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Nguyen QT, Cabal V, Debbink M, Acosta D, Flattes VJ, Baluchi D, Ovuoba N, Cariello PF, Watts BT, Clouse ER, Nyman H, Taylor E, Kemeyou L, Lucero JE, Washington JC, Figueroa E, Campbell KM, Barbaar A, Ogbeide SA, Rodríguez JE. Building an Equity-Centered Ecosystem: University of Utah Health as a Microcosm. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01982-6. [PMID: 38573425 DOI: 10.1007/s40615-024-01982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/12/2024] [Accepted: 03/17/2024] [Indexed: 04/05/2024]
Abstract
Academic medicine, and medicine in general, are less diverse than the general patient population. Family Medicine, while still lagging behind the general population, has the most diversity in leadership and in the specialty in general, and continues to lead in this effort, with 16.7% of chairs identifying as underrepresented in medicine. Historical and current systematic marginalization of Black or African American, Latina/e/o/x, Hispanic or of Spanish Origin (LHS), American Indian/Alaska Native, Native Hawaiian/Pacific Islander, and Southeast Asian individuals has created severe underrepresentation within health sciences professions. Over the last 30 years, the percentage of faculty from these groups has increased from 7 to 9% in allopathic academic medicine, with similar increases in Osteopathic Medicine, Dentistry, and Pharmacy, but all lag behind age-adjusted population means. Traditionally, diversity efforts have focused on increasing pathway programs to address this widening disparity. While pathway programs are a good start, they are only a portion of what is needed to create lasting change in the diversity of the medical profession as well as the career trajectory and success of underrepresented in medicine (URiM) health professionals toward self-actualization and positions of leadership. This article elucidates all parts of an ecosystem necessary to ensure that equity, diversity, and inclusion outcomes can improve.
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Affiliation(s)
- Quang-Tuyen Nguyen
- Department of Pediatrics, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | | | - Michelle Debbink
- Department of Obstetrics and Gynecology, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - David Acosta
- Association of American Medical Colleges, Washington, DC, USA
| | | | - Donna Baluchi
- Eccles Health Sciences Library, University of Utah, Salt Lake City, UT, USA
| | - Natasha Ovuoba
- Huntsman Cancer Insitute, University of Utah, Salt Lake City, UT, USA
| | - Paloma F Cariello
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Bart T Watts
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Erin R Clouse
- University of Utah Medical Group, Salt Lake City, UT, USA
| | - Heather Nyman
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Eliza Taylor
- Department of Family and Preventive Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Line Kemeyou
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Julie E Lucero
- Department of Health and Kinesiology, College of Health, University of Utah, Salt Lake City, UT, USA
| | | | | | - Kendall M Campbell
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Abdulkhaliq Barbaar
- University of Utah Health Equity, Diversity and Inclusion, University of Utah, Salt Lake City, UT, USA
| | - Stacy A Ogbeide
- Department of Family Medicine, University of Texas Health Sciences Center, San Antonio, TX, USA
| | - José E Rodríguez
- Department of Family and Preventive Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA.
