh that uh is our hope that we can begin to n- use the new tools available to us to begin to predict risk uh and begin to have uh a treat risk so that we're actually making very common causes of morbidity and mortality rare.

If I could interrupt you s- before the Chairman gavels us down,

Yeah.

I I wanna thank you all, but, Mister Chairman, I also ask unanimous consent to enter in the record a letter to the committee from the San Francisco Hill detailing UCSF's work to address the anti-semitism and UCLA's latest campus anti-semitism report from the anti-defamation league, showing a grade of B. Thank you, Mister Chairman.

Without objection, it'll be entered, and uh w- point of personal privilege, I wanna also say to my good friend, uh from California. We are grateful to God and the wisdom given to medical, science, and research that you're still with us too.

And I'm grateful that my doctors came from all kind of backgrounds.

Yeah. We're grateful that you're here with us. I now recognize uh the gentleman from Wisconsin, Mister Grothman.

First of all, a com- a comment on on General D. I I suggest a good book for people to read on the topic. America's Cultural Revolution" by Christopher Ruffo. In he in it he lays out that the goal of the people who push this DEI is to destroy America as we know it. OK, they want to make sure when we people vote or deal with their government, rather than looking on whose policy they like more on tax policy or transportation policy or or military policy, they want America in which you say what are you gonna do for me because I'm Pacific Islander, what are you gonna do for me cuz I'm Native American. They wanna forever do that to Americans, and when they succeed in that, uh it'll be the end of America. Uh the second thing I wanna point out is it was said by uh someone uh on the Democrat side there that it's always good to break down barriers of admission to universities. When breaking down barri barriers means you lower the standards It means a college degree means less, or a medical degree means less. That should be obvious and that's not a good thing. The other thing before I ask a question, uh uh, Mister Hawgood, is I'm appalled that you would do trans-surgeries on a n- eighteen or nineteen year old. You know, people change their mind about these things, and just because it's legal and you can make money at it, doesn't make it right. I cannot imagine a situation in which you would take an eighteen or nineteen year old and do one of these sex change operations when you should know very well uh very well that a significant number of these people change, uh change what what their feelings are. Now, um the first uh general question for we will take uh um mister Dubenet uh classes in in in your university cover environmental justice, housing injustice, anti-settler uh colonialism, disability justice. One of the concerns that some of us has is the co- complete lack of diversity in um universities with regard to faculty. As far as the people who teach these classes subjectively, I mean, America's divided, about half Republican, half Democrat. Do you think uh the people who teach these classes are like half Republican, half Democratic, you think there's an ideological bias there?

Uh Congressman, I don't know about the uh p- uh political stance of our or political party of any of our faculty.

Do you think common sense would tell you that people who teach these classes are, you lack ideological diversity, among the faculty or do you not even care?

Um, I just have not been in practice of asking our faculty what a political party they endorse.

OK, now I'm sorry I gotta go to a meeting, but that that is a major concern I have in these classes. I don't think they reflect a cross-section of America in the faculty. I think they are left-wing faculty, and I think that medical students required to take classes from these people, is appalling, but thank you.

Gentlemen yields, I now recognize the gentlelady from Arizona, Ms. Grijalva.

Thank you. Um, Mister Chairman, I must ask why we're here. This hearing is a monumental waste of this committee's time. We are spending hours scrutinizing the curriculum and raking over the coals the leaders of three specific schools, while a thirteen thousand case backlog languishes at the HHS office for civil rights. We're playing politics with DEI rhetoric and yet again attacking our trans community while rural communities in states like mine like Arizona, are facing a future where they will have less than half the doctors they need. Instead of addressing the one trillion dollar cut to Medicaid that is squeezing our state's budget or the five million Americans who just lost their health care insurance we are here to stage a political performance. Our constituents deserve a committee that focuses on the real health care crises they face every single day. And I want to thank each and every one of you for being here, um, for tolerating the treatment that I've seen is, is really, um, dangerous, in my opinion. We can't afford to have fewer physicians. We can't afford for them not to understand how to treat our most vulnerable communities. Now, instead of helping Americans, sitting here targeting medical schools and holding hearings like these, like the one we're having today, to complain about health equity. We need to train the next generation of doctors to understand the realities of every person they treat because different people need different kinds of care. That knowledge is what creates good physicians and good patient outcomes. So my first question will be to Doctor Mitchell. Native Americans in Arizona experience premature death rates from treatable conditions that are nearly three times higher than white residents, a core public health concept is that in order to bring about change, you go to where there is the most need. This is known as targeted intervention or precision public health. Only then will you truly change the trajectory of a disease or health burden. What happens if medical students are forced to ignore to ignore this scientific reality?

