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Affiliation(s)
- Mariam O Fofana
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
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Zaidi Z, Partman IM, Whitehead CR, Kuper A, Wyatt TR. Contending with Our Racial Past in Medical Education: A Foucauldian Perspective. TEACHING AND LEARNING IN MEDICINE 2021; 33:453-462. [PMID: 34279159 DOI: 10.1080/10401334.2021.1945929] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/27/2021] [Indexed: 06/13/2023]
Abstract
Practices of systemic and structural racism that advantage some groups over others are embedded in American society. Institutions of higher learning are increasingly being pressured to develop strategies that effectively address these inequities. This article examines medical education's diversity reforms and inclusion practices, arguing that many reify preexisting social hierarchies that privilege white individuals over those who are minoritized because of their race/ethnicity. Evidence: Drawing on the work of French theorist Michel Foucault, we argue that medical education's curricular and institutional practices reinforce asymmetrical power differences and authority in ways that disadvantage minoritized individuals. Practices, such as medical education's reliance on biomedical approaches, cultural competency, and standardized testing reinforce a racist system in ways congruent with the Foucauldian concept of "normalization." Through medical education's creation of subjects and its ability to normalize dominant forms of knowledge, trainees are shaped and socialized into ways of thinking, being, and acting that continue to support racial violence against minoritized groups. The systems, structures, and practices of medical education need to change to combat the pervasive forces that continue to shape racist institutional patterns. Individual medical educators will also need to employ critical approaches to their work and develop strategies that counteract institutional systems of racial violence. Implications: A Foucauldian approach that exposes the structural racism inherent in medical education enables both thoughtful criticism of status-quo diversity practices and practical, theory-driven solutions to address racial inequities. Using Foucault's work to interrogate questions of power, knowledge, and subjectivity can expand the horizon of racial justice reforms in medicine by attending to the specific, pervasive ways racial violence is performed, both intra- and extra-institutionally. Such an intervention promises to take seriously the importance of anti-racist methodology in medicine.
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Affiliation(s)
- Zareen Zaidi
- Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | | | - Cynthia R Whitehead
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ayelet Kuper
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tasha R Wyatt
- Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
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Sharda S, Dhara A, Alam F. Not neutral: reimagining antiracism as a professional competence. CMAJ 2021; 193:E101-E102. [PMID: 33462148 PMCID: PMC7835085 DOI: 10.1503/cmaj.201684] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Saroo Sharda
- Department of Anesthesia (Sharda), Halton Healthcare - Oakville Trafalgar Memorial Hospital, Oakville, Ont.; Department of Anesthesia (Sharda), McMaster University, Hamilton Ont.; Department of Family Medicine (Dhara), Dalhousie University, Halifax, NS; Department of Anesthesia (Alam), Sunnybrook Health Sciences Centre; Department of Anesthesiology and Pain Medicine (Alam), and The Wilson Centre for Research in Medical Education (Alam), Faculty of Medicine, University of Toronto, Toronto, Ont.