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Campbell KM, Ogbeide SA, Echiverri A, Guillaume G, Henderson JE, Jackson N, Marquez CM, Miranda C, Montoya M, Oni K, Pierre G, Semenya AM, Scott L, Udezi V, Flattes VJ, Rodríguez JE, Washington JC. Are committee experiences of minoritized family medicine faculty part of the minority tax? a qualitative study. BMC MEDICAL EDUCATION 2023; 23:862. [PMID: 37957655 PMCID: PMC10644420 DOI: 10.1186/s12909-023-04848-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Because much of the work in academic medicine is done by committee, early career URiM faculty, are often asked to serve on multiple committees, including diversity work that may not be recognized as important. They may also be asked to serve on committees to satisfy a diversity "check box," and may be asked more often than their non-URiM peers to serve in this capacity. We sought to describe the committee experiences of early career URiM faculty, hypothesizing that they may see committee service as a minority tax. METHODS Participants in the Leadership through Scholarship Fellowship (LTSF) were asked to share their experiences with committee service in their careers after participating in a faculty development discussion. Their responses were analyzed and reported using qualitative, open, axial, and abductive reasoning methods. RESULTS Four themes, with eight sub-themes (in parenthesis), emerged from the content analysis of the LTSF fellows responses to the prompt: Time commitment (Timing of committee work and lack of protected time for research and scholarship), URiM Committee service (Expectation that URiM person will serve on committees and consequences for not serving), Mentoring issues (no mentoring regarding committee service, faculty involvement is lacking and the conflicting nature of committee work) and Voice (Lack of voice or acknowledgement). CONCLUSIONS Early career URiM faculty reported an expectation of serving on committees and consequences for not serving related to their identity, but other areas of committee service they shared were not connected to their URiM identity. Because most of the experiences were not connected to the LTSF fellows' URiM identity, this group has identified areas of committee service that may affect all early career faculty. More research is necessary to determine how committee service affects URiM and non-URiM faculty in academic family medicine.
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Affiliation(s)
| | - Stacy A Ogbeide
- University of Texas Health Sciences Center at San Antonio, San Antonio, USA
| | | | - Gina Guillaume
- North by Northeast Community Health Center, Portland, USA
| | | | | | | | | | | | - Keyona Oni
- Carolinas Healthcare System, Charlotte, USA
| | - Grant Pierre
- University of Massachusetts Medical School, Boston, USA
| | | | | | - Victoria Udezi
- University of Texas Southwestern Medical School, Dallas, USA
| | - Valerie J Flattes
- University of Utah Health, 26 S 2000 E, 5750B EHSEB, 84112, Salt Lake City, UT, USA
| | - José E Rodríguez
- University of Utah Health, 26 S 2000 E, 5750B EHSEB, 84112, Salt Lake City, UT, USA.
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Campbell KM. Mitigating the Isolation of Minoritized Faculty in Academic Medicine. J Gen Intern Med 2023; 38:1751-1755. [PMID: 36547754 PMCID: PMC10212885 DOI: 10.1007/s11606-022-07982-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
Increasing numbers of faculty who are underrepresented in medicine has been a focus of academic health systems. Understanding the experiences of these faculty helps in creating environments that are inclusive and supportive, promoting faculty success. When compared with non-minoritized faculty, minoritized faculty face racism, isolation, diversity efforts disparities, clinical efforts disparities, lack of faculty development, and promotion disparities. While there have been contributions to the literature to better characterize disparities faced by minoritized faculty, little has been written about isolation. Isolation occurs when faculty underrepresented in medicine do not feel like part of the department or institution. They may feel excluded from mainstream culture as if they are invisible. They may be excluded from conversations, group chats, get togethers, or other work-related or social functions. These feelings can manifest as imposter syndrome and impact work performance and decision-making. In this article, the author shares how to recognize and mitigate isolation to promote an inclusive environment for all faculty.
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Affiliation(s)
- Kendall M Campbell
- Department of Family Medicine, The University of Texas Medical Branch, Galveston, TX, USA.