Thank you for that question. I I think more people will die. I mean, I'm a forensic pathologist and um I often say I see failed policy on my autopsy table.

Mm.

I see individuals that should have been diagnosed with cardiovascular disease show up and the first time they're diagnosed is when they have a terminal heart attack. And so um we as a country really can put ourselves in position if we focus on the physician workforce and focus on the diversity of the physician workforce in a way that directs where these physicians are to practice, to receive uh tuition remission, to receive incentives to serve in community. There was a time in this country where you could serve in the community and then get uh your tuition rem- uh remitted. That's a workforce environment where you can actually decrease the morbidity and mortality of communities like you've just suggested.

Thank you. There seems to be some implication here today that the mission of your schools has strayed or the quality of your institutions has suffered from the inclusion of diversity, health equity, and a focus on health disparities in your curriculum. Would each of you like to take a moment to remind the committee of your mission and of the quality of the students and faculty who are attracted to join you each year, and to be part of that mission? And we can just go down the line if you like.

Uh, yes, we, um, live in a county of ten million people. Uh, it's the most diverse county in the country. Um, we're also a very competitive, uh, school to get into.

Mm-hmm.

We have often over twelve thousand applications for a hundred and sift- uh, seventy positions. Um, our students, um, participate in care not only in our university, uh, hospital, but also in the VA, in Venice Family Clinic, in the LA County Health System. So they're uh actually um are taught w- uh amongst our diverse population. Um when they leave us they go to the top residency programs in the country.

Mm-hmm.

Uh those, many of them come back to be on our faculty. Um and in nearly every case, when our students come back to join the faculty, they are the people whom when I refer others to them, I can say, go see doctor A, because he or she could take care of my own immediate family. And so, I think uh our track record of doing that and having training within uh the entirety of the Los Angeles region um, it creates a a venue uh for having uh training uh that uh that leads to an appreciation of the social determinants of health um and I had a student uh speak with me recently about

The uh gentlelady's time has expired

experience of the

so I'm gonna have to leave you there.

I wish I had you each had the opportunity to answer that question,

Yep.

cuz I think that there's so much information that's misleading.

I now I now recognize the ranking member,

I really love to read. Thank you.

the gentleman from Virginia for his questioning.

Thank you. Thank you, Mr. Chairman. Um, Doctor Mitchell, I wanna thank the National Medical Association for all that you've done over the years. Um, my father was a member of the National Medical Association, so I'm very well aware that good work. Um, now you're you're familiar with H R one, the big ugly bill. Can you say how that limits opportunities to medical school and who it limits um, who it adversely affects.

Well, we - we spoke earlier about, um, the ceiling in loans for graduate medical educa- or graduate, um, students, especially medical students, and so I won't reiterate that, but this workforce requirement that comes into play is really going to have a - a - a hit on our safety net hospitals. Many of our safety net hospitals, um, also our residency programs. And those residency programs teach the next generation that are are truly treating a diverse uh patient population. And so we worry about the stability of um these hospitals that are training institutions across the country.

Thank you. And I'd ask the three deans whether or not you're all state schools, is the likelihood of going into practice in an underserved area or going into uh in an area of shortage like primary care,

Um, well we have uh programs that encourage uh participation, such as the Prime program uh in in California.

Well, is the fa- is it is the fact that someone is likely to go into an underserved area or go into an underserved uh area of shortage, should that be considered in admissions?

