ABSTRACT
Background
Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles.
Objective
The study’s purpose was to document URM faculty perceptions and experience of the culture of academic medicine in the US and to raise awareness of obstacles to achieving the goal of having people of color in positions of leadership in academic medicine.
Design
The authors conducted a qualitative interview study in 2006–2007 of faculty in five US medical schools chosen for their diverse regional and organizational attributes.
Participants
Using purposeful sampling of medical faculty, 96 faculty were interviewed from four different career stages (early, plateaued, leaders and left academic medicine) and diverse specialties with an oversampling of URM faculty.
Approach
We identified patterns and themes emergent in the coded data. Analysis was inductive and data driven.
Results
Predominant themes underscored during analyses regarding the experience of URM faculty were: difficulty of cross-cultural relationships; isolation and feeling invisible; lack of mentoring, role models and social capital; disrespect, overt and covert bias/discrimination; different performance expectations related to race/ethnicity; devaluing of research on community health care and health disparities; the unfair burden of being identified with affirmative action and responsibility for diversity efforts; leadership’s role in diversity goals; and financial hardship.
Conclusions
Achieving an inclusive culture for diverse medical school faculty would help meet the mission of academic medicine to train a physician and research workforce that meets the disparate needs of our multicultural society. Medical school leaders need to value the inclusion of URM faculty. Failure to fully engage the skills and insights of URM faculty impairs our ability to provide the best science, education or medical care.
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ACKNOWLEDGMENTS
The authors gratefully acknowledge the critical funding support of the Josiah Macy, Jr., Foundation and the supplemental funds to support data analysis provided by the US Office of Public Health and Science, Office on Women’s Health and Office on Minority Health; the National Institutes of Health, Office of Research on Women’s Health; the Agency for Healthcare Research and Quality; the Centers of Disease Control and Prevention, and the Health Resources and Services Administration (contract: HHSP233200700556P). The authors thank Peter Conrad and Sharon Knight, who participated in data collection and data coding, and Kerri O’Connor for manuscript preparation. The authors are indebted to the medical faculty who generously shared their experiences in the interviews.
Contributors
Specific Contributions From Each Author
Pololi: conception, design, data collection, analysis and interpretation, drafting the article, final approval.
Cooper: analysis and interpretation, drafting the article, final approval.
Carr: data collection and coding, manuscript review, final approval.
Funders
United States Office of Public Health and Science, Office on Women’s Health, Contract: HHSP233200700556P
Josiah Macy, Jr. Foundation
Prior Presentations
Society of General Internal Medicine, 33rd Annual Meeting, 2010. Research plenary presentation.
Conflict of Interest
None disclosed.
Ethical Approval
Brandeis University Institutional Review Board for the protection of human subjects approved the study.
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Pololi, L., Cooper, L.A. & Carr, P. Race, Disadvantage and Faculty Experiences in Academic Medicine. J GEN INTERN MED 25, 1363–1369 (2010). https://doi.org/10.1007/s11606-010-1478-7
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DOI: https://doi.org/10.1007/s11606-010-1478-7