Learning From the Past and Working in the Present to Create an Antiracist Future for Academic Medicine (original) (raw)

Abstract

The members of the Academic Medicine Editorial Board with lived experiences of racism were invited to prepare this editorial. The opinions expressed in this editorial do not necessarily reflect the opinions of the AAMC or its members. Funding/Support: A.K.K. receives funding from the F.M. Hill Foundation of Women's College Hospital. Other disclosures: C.L.B. has intellectual property in and receives royalties from BioFire Diagnostics through the University of Utah Foundation and serves as a scientific advisor for IDbyDNA. Neither is related to the current work.

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References (74)

  1. Wear D, Zarconi J, Aultman JM, Chyatte MR, Kumagai AK. Remembering Freddie Gray: Medical education for social justice. Acad Med. 2017;923:312-317.
  2. Yancy CW. Academic medicine and Black Lives Matter: Time for deep listening. JAMA. 2020;324:435-436.
  3. Philimon W. Not just George Floyd: Police departments have 400-year history of racism. USA Today. Published June 7, 2020. https://www.usatoday.com/story/news/nation/2020/06/07/black-lives-matters-police- departments-have-long-history-racism/3128167001/. Accessed September 3, 2020.
  4. Edwards F, Lee H, Esposito M. Risk of being killed by police use of force in the United States by age, race-ethnicity, and sex. Proc Natl Acad Sci U S A. 2019;116:16793-16798.
  5. Kish-Gephart JJ, Harrison DA, Treviño LK. Bad apples, bad cases, and bad barrels: Meta- analytic evidence about sources of unethical decisions at work. J Applied Psych. 2010;95:1- 31.
  6. Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: The National Academies Press; 2003.
  7. Report of the Secretary's Task Force on Black and Minority Health. Washington, DC: U.S. Department of Health and Human Services; 1985.
  8. Bourdieu P, Thompson JB. Language and Symbolic Power. Cambridge, MA: Harvard University Press; 1991.
  9. Sharma M, Pinto AD, Kumagai AK. Teaching the social determinants of health: A path to equity or a road to nowhere? Acad Med. 2018;93:25-30.
  10. Flexner A. Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching. Bulletin No. 4. Boston, MA: Updyke; 1910.
  11. Johnston GA. The Flexner Report and Black medical schools. J Natl Med Assoc. 1984;76: 223-225.
  12. Miller LE, Weiss RM. Revising Black medical school extinctions. J Hist Med Allied Sci. 2012;67:217-243.
  13. Harley EH. The forgotten history of defunct Black medical schools in the 19th and 20th centuries and the impact of the Flexner Report. J Natl Med Assoc. 2006;98:1425-1429.
  14. American Medical Association. The history of African Americans and organized medicine. AMA History. January 24, 2020. https://www.ama-assn.org/about/ama-history/history- african-americans-and-organized-medicine. Accessed August 26, 2020.
  15. Washington HA, Baker RB, Olakanmi O, et al. Segregation, civil rights, and health disparities: The legacy of African American physicians and organized medicine, 1910-1968. J Natl Med Assoc. 2009;101:513-527.
  16. Ansell DA, McDonald EK. Bias, Black lives, and academic medicine. New Engl J Med. 2015;372:1087-1089.
  17. Issaka RB. Good for us all. JAMA. 2020;324:556-557.
  18. Montenegro RE. My name is not "interpreter." JAMA. 2020;323:1700-1701.
  19. Tweedy D. Black Man in a White Coat: A Doctor's Reflections on Race and Medicine. London, England: Picador; 2015.
  20. Green CR, McCullough WR, Hawley JC. Visiting Black patients: Racial disparities in security standby requests at an academic medical center. J Natl Med Assoc. 2018;110:37-43.
  21. Nivet MA. Minorities in academic medicine: A review of the literature. J Vasc Surgery. 2010;51:53S-58S.
  22. Xierali IM, Fair MA, Nivet MA. Faculty Diversity in U.S. Medical Schools: Progress and Gaps Coexist. Analysis in Brief. 2016;1-3.
  23. Fischbach RL, Hunt M. "Behind every problem lies an opportunity": Meeting the challenge of diversity in medical schools. J Womens Health Gend Based Med. 1999;8:1240-1247.
  24. Terrell C, Beaudreau J. 3000 by 2000 and beyond: Next steps for promoting diversity in the health professions. J Dental Educ. 2003;67:1048-1052.