Um, we have a holistic review uh process. Um and w- uh some of some of those issues actually are discussed.

Okay, Doctor Hagen.

We have two uh specific tracks in our medical school and therefore in our admissions process. Uh first of all you have to meet the merit-based requirement for admission to the overall school, but then within these tracks we have one for uh students who have a propensity for the what we call the urban underserved. Um and a second

Thank you.

uh where we have just started a regional campus in the Central Valley that we call our uh San Joaquin Valley program that is designed to attract students interested

Mm.

in rural health.

And Doctor Binodieri?

We do have a program directed to rural medicine in the campus of Peoria, Rockford, uh and I'm pleased to inform that uh seventy-five percent of the graduates of this program do stay in rural uh America, of which fifty five percent serve rural Illinois, so I believe it's an important program. I do believe that uh

Okay, I have to have some other questions I w- I need need to get to. The you you both put a lot of weight on the MCAT. It's my understanding that the MCAT is not a very good predictor of things like bed set matter, patient satisfaction, or even better, patient outcome when practicing. Is that true?

Uh, yes, I'm aware of uh the research showing that in fact what the MCAT predicts is that uh these are students who can do well on subsequent uh standardized testing.

That's standardized testing, but not patient outcome when they're practicing.

Um, I'm not aware of a research that shows a direct relation for here.

OK. Doctor Hayw- Haygood.

I think you're correct in that it's an imperfect m- measure. There is a certain MCAT score required to uh demonstrate the ability to get through medical school.

Doctor Benedetti?

Yeah.

We use a lower limit to accept candidate, below which we do not uh interview candidates.

Um eh do- Doctor Mitchell, can you s- say again why it's important to have a diverse faculty, particularly as it pertains to impl- implicit bias?

Well, diverse faculty is going to have to treat their uh treat, excuse me, teach the the medical students. And these medical students need a a full array of experiences in ensuring that they are prepared to treat a full array of patients throughout the country. And so ensuring that physicians, whether they're faculty or students, are able to deal with their own implicit bias and have curriculum that's able to help people identify their own implicit bias is extremely important. And that doesn't happen in a monolith, it happens when you have diverse individuals around you that can bring different perspectives surrounding patient care and patient safety and quality.

Thank you. Um, Mr. Chairman, I asked uh Eunice Sentenor, under the record, a um testimony from the L- Legal NAACP Legal Defense and Education Fund um showing the importance of uh DEI in medicine.

Without objection and hearing none, it will be entered.

You're back.

The gentleman yields. I thank the uh the panel for uh deliberating with us today. I now recognize the ranking member, the gentleman for V- from Virginia for his uh closing comments.

Thank you, Mr. Chairman. Uh, and once again I wanna thank the witnesses for being with us today. Uh, the day's hearing made one thing clear, that discrimination should not be in our medical schools or our healthcare system, and that includes anti-semitism. All students deserve to learn in environments where they can feel safe, respected, and supported, and every institution has a responsibility to ensure that they do. But addressing anti-semitism cannot come become to undermine the very principles that helped create inclusive learning environments in the first place diversity equity and inclusion are not the cause of discrimination they are part of the way we prepare the future physicians to recognize bias treat patients with dignity and provide the highest quality of care throughout today's hearing we've heard concerns about the culture on our campuses these concerns deserve to be taken seriously But if we are serious about combating discrimination, we must also be serious about supporting institutions and uh responsible for enforcing civil rights. Hollowing out the Department of Education's Office of Civil Rights, attacking education programs that teach future physicians about health disparities, and substituting oversight with political theater do not make students safer. We have a responsibility to not just score political points, we have to ensure that every student ensures, including Jewish students, can pursue their education free from harassment and discrimination, and that every future physician graduates prepared to care for an increasingly diverse nation. Health care works best when every patient is treated with dignity and every student has the opportunity to learn in an environment built on respect. We should be strengthening those values, not weakening them. When as we uh return for uh tomorrow for a mark-up, I hope that students, educators and families who depend on these institutions are at the top of our mind. The choices we make in this committee matter. They will determine whether or not Congress stands behind institutions that protect students' su- civil rights and educational opportunities or continues down the path that administrations uh of the administration's efforts to dismantle the Department of Education. So again, I wanna thank our witnesses. Uh, they have, um, reiterated the fact that if we do not, um, have diverse education, diverse faculty, uh, that can have, um, even fatal effects on the provision of health care in America. So with that, Mr. Chairman, I yield back.