| | - Aruna Dhara
- Department of Anesthesia (Sharda), Halton Healthcare - Oakville Trafalgar Memorial Hospital, Oakville, Ont.; Department of Anesthesia (Sharda), McMaster University, Hamilton Ont.; Department of Family Medicine (Dhara), Dalhousie University, Halifax, NS; Department of Anesthesia (Alam), Sunnybrook Health Sciences Centre; Department of Anesthesiology and Pain Medicine (Alam), and The Wilson Centre for Research in Medical Education (Alam), Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Fahad Alam
- Department of Anesthesia (Sharda), Halton Healthcare - Oakville Trafalgar Memorial Hospital, Oakville, Ont.; Department of Anesthesia (Sharda), McMaster University, Hamilton Ont.; Department of Family Medicine (Dhara), Dalhousie University, Halifax, NS; Department of Anesthesia (Alam), Sunnybrook Health Sciences Centre; Department of Anesthesiology and Pain Medicine (Alam), and The Wilson Centre for Research in Medical Education (Alam), Faculty of Medicine, University of Toronto, Toronto, Ont
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Odukoya EJ, Kelley T, Madden B, Olawuni F, Maduakolam E, Cianciolo AT. Extending "Beyond Diversity": Culturally Responsive Universal Design Principles for Medical Education. TEACHING AND LEARNING IN MEDICINE 2021; 33:109-115. [PMID: 33792455 DOI: 10.1080/10401334.2021.1890679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This commentary follows up on Maduakolam et al. (2020) "Beyond Diversity: Envisioning Inclusion in Medical Education Research and Practice," which introduced Culturally Responsive Universal Design for Learning (CRUDL) as an approach to accounting for learner diversity in educational theory development and curriculum design. We flesh out the principles of CRUDL, using publications in this issue of Teaching and Learning in Medicine as case examples for how the principles work in action. With this scholarly thought exercise, we seek to demonstrate the feasibility and promise of curriculum that is accountable to diverse learners and the impact of historical trauma. We also explore how research inclusive of diverse social identities could inform curriculum design by identifying how social identity, learning environment, educational activities, and learner engagement interact to produce diverse learning experiences and performance. Scholarly thought exercises such as this one may help bridge the gap between professed ideals and action with respect to inclusive medical education; CRUDL principles provide a helpful framework for planning and evaluating accountable curriculum design.
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Affiliation(s)
| | - Tatiana Kelley
- Department of Medical Education, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Barra Madden
- Department of Medical Education, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Felicia Olawuni
- Department of Medical Education, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Erica Maduakolam
- Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Anna T Cianciolo
- Department of Medical Education, Southern Illinois University School of Medicine, Springfield, Illinois, USA
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Sharda S, Dhara A, Alam F. L’antiracisme comme compétence professionnelle: quand la neutralité ne suffit plus. CMAJ 2021; 193:E436-E438. [PMID: 33753373 PMCID: PMC8096391 DOI: 10.1503/cmaj.201684-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Saroo Sharda
- Service d'anesthésie (Sharda) de Halton Healthcare - Hôpital Trafalgar Memorial d'Oakville, Ont.; Département d'anesthésie (Sharda) de l'Université McMaster, à Hamilton, Ont.; Département de médecine familiale (Dhara) de l'Université Dalhousie, à Halifax, N.-É.; Service d'anesthésie (Alam) du Centre des sciences de la santé Sunnybrook; Département d'anesthésiologie et de médecine de la douleur (Alam); et Centre Wilson de recherche en éducation (Alam) de la Faculté de médecine de l'Université de Toronto, Ont.
| | - Aruna Dhara
- Service d'anesthésie (Sharda) de Halton Healthcare - Hôpital Trafalgar Memorial d'Oakville, Ont.; Département d'anesthésie (Sharda) de l'Université McMaster, à Hamilton, Ont.; Département de médecine familiale (Dhara) de l'Université Dalhousie, à Halifax, N.-É.; Service d'anesthésie (Alam) du Centre des sciences de la santé Sunnybrook; Département d'anesthésiologie et de médecine de la douleur (Alam); et Centre Wilson de recherche en éducation (Alam) de la Faculté de médecine de l'Université de Toronto, Ont
| | - Fahad Alam
- Service d'anesthésie (Sharda) de Halton Healthcare - Hôpital Trafalgar Memorial d'Oakville, Ont.; Département d'anesthésie (Sharda) de l'Université McMaster, à Hamilton, Ont.; Département de médecine familiale (Dhara) de l'Université Dalhousie, à Halifax, N.-É.; Service d'anesthésie (Alam) du Centre des sciences de la santé Sunnybrook; Département d'anesthésiologie et de médecine de la douleur (Alam); et Centre Wilson de recherche en éducation (Alam) de la Faculté de médecine de l'Université de Toronto, Ont
