Let us not neglect the impact of organizational culture on increasing diversity within medical schools

All three authors have a keen research and practical interest in selection and widening access to medicine.

In this issue, Young et al. present a six-point framework for pipeline and program development, intended to increase diversity in Canadian medical schools. Using a framework of knowledge translation, the authors emphasize the key role of collecting and monitoring longitudinal diversity-related data in designing, implementing and evaluating diversity-related initiatives. Young et al. argue the use of such data will not only improve best practice, but will also help build more tailored structures for lasting change.

We wholeheartedly agree that such data are essential. However, Young et al.’s focus on processes, new initiatives and structural change positions the article at the level of organizational and systems-level change. This is potentially problematic as, while systems-level changes may be an important initial step towards reducing functional barriers (to, in this case, increasing diversity within medicine), unless these barriers are also addressed at a cultural level, it is unlikely change will be effective, lasting or genuine.