Equitable and inclusive representation of diverse groups historically underrepresented in science and medicine—including women, racial/ethnic minorities, and persons with disabilities1 (hereafter referred to as faculty from underrepresented groups [URGs])—is vital for the advancement of health, scientific discovery, and education. The retention and advancement of faculty from URGs is necessary not only to redress known inequities in academia but also because, together, people with dissimilar perspectives and histories develop more effective solutions to intractable problems.2 Further, a diverse faculty better reflects the communities and patients that those of us in academic medicine serve. Recognizing this reality, many institutions have developed strategic plans with a focus on diversity and inclusion, but well-intentioned institutional efforts to foster more diversity and inclusion may have the unintended consequence of disproportionately burdening faculty from URGs with service. Many universities seek representation of diverse populations on committees, yet the low number of faculty members from URGs creates a “supply–demand” mismatch that overburdens faculty from URGs relative to their majority counterparts.3–5 Being overburdened with service may contribute to a negative cycle in which faculty from URGs do not progress at the same level as their peers from majority groups and, ultimately, leave the academy, which in turn further exacerbates the inequities that exist in academic medicine (e.g., fewer faculty from URGs in higher ranks or leadership positions). This so-termed “minority tax” usually refers to people from racial/ethnic minority groups6,7 but is also relevant to others, including women and those who have disabilities. Further, this “minority tax” extends beyond committee work to include disproportionate mentoring demands,8,9 especially of students, other trainees, and new faculty from URGs. The minority tax is even greater for individuals who exist at the intersection of multiple URGs—for example, women of color.5 To illustrate, data suggest that, compared with men of color, women of color receive more service requests and engage in service that requires more time.10,11
Institutional service is a part of academic “citizenship,” and benefits of this work accrue not only to institutions but also, importantly, to the faculty who provide the service, including faculty from URGs. Faculty from URGs often want to participate in service activities, and they feel a sense of duty to ensure that diverse interests are represented, especially in areas relevant both to the institution and to URGs (e.g., promotion and tenure, hiring professionals and admitting students, mentoring and supporting students and others from URGs).6,12 Additionally, the institution benefits from convening groups whose members represent a large range of viewpoints. That is, having faculty members with diverse perspectives and backgrounds tackle important, complex problems leads to better, more creative and comprehensive solutions.2 Despite this added value for the institution and personal satisfaction for faculty from URGs, service is problematic when it becomes disproportionate relative to the scholarly productivity required to attain tenure, promotion, and other benchmarks of academic success. Although the risk of becoming overburdened with service exists for all early-career faculty, those from URGs are particularly vulnerable given the supply–demand mismatch. Thus, it is critical to provide faculty from URGs with ways to strategically engage in service—strategies that, often part of a tacit knowledge base in majority networks, may not be inherently accessible to individuals from URGs.
Recognizing this need to share strategies for success, we offer recommendations for institutional leaders and for early-career faculty from URGs. We hope our strategies help faculty members from URGs advantageously engage in service activities that will advance not only the mission of the institution but also their own goals and aspirations. The perspectives and ideas we offer are the result of convening a small group of multidisciplinary faculty from URGs from institutions across the United States. We were selected to participate in a career development program, funded by the National Heart, Lung, and Blood Institute, called “Programs to Increase Diversity Among Individuals Engaged in Health-Related Research” (PRIDE). Our PRIDE program site at the University of California, San Francisco, which focused on the implementation of evidence-based research, was called “Research in Implementation Science for Equity” (RISE). Scholars in PRIDE-RISE received structured mentorship and guidance, including from senior faculty and administrators (e.g., professors, a dean, a center director)—also from URGs—who are recognized leaders within and beyond their institutions in the field of health equity. As individuals from differing racial/ethnic backgrounds, with diverse physical disabilities, and of different sexes, we were each keenly aware of our own individual experiences, including both triumphs and challenges, in navigating academia. It was not until we all came together that the power of sharing our collective experiences during career development workshops became evident. Through discussions with senior faculty members and administrators, structured exercises to evaluate and better understand our work environments, and peer mentoring, we emerged with the following: (1) affirmation that our individual experiences as faculty from URGs were not unique—that is, that other individuals from URGs were having the same experiences, and we were not alone; (2) strategies to promote scholarly productivity, including ways to avoid burnout from the minority tax; and (3) a sense of duty to share insights from our training with the broader academic community.
We argue that balancing academic citizenship with their own scholarship requires early-career faculty from URGs to engage strategically in service opportunities. We also urge institutional leaders and mentors to recognize this unique challenge and protect faculty from URGs from disproportionate service demands while also prioritizing service opportunities that are vital for each faculty member’s individual career development and promotion. Here, we offer practical recommendations aimed at balancing the needs of early-career faculty from URGs and institutional leaders alike. Although we developed these strategies with early-career faculty from URGs in mind (given the documented impact of the minority tax), we believe they are relevant to all academic faculty.