  25. Nickens HW, Ready TP, Petersdorf RG. Project 3000 by 2000 --Racial and ethnic diversity in U.S. medical schools. N Engl J Med. 1994;331:472-476.
  26. Association of American Medical Colleges. Figure 15. Percentage of full-time U.S. medical school faculty by race/ethnicity, 2018. Published December 31, 2018. https://www.aamc.org/data-reports/workforce/interactive-data/figure-15-percentage-full- time-us-medical-school-faculty-race/ethnicity-2018. Accessed September 3, 2020.
  27. Filut A, Carnes M. Will losing Black physicians be a consequence of the COVID-19 pandemic? [published online ahead-of-print July 28, 2020].
  28. Acad Med.
  29. Campbell KM, Hudson BD, Tumin D. Releasing the net to promote minority faculty success in academic medicine. J Racial Ethn Health Disparities. 2020;7:202-206.
  30. Carson TL, Aguilera A, Brown SD, et al. A seat at the table: Strategic engagement in service activities for early-career faculty from underrepresented groups in the academy. Acad Med. 2019;94:1089-1093.
  31. Osseo-Asare A, Balasuriya L, Huot SJ, et al. Minority resident physicians' views on the role of race/ethnicity in their training experiences in the workplace. JAMA Netw Open. 2018;1:e182723.
  32. Rodríguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: What of the minority tax? BMC Med Educ. 2015;15:6.
  33. Campbell KM, Corral I, Linares JLI, Tumin D. Projected estimates of African American medical graduates of closed historically Black medical schools. JAMA Netw Open. 2020;3:e2015220.
  34. Fanon F. Black Skin, White Masks. New York, NY: Grove Press; 1952.
  35. Poon S, Nellans K, Rothman A, et al. Underrepresented minority applicants are competitive for orthopaedic surgery residency programs, but enter residency at lower rates. J Am Acad Orthop Surg. 2019;27:e957-e968.
  36. Gregg J, Saha S. Losing culture on the way to competence: The use and misuse of culture in medical education. Acad Med. 2006;81:542-547.
  37. Beagan BL. 'Is this worth getting into a big fuss over?' Everyday racism in medical school. Med Educ. 2003;37:852-860.
  38. Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016;113:4296-4301.
  39. McFarling UL. Dermatology faces a reckoning: Lack of darker skin in textbooks and journals harms care for patients of color. STAT. July 21, 2020. https://www.statnews.com/2020/07/21/dermatology-faces-reckoning-lack-of-darker-skin-in- textbooks-journals-harms-patients-of-color/. Accessed August 26, 2020.
  40. Nolen L. How medical education is missing the bull's-eye. N Engl J Med. 2020;382:2489- 2491.
  41. Harris S. Medical Student Creates Handbook of Critical Signs on Black and Brown Skin. Medscape. Published July 14, 2020. https://www.medscape.com/viewarticle/933875\. Accessed September 4, 2020.
  42. Nieblas-Bedolla E, Christophers B, Niknski NT, Schumann PD, Stein, E. Changing how race is portrayed in medical education: Recommendations from medical students [published online ahead-of-print May 5, 2020]. Acad Med.
  43. Skloot R. The Immortal Life of Henrietta Lacks. New York, NY: Crown Publishing; 2010.
  44. Hoppe TA, Litovitz, A, Willis KA, et al. Topic choice contributes to lower rate of NIH awards to African-American/Black scientists. Sci Adv. 2019;5:eaaw7238.
  45. Ginther DK, Schaffer WT, Schnell J, et al. Race, ethnicity and NIH research awards. Science. 2011;333:1015-1019.
  46. Hofstra B, Kulkarni VV, Munoz-Najar Galvez S, He B, Jurafsky D, McFarland DA. The diversity-innovation paradox in science. Proc Natl Acad Sci U S A. 2020;117:9284-9291.
  47. Bickler PE, Feiner JR, Severinghaus JW. Effects of skin pigmentation on pulse oximeter accuracy at low saturation anesthesiology. 2005;102:715-719.
  48. Moran-Thomas A. How a popular medical device encodes racial bias. Boston Review. August 5, 2020. http://bostonreview.net/science-nature-race/amy-moran-thomas-how- popular-medical-device-encodes-racial-bias. Accessed August 26, 2020.