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Wyatt TR, Rockich-Winston N, White D, Taylor TR. "Changing the narrative": a study on professional identity formation among Black/African American physicians in the U.S. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:183-198. [PMID: 32572728 DOI: 10.1007/s10459-020-09978-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Professional identity formation (PIF) is considered a key process in physician development. However, early PIF research may have inadvertently left out experiences from ethnically/racially minoritized physicians. As a result, the PIF literature may have forwarded dominant perspectives and assumptions about PIF that does not reflect those of minoritized physicians. This study used a cross-sectional study design, in which interview data was initially collected using constructivist grounded theory and then analyzed using critical lenses. Participants included 14 Black/African American students, 10 residents, and 17 attending physicians at two Southern medical schools in the U.S. Coding included the both/and conceptual framework developed out of Black feminist scholarship, and further analyzed using medicine's culture of Whiteness. These lenses identified assumptions made in the dominant PIF literature and how they compared to the experiences described by Black physicians. The results show that medical education's historical exclusion of minoritized physicians in medical education afforded a culture of Whiteness to proliferate, an influence that continues to frame the PIF research. Black physicians described their professional identity in terms of being in service to their racial/ethnic community, and the interconnectedness between personal/professional identities and context. Their professional identity was used to challenge larger social, historical, and cultural mistreatment of Black Americans, findings not described in the dominant PIF research. Black physicians' experiences as minoritized individuals within a culture of Whiteness reveals that the PIF literature is limited, and the current framings of PIF may be inadequate to study minoritized physicians.
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Affiliation(s)
- Tasha R Wyatt
- Educational Innovation Institute, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Nicole Rockich-Winston
- Pharmacology and Toxicology Department, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.
| | - DeJuan White
- Emory University School of Medicine, Atlanta, GA, USA
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Roberts SE, Nehemiah A, Butler PD, Terhune K, Aarons CB. Mentoring Residents Underrepresented in Medicine: Strategies to Ensure Success. JOURNAL OF SURGICAL EDUCATION 2021; 78:361-365. [PMID: 32839148 DOI: 10.1016/j.jsurg.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To provide a framework for effective mentorship of residents underrepresented in medicine (UIM) situated in the context of their experiences in healthcare teams. DESIGN A perspective summarizing the important elements for the effective mentorship of UIM residents. CONCLUSION Mentorship of trainees is of profound importance in medical education as it provides tangible benefits for professional and personal development. However, given their unique experiences and position in our teams as well as the larger healthcare construct, the mentorship of UIM residents requires special consideration and focus. Implementing programs that foster diversity, cross-cultural mentorship, and sponsorship are imperative.
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Affiliation(s)
- Sanford E Roberts
- Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Ariel Nehemiah
- Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Paris D Butler
- Department of Surgery, Division of Plastic Surgery, University of Pennsylvania Health System Philadelphia, Pennsylvania
| | - Kyla Terhune
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Cary B Aarons
- Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
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D'Eon M. "Peering into the looking glass": professionalism and professional identity formation in health professions education. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e117-e119. [PMID: 33680247 PMCID: PMC7931481 DOI: 10.36834/cmej.71919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Wyatt TR, Balmer D, Rockich-Winston N, Chow CJ, Richards J, Zaidi Z. 'Whispers and shadows': A critical review of the professional identity literature with respect to minority physicians. MEDICAL EDUCATION 2021; 55:148-158. [PMID: 33448459 DOI: 10.1111/medu.14295] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/28/2020] [Accepted: 07/16/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under-represented in medicine (URM). This meta-ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians. METHODS Data were gathered using a search of six well-known medical education journals for the term 'professional identit*' in titles, keywords, abstracts and subheadings, delineated with the date range of 2012-2019. All non-relevant abstracts were removed and papers were then further reduced to those that focused only on learners' experiences. This left 67 articles in the final dataset, which were analysed using a collaborative approach among a team of researchers. The team members used their professional expertise as qualitative researchers and personal experiences as minoritised individuals to synthesise and interpret the PIF literature. RESULTS Four conceptual categories were identified as impacting PIF: Individual versus Sociocultural Influences; the Formal versus the Hidden Curriculum; Institutional versus Societal Values; and Negotiation of Identity versus Dissonance in Identity. However, a major gap was identified; only one study explored experiences of PIF in URM physicians and there was an almost complete absence of critical stances used to study PIF. Combined, these findings suggest that PIF research is building on existing theories without questioning their validity with reference to minoritised physicians. CONCLUSIONS From a post-colonial perspective, the fact that race and ethnicity have been largely absent, invisible or considered irrelevant within PIF research is problematic. A new line of inquiry is needed, one that uses alternative frameworks, such as critical theory, to account for the ways in which power and domination influence PIF for URM physicians in order to foreground how larger sociohistorical issues influence and shape the identities of minoritised physicians.