Awareness and Action: Recommendations for Institutional Leaders
Given the tremendous investment that institutions make to recruit early-career faculty, it is advantageous for institutional leaders to ensure that all these new faculty members succeed. Here we define leaders as anyone who is in a position to influence the academic environment for early-career faculty—that is, deans, department chairs, division directors or chiefs, and any administrators focused on faculty development. To create an environment where faculty from URGs can be successful, leaders must be aware of—and implement solutions to—common pitfalls these faculty face (e.g., overcommitting to service activities). Although we recognize that balancing the institution’s need for diverse representation in service activities with the individual needs of faculty members from URGs may be challenging, we suggest that these needs are synergistic. The institution benefits from having broader perspectives on committees and in working toward important goals, and the individual benefits from being a part of and contributing to a more diverse and inclusive environment. Similarly, both the institution and the individual faculty member benefit from addressing the professional needs of the individual. This mutual benefit contributes to the success and retention of faculty from URGs, which in turn mitigates the supply–demand mismatch that has historically led to overburdening individuals from URGs. Given the cyclical nature of the needs of the institution and the individual faculty member, the academic medicine community must explore ways to be more strategic both in how it engages faculty from URGs in service activities and in how it provides tangible support for these faculty, commensurate with their service contributions.
We propose the following recom mendations as starting points for leaders (see also List 1):
- Explicitly acknowledge that the minority tax exists, and be transparent about when invitations for service are being issued to meet institutional mandates for diversity. Consider obtaining advice about how to speak honestly about the minority tax issue from professional coaches or from colleagues who have been successful in this arena. Although potentially uncomfortable, such acknowledgment and transparency foster deeper trust and validate the experiences of faculty from URGs.
- Build a critical mass—at all levels of the institution—of faculty from URGs. This requires ongoing introspection and action. One expert on cultural diversity in higher education, Aldemaro Romero Jr,13 has outlined best practices for recruiting, retaining, and promoting diversity; highlights include conducting climate assessment studies, developing fair and sound search processes, “hiring more than one diverse person at a time,” corralling adequate funding from varied sources, and gathering and evaluating quantitative and qualitative retention data. Additionally, he recommends offering robust mentoring programs and leadership opportunities.13 Intentionally recruiting and working to retain faculty from URGs will help produce an adequate number of faculty from URGs to fulfill the many service needs of the institution without overburdening a few individuals.12
- Create a culture that encourages all early-career faculty to protect their time by strategically engaging in service activities. Instead of fostering an environment where appearing to be “busy” is celebrated, encourage faculty to be judicious about their choices to maximize productivity and impact. Be explicit with faculty from URGs about the value of their diverse perspectives and how these perspectives may be in high demand. Be transparent about the disproportionately high number of service requests that they may receive because of their comparatively smaller number.
- Consider equity in service commitments as an indicator of the “health” of the department. For each faculty member, document and monitor service- and mentorship-related activities on an annual basis (in the same way that publications and presentations are tracked), use this information to identify where inequities exist, and rectify them. Ensuring equity entails not only recognizing the broad types of institutional and community activities in which faculty from URGs engage but also assigning proper value to those activities when considering individual faculty members for promotion and/or tenure.
- Recognize the unique challenges faculty from URGs face when navigating service and mentorship requests. Consider implementing mechanisms by which faculty from URGs can secure additional resources for support as they help the institution fulfill diversity mandates for service. For example, provide overtaxed faculty members with either administrative support staff or protected time for engaging in extra service activities. Another possibility (being piloted at one of our institutions) is to provide funding, based on a successful application, to support, specifically, faculty from URGs who mentor and engage in other activities; such funding is designed expressly to mitigate the effects of the minority tax.
- Provide training to faculty on mentoring students from URGs, so that mentoring within and across racial/ethnic lines can occur more frequently and effectively.14 This faculty development may include training faculty from majority groups to acknowledge and understand the challenges more frequently experienced by individuals from URGs (e.g., stereotype threat, social isolation).15
Strategic Service: Recommendations for Early-Career Faculty From URGs
Service is essential to career development, but should be undertaken strategically. When evaluating service requests, faculty from URGs may benefit from deferring their response and, instead, offering a timeline for communicating a decision (e.g., within 72 hours). The time may be useful for gathering as many details as possible about the responsibilities, benefits, and downsides involved in the service work. We recommend taking time to carefully consider the request in consultation with trusted colleagues within and outside the institution. An insider’s perspective is critical for understanding relevant institutional politics and culture, whereas an outsider’s perspective offers an unbiased opinion in a broader context. We advise faculty from URGs to carefully consider the answers to the following questions before agreeing to an invitation to serve (see also List 2):
- Does the work align with your research and/or career goals? Does the work present an opportunity to develop a skill or relationship that facilitates reaching these goals? An individual development plan (IDP) outlining career and academic objectives, vetted by a department chair, chief, and/or mentor, can be an indispensable guidepost when evaluating this alignment. The IDP should be a working document that includes short-term objectives, long-term goals, educational and training activities, expected products, and a projected timeline.