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Bath EP, Brown K, Harris C, Guerrero A, Kozman D, Flippen CC, Garraway I, Watson K, Holly L, Godoy SM, Norris K, Wyatt G. For us by us: Instituting mentorship models that credit minoritized medical faculty expertise and lived experience. Front Med (Lausanne) 2022; 9:966193. [PMID: 36341236 PMCID: PMC9634999 DOI: 10.3389/fmed.2022.966193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2023] Open
Abstract
The woefully low proportion of scientists and clinicians underrepresented in medicine (UIM), including members of African-American/Black, Hispanic/Latinx, American Indian/Alaska Native or Native Hawaiian/Pacific Islander communities, is well characterized and documented. Diversity in medicine is not only just, but it improves quality and outcomes. Yet, diversity in academic medicine remains stagnant, despite national recognition and urgent calls to improve diversity, equity, and inclusion across health sciences. One strategy that has shown to improve diversity in many sectors is high quality mentoring. While many institutions have adopted mentoring programs, there remains a lack of mentorship that is equitable, individualized, and sets a clear timeline for academic milestones that will position UIM mentees at the optimal trajectory for promotion and retention. A barrier to assembling these programs is the small number of UIM among the senior faculty ranks who are able to serve in this role, given the disproportionate burden to serve on a multitude of academic committees, task forces, and workgroups to fulfill institutional mandates to diversify representation. These time-consuming services, documented in the literature as the "minority tax," are generally uncompensated and unaccounted for in terms of consideration for promotion, leadership positions, and other measures of career advancement. The Justice, Equity, Diversity, and Inclusion Academic Mentors (JAM) Council represents a novel, culturally responsive, and anti-racist approach to achieve a more equitable and inclusive institutional environment. This approach strategically leverages the intergenerational wisdom and experience of senior UIM faculty via time-protected effort with the overall goals of improving rates of promotion, retention, and career satisfaction of early career UIM colleagues. This community case study describes the rationale, resources needed, processes, and proposed workflow required to launch the JAM Council, as well as the major roles and responsibilities for JAM mentors and mentees, which may be considered by academic medical centers focused on improving diversity among the faculty ranks.
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Affiliation(s)
- Eraka P. Bath
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kathleen Brown
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Radiological Sciences, UCLA Health System, Los Angeles, CA, United States
| | - Christina Harris
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Division of General Internal Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alma Guerrero
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Developmental-Behavioral Pediatrics, UCLA Mattel Children's Hospital, Los Angeles, CA, United States
| | - Daniel Kozman
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Medicine, UCLA Health System, Los Angeles, CA, United States
- Division of General Internal Medicine and Health Services Research, UCLA Health System, Los Angeles, CA, United States
| | - Charles C. Flippen
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Neurology, UCLA Health System, Los Angeles, CA, United States
| | - Isla Garraway
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Urology, UCLA Health System, Los Angeles, CA, United States
| | - Karol Watson
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Medicine, UCLA Health System, Los Angeles, CA, United States
| | - Langston Holly
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Neurology, UCLA Health System, Los Angeles, CA, United States
| | - Sarah M. Godoy
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Keith Norris
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Division of General Internal Medicine and Health Services Research, UCLA Health System, Los Angeles, CA, United States
| | - Gail Wyatt
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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Rodríguez JE, Figueroa E, Campbell KM, Washington JC, Amaechi O, Anim T, Allen KC, Foster KE, Hightower M, Parra Y, Wusu MH, Smith WA, Villarreal MA, Pololi LH. Towards a common lexicon for equity, diversity, and inclusion work in academic medicine. BMC MEDICAL EDUCATION 2022; 22:703. [PMID: 36195946 PMCID: PMC9533485 DOI: 10.1186/s12909-022-03736-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Differential rewarding of work and experience has been a longtime feature of academic medicine, resulting in a series of academic disparities. These disparities have been collectively called a cultural or minority "tax," and, when considered beyond academic medicine, exist across all departments, colleges, and schools of institutions of higher learning-from health sciences to disciplines located on university campuses outside of medicine and health. A shared language can provide opportunities for those who champion this work to pool resources for larger impacts across the institution. This article aims to catalog the terms used across academic medicine disciplines to establish a common language describing the inequities experienced by Black, Latinx, American Indian/Alaska Native and Native Hawaiian/Other Pacific Islander, Women, and other underrepresented people as well as queer, disabled, and other historically marginalized or excluded groups. These ideas are specific to academic medicine in the United States, although many can be used in academic medicine in other countries. The terms were selected by a team of experts in equity, diversity, and inclusion, (EDI) who are considered national thought leaders in EDI and collectively have over 100 years of scholarship and experience in this area.
