Recruitment of Black men and women into psychiatry requires those currently in the field to invest effort at multiple points along the workforce pipeline and, in light of the observation that numbers of Black women matriculants in medical school are increasing (though still insufficient), to explore how gender may shape experiences along this pipeline. Middle and high school students, who may be vulnerable to discrimination, limited exposure to career options, and other socioeconomic adversities that may derail future education, need to be encouraged to pursue careers in health care. Examples of these programs include the Health Professions Recruitment and Exposure Program (HPREP) at institutions like University of Texas Southwestern, Yale, and University of Chicago [12,13,14]. These pipeline programs introduce students to careers in medicine and provide the opportunity to network with medical students and attending physicians. College students will also benefit from mentoring and exposure to health care work opportunities. We would encourage academic psychiatrists to look not only at their undergraduate colleges affiliated with their institutions but also at other colleges surrounding their institutions. Bright, interested students of color may be close by and in need of mentoring and support. We encourage academic psychiatrists to look beyond the expected internal candidates.
A pressure to conform in medical school or to become part of the “culture of medicine” can diminish or quash a celebration of individual differences [15]. Students should not succumb to pressures to become a stereotypical doctor or to spend their lifetime becoming something they are not [16]. Professionalism is best served by a health care culture that is diverse, attentive, and responsive to the needs of patients from varying backgrounds. The hidden curriculum, with messages such as “don’t stand out,” “don’t make too much noise,” and “don’t be different from the other students,” can subvert individual differences and diminish the good that individuals can do in our field.
Humanities courses in medical school can serve as two-way conversations about race and culture. Examples of curricula on cultural humility, which promote discussions about race and which focus on addressing injustices and disparities in health care, should be shared as models for undergraduate and graduate medical education and faculty development [17,18,19]. Regional partnerships, such as one described by Harris et al. [20], can benefit trainees, faculty, and institutions alike. Partnerships should be fostered between academic psychiatry organizations, including the American Association of Directors of Psychiatric Residency Training and the Association of Directors of Medical Student Education in Psychiatry, and underrepresented minority medical student organizations, including the Student National Medical Association and the Latino Medical Student Association. Ongoing multi-organizational meetings and structures devoted to addressing bias in general are needed. Racial and ethnic bias is one part of the picture, but other kinds of bias exist, such as bias toward LGBTQ patients, patients with obesity, patients with substance use disorders, and patients with psychiatric conditions in general. Broadening awareness of the different varieties of implicit bias can foster a culture of acceptance and inclusion.
If the expectation that modeling and mentoring by current minority faculty are the only ways to recruit Black women and men into psychiatry, the current situation will only get worse for the specialty over time. Psychiatry simply does not have the number of minority faculty to meet the existing demands, and asking those faculty to do more of the same leads to burnout, disillusionment, and eventually attrition from academic careers. It is the very definition of the “minority tax” [21]: asking underrepresented minority faculty to take on higher burdens and presence simply because they are minority. One strategy is to provide protected time and relief from clinical productivity expectations or other routine duties to perform these essential tasks in education, mentoring, recruitment, and advocacy.
All interested psychiatrists from a variety of practices, settings, and subspecialties can assist with mentoring. Academic departments will need to invest in programs that mentor underrepresented minority faculty [22], including Black men and women, and perhaps access outside funding sources to do so. It cannot be up to underrepresented medical faculty alone to shoulder this burden, given the barriers already in place. All in the academic department will need to emphasize and bring to life cultural humility.
We value the current academic diversity within our midst because we believe that interaction with individuals from varied backgrounds and life experiences provides opportunities to achieve unique and creative approaches to medical education, research, and clinical care [23]. Academic programs and universities should identify and address barriers to the recruitment and retention of Black men and women. True and unwavering commitment to inclusiveness in academic psychiatry and efforts to ensure diversity in the pipeline for the field will enrich and strengthen the profession of medicine in the generations to come. Such commitment and efforts will also demonstrate integrity and consistency: the values that govern clinical and advocacy work in psychiatry also are expressed in our dedication to welcoming all people to be our colleagues—our teachers, mentors, learners, and collaborators—working shoulder to shoulder and fulfilling our responsibilities to our patients, to society, and to one another in academic medicine.