  49. Obermeyer Z, Powers B, Vogeli C, Mullainathan S. Dissecting racial bias in an algorithm used to manage the health of populations. Science. 2019;366:447-453.
  50. Behera A, Tan J, Erickson H. Diversity and the next generation of physician scientists. J Clin Transl Sci. 2019;3:47-49.
  51. King CJ, Redwood, Y. The health care institution, population health and Black lives. J Natl Med Assoc. 2016;108:131-136.
  52. Liao Y, Bang D, Cosgrove S, et al. Surveillance of health status in minority communities --- Racial and Ethnic Approaches to Community Health Across the U.S. (REACH U.S.) Risk Factor Survey, United States, 2009. MMWR Surveill Summ. 2011;60:1-44.
  53. Blumenthal D, Fowler EJ, Abrams M, Collins SR. COVID-19 -Implications for the health care system [published online ahead of print July 23, 2020].
  54. N Engl J Med.
  55. Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and mortality among Black patients and White patients with COVID-19. N Engl J Med. 2020;382:2534-2543.
  56. Gold JAW, Wong KK, Szabelwski CM, et al. Characteristics and clinical outcomes of adult patients hospitalized with COVID-19 -Georgia, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69:545-550.
  57. The COVID Tracking Project. The Atlantic. covidtracking.com. Accessed August 11, 2020.
  58. Coronavirus (COVID-19). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/index.html. Accessed August 11, 2020.
  59. Oppel Jr. RA, Gebeloff R, Lai KKR, Wright W, Smith M. The fullest look yet at the racial inequity of coronavirus. The New York Times. July 5, 2020. https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-african-americans- cdc-data.html. Accessed August 11, 2020.
  60. Wrigley-Field E. US racial inequality may be as deadly as COVID-19. Proc Natl Acad Sci U S A. 2020;24:202014750.
  61. Deming WE. The New Economics: For Industry, Government, Education. 2nd ed. Cambridge, MA: MIT Press; 2000.
  62. Dweck CS. Mindset: The New Psychology of Success. New York, NY: Random House; 2006.
  63. Ashburn-Nardo L, Morris KA, Goodwin SA. The confronting prejudiced responses (CPR) model: Applying CPR in organizations. Acad Manage Learn Educ. 2017;7:332-342.
  64. Doll KM, Thomas CR, Jr. Structural solutions for the rarest of the rare -Underrepresented- minority faculty in medical subspecialties. N Engl J Med. 2020;383:283-285.
  65. White Coats For Black Lives. About WC4BL. https://whitecoats4blacklives.org/about/. Accessed August 26, 2020.
  66. Charles D, Himmelstein K, Keenan W, Barcelo N. White Coats for Black Lives: Medical students responding to racism and police brutality. J Urban Health. 2015;92:1007-1010.
  67. Berwick DM. The moral determinants of health. JAMA. 2020;324:225-226.
  68. Mullan F, Chen C, Petterson S, Kolsky G, Spagnola M. The social mission of medical education: Ranking the schools. Ann Intern Med. 2010;152:804-811.
  69. Kaplan SE, Raj A, Carr PL, Terrin N, Breeze JL, Freund KM. Race/ethnicity and success in academic medicine: Findings from a longitudinal multi-institutional study. Acad Med. 2018;93:616-622.
  70. Lett LA, Orji WU, Sebro R. Declining racial and ethnic representation in clinical academic medicine: A longitudinal study of 16 US medical specialties. PLoS One. 2018;13:e0207274.
  71. Swarns RL. Is Georgetown's $400,000 plan to aid slave descendants enough? The New York Times. October 30, 2019. https://www.nytimes.com/2019/10/30/us/georgetown-slavery- reparations.html. Accessed August 26, 2020.
  72. Ci Corpo R. Georgetown reparations plan for slaves sold by university draws criticism from students. America: The Jesuit Review. November 4, 2019. https://www.americamagazine.org/politics-society/2019/11/04/georgetown-reparations-plan- slaves-sold-university-draws-criticism. Accessed August 26, 2020.
  73. Editorial: SNMA portends a great future for NMA. J Natl Med Assoc. 1975;67:318,334.
  74. Parker T. Ten Sermons of Religion. III. Of Justice and the Conscience. In: The Collected Works of Theodore Parker. Cobbe FP, ed. London, England: Trübner & Co, Ludgate Hill; 1879.