Identifying white privilege is the first step towards sharing its power. The challenge in its identification is that people who possess it are often oblivious to its existence . Raising the issues of racism and white privilege can elicit reactions of denial, hostility, anger, and violence . To overcome or circumvent these responses, multi-pronged approaches to addressing systems of white privilege have been developed over the last several decades. These include bias and cultural competency training, implicit association testing, and workshops on restorative justice. These sorts of workshops and trainings have been tailored for many venues, including the clinical environment, classroom education, faculty and staff hiring, and medical school admissions [13,14,15]. Once the power of white privilege is identified, it can be defined,harnessed and ultimately shared. We propose that sharing the power of white privilege can be done in positive ways that improve the representation of underrepresented groups in medicine and increase the support provided to members of underrepresented groups. Specifically, institutional leaders in academic medicine can share the power of white privilege at the level of a medical school or academic medical center, leveraging their own white privilege to foster greater inclusion and equity at all levels of the organization.
To develop strategies for sharing the power of white privilege, we first map manifestations of individual privilege, taken from the work of Dr. Peggy McIntosh [3, 16], onto opportunities for individual and institutional action in academic medicine (Table 1). For example, the individual privilege of being able to work alongside people of the same race can be shared by leaders in position to make hiring decisions, who can aim to hire more people of color. The power associated with this privilege can also be shared through institutional actions, such as cluster hiring of underrepresented minority faculty. A further challenge entails sharing institutional white privilege, since power accruing to an entire privileged institution can be shared only through the actions of the institution as a whole.
Specific institutional strategies to share the power of white privilege include PWIs initiating partnerships with minority-serving institutions [10, 17,18,19] to foster faculty collaboration as well as student growth and advancement. These partnerships can share privilege associated with PWIs’ historical advantage in financial resources and staffing. Recognizing that most medical school leaders are white men, who benefit from both white and male privilege, the leaders of PWI medical schools can collectively commit to lead and groom underrepresented minority faculty to take their place. In particular, they can intentionally coach and sponsor people with less power (underrepresented minorities) to take on key leadership roles, including senior leadership positions that have power and influence in the institution.
White privilege allows those who have it to ignore it, and it allows for experiences common to Black and other people of color to be overlooked. Personnel who participate in the application process at medical schools should explore the impact of social determinants of health, access to healthcare, and health outcomes of Black men , ensuring that allostatic load and ethno-historical trauma are addressed in medical education. A starting point would be learning about the damage white privilege can cause, including sources who speak of this from a white man’s perspective. [12, 21, 22] White privilege allows PWI leaders to insist on rigid “merit-based” admissions criteria, ensuring that admissions practices discriminate against applicants from disadvantaged backgrounds. It causes institutions to value accomplishments of applicants that are dependent on privilege. Faculty leaders can recognize this ingrained habit of blaming inequities (outcomes) on learners’ social, cultural, or educational backgrounds, and replace it with a practice of assigning academic value to life experience, including “distance traveled” for underrepresented minority students, as an essential component in a holistic admissions process.  This process should extend to undergraduate pre-medical advising, to overcome disparities in who is supported and encouraged to apply to medical school.
A common element of our suggestions is for academic medicine leaders to critically examine their institution’s policies and their own interactions with faculty and learners, asking themselves, “Are exclusionary practices operating here?”  Because white privilege allows current leadership of PWI medical schools to guide the direction of medical education in the future, leaders of these institutions can foster the elimination of entrenched biases, stereotypes, and discrimination. They can practice intentionality and critically examine and eliminate racist structures, policies, practices, embedded norms, and values that sustain inequities. In the near term, intentional conscious sharing of white privilege can improve institutions in many ways, from education, to patient care, to health outcomes. In the long term, the strategies we outline can become part of a blueprint for change in academic medical centers throughout the USA.