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Affiliation(s)
- José E Rodríguez
- University of Utah Health, 26 S 2000 E, 5750B EHSEB, Salt Lake City, UT, 84112, USA.
| | | | - Kendall M Campbell
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | | | | | - Tanya Anim
- Lee Memorial Health and Florida State University, Ft. Meyers, FL, USA
| | - Kari-Claudia Allen
- Prisma Health/University of South Carolina School of Medicine, Columbia, SC, USA
| | - Krys E Foster
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Maia Hightower
- University of Utah Health, 26 S 2000 E, 5750B EHSEB, Salt Lake City, UT, 84112, USA
| | - Yury Parra
- New York City Health and Hospitals, New York, NY, USA
| | | | - William A Smith
- Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | - Mary Ann Villarreal
- University of Utah Health, 26 S 2000 E, 5750B EHSEB, Salt Lake City, UT, 84112, USA
| | - Linda H Pololi
- The National Initiative On Gender, Culture and Leadership in Medicine: C-Change, Brandeis University, Boston, MA, USA
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Konuthula D, de Abril Cameron F, Jonassaint N, Ufomata E, Torres O, Essien UR, Hamm ME, Merlin J, Ragavan MI. Perspectives on Anti-Black Racism and Mitigation Strategies Among Faculty Experts at Academic Medical Centers. JAMA Netw Open 2022; 5:e228534. [PMID: 35452105 PMCID: PMC9034397 DOI: 10.1001/jamanetworkopen.2022.8534] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Black faculty and trainees remain underrepresented in academic medicine because of systemic racism. Years of diversity and inclusion efforts have not succeeded in eliminating the unique challenges faced by Black faculty in academic medicine. OBJECTIVES To elicit expert faculty perspectives on anti-Black racism in academic medicine based on lived and/or professional experience and to solicit recommendations for an intervention for faculty to dismantle anti-Black racism within academic medical centers. DESIGN, SETTING, AND PARTICIPANTS This qualitative study included semistructured interviews with experts in understanding and dismantling anti-Black racism within academic medical centers. Participants had expertise in anti-Black racism through their lived experience as a Black faculty member and/or professional experience in diversity, equity, and inclusion efforts. Participants were recruited from academic medical centers from around the United States. Interviews were conducted through an online meeting platform, audio recorded, transcribed verbatim, and subsequently coded following an inductive qualitative description approach. Interviews were completed between October 2020 and March 2021. MAIN OUTCOMES AND MEASURES Outcomes include the experiences of Black faculty and trainees in academic medicine and recommendations for developing an intervention to dismantle anti-Black racism within academic medicine. RESULTS A total of 16 participants completed this study; most identified as Black or African American (9 [56%]) and female (10 [63%]). Results were sorted into 2 content domains, with several themes within those domains: (1) barriers faced by Black faculty and trainees and potential solutions and (2) recommendations for an intervention directed at faculty to dismantle anti-Black racism in academic medicine. Barriers faced by Black faculty and trainees included lack of representation; challenges with the recruitment, retention, and promotion of Black faculty; and experiences of microaggressions and overt racism. Participants suggested that an intervention should have a comprehensive learning objective; be mandatory for all faculty, with the exception of Black faculty; draw from outside expertise; and receive allocation of resources and funding equal to other important training modules. CONCLUSIONS AND RELEVANCE The findings of this study affirm prior work about the unique challenges faced by Black faculty and trainees in academic medicine because of interpersonal and institutional racism and build on this prior work by soliciting recommendations to guide intervention development. An intervention to dismantle anti-Black racism within academic medicine is urgently needed and will require leadership buy-in and financial commitments from institutions for effective development and implementation.
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Affiliation(s)
- Dedeepya Konuthula
- Internal Medicine–Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Flor de Abril Cameron
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Naudia Jonassaint
- Division of General Internal Medicine, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Eloho Ufomata
- Division of General Internal Medicine, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Orquidia Torres
- Division of Adolescent and Young Adult Medicine, University of Pittsburgh and University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Utibe R. Essien
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Megan E. Hamm
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jessica Merlin
- Division of General Academic Pediatrics, University of Pittsburgh and University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maya I. Ragavan
- Division of General Academic Pediatrics, University of Pittsburgh and University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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