Gaps in medical education curricula on skin of color in medical school, residency, and beyond: Part 1

Various studies have revealed a disproportionately low representation of skin of color (SOC) dermatology in the medical education system of the United States. This disparity contributes to adverse experiences, missed and/or delayed diagnoses, and overall health inequities for individuals of color. The lack of sufficient SOC education begins at the medical school level and continues throughout residency, fellowship, and beyond formal training. This lack of education can be seen in the dearth of images of common and uncommon skin conditions in darker skin in widely used textbooks and educational resources as well as in the lack of formal training in SOC in many residency programs. Thus far, there have been valuable strides to make dermatologic education more inclusive of all skin colors, but there remains significant work to be done. With the population of the United States expected to continue to diversify and with the expectation that SOC will be a trait of over half of the population of the United States by 2050, it is important to strive for health equity by ensuring that comprehensive and inclusive medical training incorporates SOC. This paper will explore the issue of gaps in medical education in SOC dermatology at all levels and offer a strategic call to action to aid in rectifying this situation.

Latinx Bioethics: Toward a Braver, Broader, and More Just Bioethics

In recognizing that overcoming anti-Blackness and structural racism requires a collective effort, Latinx bioethics has emerged as a space in the larger field of bioethics where Latino scholars, researchers, artists, and other bioethics professionals are contributing to deconstructing anti-Blackness. With attention to race and ethnocultural perspectives, Latinx bioethics draws from bioethical theories and conceptual frameworks to address ethical and moral issues affecting Latino communities. This essay aims to explain how Latinx bioethics aids in centering the Latinx voice and eradicating anti-Blackness in bioethics. After introducing the Latinx bioethics framework and mission, the essay explores the overlap between Black bioethics and Latinx bioethics and discusses why this overlap calls for cross-examination and collaboration in the field. The essay concludes with a summary of recommendations and reflections that bioethics can adopt to begin progressing toward a more inclusive and racially equitable field.

Anti-Black Racism and Power: Centering Black Scholars to Achieve Health Equity

In health equity research, anti-Black racism and power imbalances manifest at every phase of the research process and contribute to the marginalization and exclusion of Black scholars. This essay highlights how power operates as a central component of anti-Black racism, and I describe the importance of centering Black scholars in funding, conducting, and implementing health equity research. Interdisciplinary collaboration between the fields of bioethics, public health ethics, and health equity could generate dialogue and develop recommendations to help balance power dynamics, address anti-Black racism, and, ultimately, make meaningful progress toward health equity.

The Bottleneck Metaphor of Leadership Culture: How Shared Understandings About Leadership Develop in Groups and Impede Diversity and Effectiveness of Leaders

There are two big problems related to leadership today: unequal representation and high failure rates among leaders. This conceptual paper argues that commonly shared values, assumptions, and beliefs about leadership, i.e., universal leadership culture, are the common cause of both problems. After the concepts and levels related to leadership culture were explained, we introduce a multilevel, multi-actor process model named the bottleneck metaphor of leadership culture. This metaphor describes how leadership cultures are co-constructed by multiple actors based on their involvement in leader selection and reproduce themselves in groups over time based on emergent leaders' characteristics. Next, a diagnostic tool called “the leadership mirror” is proposed for organizations that want to assess their leadership culture's current state as a starting point for further interventions. Specific suggestions are made for various actors, ranging from individuals to organizations, for their possible roles in preventing undesired leadership cultures.