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Affiliation(s)
- Tasha R Wyatt
- Educational Innovation Institute, Medical College of Georgia, Augusta, Georgia, USA
| | - Dorene Balmer
- Department of Paediatrics, Children's Hospital of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nicole Rockich-Winston
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta, Georgia, USA
| | - Candace J Chow
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Joslyn Richards
- Educational Innovation Institute, Medical College of Georgia, Augusta, Georgia, USA
| | - Zareen Zaidi
- Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
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Schuster MA, Conwell WD, Connelly MT, Humphrey HJ. Building Equity, Inclusion, and Diversity Into the Fabric of a New Medical School: Early Experiences of the Kaiser Permanente Bernard J. Tyson School of Medicine. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:S66-S70. [PMID: 32889938 DOI: 10.1097/acm.0000000000003695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In July 2020, the Kaiser Permanente Bernard J. Tyson School of Medicine opened in Pasadena, California, with an inaugural class of 50 students. The school endeavors to address systemic barriers that have contributed to health care and educational disparities in the United States. To realize its vision for change, equity, inclusion, and diversity (EID) have been woven throughout the school. Board members were chosen in part based on their commitment to the core values of EID. The board developed mission, vision, and values statements that explicitly avow a commitment to EID and recruited a dean (and the dean recruited leaders) who espoused and evinced these values. Leaders, faculty, and staff received training to foster an inclusive environment and ensure accountability. The school developed a curriculum that has been thoroughly evaluated for its representative and inclusive content by a team drawn from all departments. The diverse first class, selected through a holistic admissions approach, has access to student support systems that emphasize an appreciation of the distinct experiences and context of each student. The school plans a rigorous evaluation program to assess its performance in EID. Although the school may well fall short of achieving all of its EID objectives, by learning from its experiences and from evidence of others in academic medicine, the school recognizes its opportunity to continue to come closer to achieving its goals and to help shape and contribute to the national and international discourse on EID.
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Affiliation(s)
- Mark A Schuster
- M.A. Schuster is founding dean and chief executive officer, and professor, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Walter D Conwell
- W.D. Conwell is associate dean, Equity, Inclusion, and Diversity, and assistant professor, Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Maureen T Connelly
- M.T. Connelly is senior associate dean, Academic and Community Affairs, and professor, Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Holly J Humphrey
- H.J. Humphrey is president, Josiah Macy Jr. Foundation, New York, New York, and chair, Kaiser Permanente Bernard J. Tyson School of Medicine Board of Directors, Pasadena, California
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Teherani A, Perez S, Muller-Juge V, Lupton K, Hauer KE. A Narrative Study of Equity in Clinical Assessment Through the Antideficit Lens. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:S121-S130. [PMID: 33229956 DOI: 10.1097/acm.0000000000003690] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Efforts to address inequities in medical education are centered on a dialogue of deficits that highlight negative underrepresented in medicine (UIM) learner experiences and lower performance outcomes. An alternative narrative explores perspectives on achievement and equity in assessment. This study sought to understand UIM learner perceptions of successes and equitable assessment practices. METHOD Using narrative research, investigators selected a purposeful sample of self-identified UIM fourth-year medical students and senior-level residents and conducted semistructured interviews. Questions elicited personal stories of achievement during clinical training, clinical assessment practices that captured achievement, and equity in clinical assessment. Using re-storying and thematic analysis, investigators coded transcripts and synthesized data into themes and representative stories. RESULTS Twenty UIM learners (6 medical students and 14 residents) were interviewed. Learners often thought about equity during clinical training and provided personal definitions of equity in assessment. Learners shared stories that reflected their achievements in patient care, favorable assessment outcomes, and growth throughout clinical training. Sound assessments that captured achievements included frequent observations with real-time feedback on predefined expectations by supportive, longitudinal clinical supervisors. Finally, equitable assessment systems were characterized as sound assessment systems that also avoided comparison to peers, used narrative assessment, assessed patient care and growth, trained supervisors to avoid bias, and acknowledged learner identity. CONCLUSIONS UIM learners characterized equitable and sound assessment systems that captured achievements during clinical training. These findings guide future efforts to create an inclusive, fair, and equitable clinical assessment experience.