I thank the gentlemen. And again, I thank the panel for being here. It's been, uh, it's it's been helpful to hear your answers. Uh, I think we've seen s- we've seen some encouraging statements. Um, we've seen some dis- we've heard some discouraging statements as well. Um, it is our hope that, uh, there are other medical schools who were hunkered down by their television screens today watching what was going on as well. Uh, because the three that were here were here because of a purpose. uh because of some notoriety that had gone on, some concerns brought, in fact, the genesis of this hearing. The genesis of this hearing came about from members of our congressional doc, doctor's caucus, coming to me with significant concerns about what was going on in their own medical schools that they had graduated from. And so that was the primary purpose today. And I think it was an important purpose. I know there's disagreement coming from both uh one side of the aisle, even the point of this being a useless waste of time. That member was here, though, to ask questions. It's our responsibility as stewards of taxpayer dollars to confront the widespread culture of discrimination, an activist ideology that has taken over some of our most elite medical schools. My philosophy of oversight is ensure that our federal dollars get spent in ways that advance the American project. And that project is a continuing project, never perfect but moving toward perfection, in ways that prepare students to join the citizenry in their profession. Not in ways that discriminate against people based upon the color of their skin or their sex or the where they come from, their ideology or any other difference. I would make it very clear that uh this side of the aisle, the majority, does not fear, does not fear diversity. We want to promote true diversity. Um, we don't see diversity or inclusion as dirty words in a - in a full understanding of what they actually mean. That we have an emphasis on unique concerns, uh, medical and otherwise. And we address those. But we do that with full science in the background. As you've heard today, DEI acro- DEI across these schools advanced a dangerous ideology. And we hope that the words that were given today are true, that no longer some of those courses or even faculty uh in your your medical schools. Across our country, prioritizing politics over education has resulted in classes teaching the sort of propaganda we heard about today. indoctrinating students at the expense of preparing future doctors to meet the health care needs of our communities, uh that can't be allowed to persist. And that type of DEI has to be ripped out at the roots. There was a statement made during the course of our questioning today that we cannot reduce the cost of medical education. That's why the working family's tax cut bill was passed and signed into law. One of the key reasons to reduce the cost, the unnecessary cost of education, medical and otherwise, to put the downward pressure. The audacity to say that it can't be reduced is absurd. And that is keeping, that's keeping deserving students out of having an a a a a a medical education,

Mm. Mm.

more than probably anything else. A deserving student will be able to receive additional help if necessary to find that education at any of your schools on a an or any other medical school.

Mm.

And I think that'll be proven.

Mm.

Um. But I tell you what, not only the medical schools that may have been listening today and watching today, I know that there are citizens out there that have great concerns about the cost of higher education, but also the - the - the - the threat that comes from a diversity that is manufactured, that goes away from true adv- diversity, an inclusion that ends up in the exclusion of multiple groups in society, the concern about the cost in higher education and in medical education research when we had opportunities to hear an answer to a question that was asked in a biological way, a scientific way, whether a non-biological woman has had, uh, has had a baby or could have a uterus. Unbelievable. that that answer was given in an unscientific way. And the mealy-mouthed answer that was given by noted medical professionals. The general public hearing that today says this hearing was valuable cuz it was absurd that that answer could not be given directly. and unscientific information was stood by. And so, uh, we will continue trying to enhance the education in this country, a country that has the ability to have the best, best medicine in the world without being the most costly On the basis of that and no further uh evidence to be shared in this committee hearing, uh the committee stands adjourned.