- Will this work provide me with the opportunity to influence something that I value (e.g., serving on an admissions committee and influencing the pipeline of students from URGs)? This question shifts the request, especially for an early-career faculty member from a URG, from simply fulfilling a service requirement to demonstrating agency.16
- What are the risks of declining the service opportunity? This question emphasizes the role a trusted colleague, especially within the institution, plays in navigating institutional culture and mitigating risks.
If a faculty member does accept the service opportunity, “negotiating the yes” is vital. First, clarify the time commitment and expectations. Second, whenever possible, to avoid burnout, negotiate a reasonable transition out of other service and/or mentoring commitments while maintaining a spirit of collegiality and cooperation.
Undoubtedly, there will be situations when the service opportunity is not a good fit. Yet saying “no” to any request, especially from a senior colleague, can be challenging. Learning how to graciously decline is vital. Some faculty from URGs in this situation have successfully declined, saying, for example, “I do not have the capacity to add more commitments at this time.” Following this with a concrete rationale for the decision may help maintain collegial relationships: “Agreeing to this will detract from my writing and research priorities, which we agreed are critical for my career development.” Although less ideal, it can be expedient and self-protective for early-career faculty members from URGs to attribute the decision to decline to the recommendation of someone more senior (e.g., mentor, chair, dean) or even to allow a senior mentor to say “no” in their stead.
While we (and others) have suggested that the impact of the minority tax might be mitigated by institutions giving service a higher value or weight when considering the promotion, tenure, and overall productivity of a faculty member, shifting the long-standing academic culture that values grant funding and publications over service is a challenging goal that will require buy-in at an institutional level and notable time to achieve. In the meantime, understanding how to be strategic and how to value and balance service and personal career goals is a necessary skill for individual faculty members from URGs to cultivate in order to be successful in the academy. Likewise, senior leaders must be strategic in how they achieve diversity and inclusion goals without imposing a disproportionate burden of service on faculty from URGs. This balance can be achieved through awareness, strategic engagement, and a commitment to equitable service considerations. This will allow early-career faculty from URGs the coveted opportunity to contribute to the service mission of the institution without sacrificing their own commitments to the missions of research, teaching, and clinical care.
Recommendations for Leaders of Academic Medical Centers Who Want to Help Protect Faculty From Underrepresented Groups (URGs) From Overcommitting to Service
- Explicitly acknowledge and address the minority tax.
- Build a critical mass of faculty from underrepresented groups.
- Create a culture that encourages faculty to strategically engage in service activities.
- Document and monitor the service activities of each faculty member to evaluate for equity.
- Recognize the unique challenges related to service requests experienced by faculty from URGs, especially those with intersecting identities (e.g., women of color).
- Provide training to faculty on effective mentoring of students from URGs.
Strategies for Considering Service Opportunities for Early-Career Faculty From Underrepresented Groups
- Gather facts about the request and seek perspectives from colleagues both within and outside the institution.
- Evaluate the request by asking whether the work aligns with research/career goals, whether it provides an opportunity to influence something of value, and what the risks of declining are.
- Negotiate the yes by establishing expectations regarding the work and relinquishing other duties.
- When declining, remain collegial and describe the rationale for opting out.
- Seek guidance and support from senior mentors.
The authors wish to thank the National Heart, Lung, and Blood Institute–funded Programs to Increase Diversity Among Individuals Engaged in Health-Related Research (PRIDE) and the Research in Implementation Sciences for Equity (RISE) program at the University of California, San Francisco, for convening the cohort of scholars that contributed to this Invited Commentary. The authors specifically thank their mentors and the RISE principal investigators—Kirsten Bibbins-Domingo, PhD, MD, MAS; Alicia Fernandez, MD; Margaret Handley, PhD, MPH; and Adithya Cattamanchi, MD—for their intellectual and emotional support throughout the conceptualization and development of this commentary. The authors also thank their RISE colleague Nathalie Moise, MD, MS, for her critical review of this Invited Commentary.
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