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Affiliation(s)
- Arianne Teherani
- A. Teherani is professor, Department of Medicine, education scientist, Center for Faculty Educators, and director of program evaluation, University of California, San Francisco, School of Medicine, San Francisco, California; ORCID: http://orcid.org/0000-0003-2936-9832
| | - Sandra Perez
- S. Perez is a medical student, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Virginie Muller-Juge
- V. Muller-Juge is associate specialist, University of California, San Francisco, School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0002-2346-8904
| | - Katherine Lupton
- K. Lupton is associate professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Karen E Hauer
- K.E. Hauer is professor, Department of Medicine, and associate dean for competency assessment and professional standards, University of California, San Francisco, School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0002-8812-4045
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Maduakolam E, Madden B, Kelley T, Cianciolo AT. Beyond Diversity: Envisioning Inclusion in Medical Education Research and Practice. TEACHING AND LEARNING IN MEDICINE 2020; 32:459-465. [PMID: 33349086 DOI: 10.1080/10401334.2020.1836462] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This commentary examines the publications in Teaching and Learning in Medicine's Issue 32(5) from the perspectives of Black, female medical trainees. Its purpose is to demonstrate how including diverse perspectives in general medical education scholarship could prompt reconsideration of basic concepts and the development of richer, more nuanced, and practicable understanding of who medical learners are. An inclusive concept of medical education is a first step toward "culturally responsive universal design for learning," an approach to educational design that views barriers to learning as a systems problem, recognizes racism as a learning barrier, and offers learners multiple means to achieve academic success. Augmenting studies that explicitly target the experiences of trainees and faculty from marginalized racial groups, this commentary aims to establish a vision for what to do educationally with the knowledge that people bring diverse backgrounds and perspectives to their learning.
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Affiliation(s)
- Erica Maduakolam
- Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Barra Madden
- Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Tatiana Kelley
- Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Anna T Cianciolo
- Southern Illinois University School of Medicine, Springfield, Illinois, USA
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Haggins AN. To Be Seen, Heard, and Valued: Strategies to Promote a Sense of Belonging for Women and Underrepresented in Medicine Physicians. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1507-1510. [PMID: 32590469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Lingering unconscious biases and daily cues continue to permeate and persist in academic medicine environments in the form of the exclusion of physicians who are women or racially/ethnically underrepresented in medicine. Academic medicine environments must change so that women and underrepresented in medicine racial/ethnic groups are seen, heard, and valued. A shared awareness among faculty, administrators, and trainees can inform the development of intentional strategies to alter individual behaviors, academic spaces, and institutional processes to cultivate a sense of belonging. Shifting the norms in medicine and the course of historical exclusion will require professional development in areas of inclusive teaching practices, skills to cultivate mentoring relationships with diverse trainees, and fostering discussions about the relevance of personal identity, as well as attention to the symbolism and imagery in institutional messages (e.g., portraits on the walls, website, marketing campaigns) and to the value of including community involvement in productivity metrics.
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Affiliation(s)
- Adrianne N Haggins
- A.N. Haggins is assistant clinical professor, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
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