To the Editor:
The Association of American Medical Colleges has recently publicized difficulties in recruiting black males into medicine and increasing medical school faculty diversity.1 Because these problems are long-standing, we should question whether there are behaviors in academic medicine that may sabotage its own efforts toward diversity and inclusion. Productivity expert Louise Penberthy cites three common behaviors, summarized here, that sabotage the retention of diverse talent:
- Discounting the perspective and contribution of your diverse talent.
- Giving positive feedback that does not come across as positive.
- Preventing diverse talent from speaking by starting to talk before they are finished.2
These behaviors have been shown to sabotage diversity efforts, making diverse talent feel undervalued, unneeded, and isolated. In academic medicine, underrepresented minority faculty have reported all three of these experiences.3,4
Diversity and inclusion councils have been instituted to increase diversity in medical colleges. They may comprise diverse groups of staff, students, faculty, and administrators, and while this approach is useful, it also has the potential to harm diversity efforts through “subordinate diversity.” Subordinate diversity is created when there is diversity among students and staff but not among faculty and senior-level administrators who sit on the same council. Difficult issues such as perceived mistreatment, inequities, and disparities are brought forth at meetings. Students and staff may fear reprimand or even mistreatment by their bosses, teachers, and administrators serving on the same council. Areas of potential improvement may be overlooked when students and staff are quiet in environments where their voices need and should be heard. Penberthy2 suggests as a solution that individuals resist the urge to:
- Explain how the world “works.”
- Tell them they’ve been “eloquent.”
- Start speaking before they’ve finished speaking.
Academic environments should work to ensure that students and staff have equal voice as faculty and administrators. It is important that we create an environment in which all voices can be heard and appreciated. Perhaps that way we can make some headway in diversifying our physician workforce and making high-quality, unbiased health care available to those who have been the victims of health disparities.
José E. Rodríguez, MD
Associate professor and codirector, Center for Underrepresented Minorities in Academic Medicine, Florida State University College of Medicine, Tallahassee, Florida; firstname.lastname@example.org.
Kendall M. Campbell, MD
Associate professor and codirector, Center for Underrepresented Minorities in Academic Medicine, Florida State University College of Medicine, Tallahassee, Florida.
1. Association of American Medical Colleges. Altering the Course: Black Males in Medicine. 2015. Washington, DC: Association of American Medical Colleges; https://members.aamc.org/eweb/upload/Black_Males_in_Medicine_Report_WEB.pdf
. Accessed April 28, 2016.
2. Penberthy L. Are you Unconsciously Sabotaging Your Efforts Towards Diversity? Productivity Mediation. July 22, 2015. http://www.productivitymediation.com/2015/07/dont-sabotage-diversity-efforts/
. Accessed April 28, 2016.
3. Carr PL, Palepu A, Szalacha L, Caswell C, Inui T. ‘Flying below the radar’: a qualitative study of minority experience and management of discrimination in academic medicine. Med Educ. 2007;41:601609.
4. Rodríguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: what of the minority tax? BMC Med Educ. 2015;15:6.