The week of October 3, 2022 was a banner week for University of Utah Health Equity, Diversity, and Inclusion. Our author teams from across campus and the nation had five publications published in the same week. I was alerted to the situation by the Equity, Diversity, Inclusion and Anti-Racism Editor of Family Medicine, Dr. Octavia Amaechi who sent me a text saying we had three pieces in Family Medicine. She was also a fellow in the first cohort of Leadership Through Scholarship Fellowship (LTSF) which I run in collaboration with colleagues across the country at the Society of Teachers of Family Medicine. Since I was away most of September without an ability to review proofs, I was pleasantly surprised.
Our main article in Family Medicine is a qualitative study, based on reflections collected from the first cohort of the LTSF. We collaborated with Dr. Donna Ziegenfuss, who performed the qualitative analysis. While LTSF was originally designed to be a writing workshop, it became clear that the fellows found much more value in the program. I can still remember the first workshop in 2019, which was an exhilarating experience for me as a faculty member. We were fortunate that only after one year, our fellowship was selected to be a permanent offering for STFM members, and we have been funded by STFM and a grant from the American Board of Family Medicine ever since. I am very fond of this paper, as it is one of the very few where 100% of the respondents identify as underrepresented minority (URM) faculty in family medicine. It is our hope that more research regarding this group of faculty will elucidate the best practices for retention and recruitment of URM faculty in academic health sciences.
There are also two letters to the editor in the October 2022 edition of Family Medicine. One of them is authored by Kaden Jordan, a fourth-year medical student at the Spencer Fox Eccles School of Medicine at the University of Utah, who is applying to family medicine residencies. Rarely are medical students published, and even less frequently are they published as first authors. We are excited about the points Kaden made in his letter as well, reminding researchers that when doing surveys about equity, diversity and inclusion, the demographics of the respondent’s matter, and can affect the reliability of the data.
Dr. Guillaume’s piece on Cultural Competence truly does move the conversation on health equity. When cultural competence was first introduced, it rapidly was seen as a solution to growing health disparities among racial and ethnic groups in the United States. However, to date, cultural competency training has not been associated with patient outcomes. Dr. Guillaume teaches us that racial concordance (when the patient and providers share a race/ethnicity) is associated with greater acceptance of preventive measures, greater patient satisfaction and improved show rates. Her letter is a strong argument for increasing racial and ethnic diversity in all health professions.
In addition to the three pieces published in Family Medicine, PRiMER (Peer-reviewed Reports in Medical Education Research) invited our team to submit a manuscript encouraging new authors to write. It is called “Submit it Again! Lessons from Rejected Manuscripts.” As you know, we have an Equity, Diversity and Inclusion Librarian at the Eccles Health Sciences Library, Donna Baluchi, MLIS, who is a co-author on this piece. Her special talents also created the infographic that we would like everyone to use. This is the first time that we have our EDI librarian as a co-author, but she will be co-authoring most of the work that comes out of our office in the upcoming months.
Arguably the most important paper in the list is the paper entitled “Towards a Common Lexicon for Equity Diversity and Inclusion work in Academic Medicine." Our author team was originally invited to submit this manuscript to a different journal. The guest editors, the reviewers, and the editor of the journal reviewed the piece, but it was ultimately rejected. It is important to note that, during the review process, the original journal sent us reviews that were for another paper. We immediately re-submitted to BMC Medical Education, which has a higher impact factor, and where our team has been honored for the most cited paper of 2015, “Addressing Disparities in Academic Medicine: What of the Minority Tax?” It is now published, with multiple authors from across health sciences and main campus. We hope that this work is widely shared within the department so that we can use the terms and solutions provided to establish equity in the spaces in which we work, play, and learn.
Differential rewarding of work and experience has been a longtime feature of academic medicine, resulting in a series of academic disparities. These disparities have been collectively called a cultural or minority “tax,” and, when considered beyond academic medicine, exist across all departments, colleges, and schools of institutions of higher learning–from health sciences to disciplines located on university campuses outside of medicine and health. A shared language can provide opportunities for those who champion this work to pool resources for larger impacts across the institution. This article aims to catalog the terms used across academic medicine disciplines to establish a common language describing the inequities experienced by Black, Latinx, American Indian/Alaska Native and Native Hawaiian/Other Pacific Islander, Women, and other underrepresented people as well as queer, disabled, and other historically marginalized or excluded groups. These ideas are specific to academic medicine in the United States, although many can be used in academic medicine in other countries. The terms were selected by a team of experts in equity, diversity, and inclusion, (EDI) who are considered national thought leaders in EDI and collectively have over 100 years of scholarship and experience in this area.
Authors
- José E. Rodríguez - University of Utah Health
- Edgar Figueroa - Weill Cornell Medicine
- Kendall M. Campbell - Department of Family Medicine, University of Texas Medical Branch
- Judy C. Washington - Overlook Hospital at Atlantic Health
- Octavia Amaechi - Spartanburg Regional Medical Center
- Tanya Anim - Lee Memorial Health and Florida State University
- Kari-Claudia Allen - Prisma Health/University of South Carolina School of Medicine
- Krys E. Foster - Sidney Kimmel Medical College at Thomas Jefferson University
- Maia Hightower - University of Utah Health
- Yury Parra - New York City Health and Hospitals
- Maria H. Wusu - Morehouse School of Medicine
- William A. Smith - Huntsman Mental Health Institute, University of Utah
- Mary Ann Villarreal - University of Utah Health
- Linda H. Pololi - The National Initiative on Gender, Culture and Leadership in Medicine: C-Change, Brandeis University
Rodríguez, J.E., Figueroa, E., Campbell, K.M. et al. Towards a common lexicon for equity, diversity, and inclusion work in academic medicine. BMC Med Educ 22, 703 (2022). https://doi.org/10.1186/s12909-022-03736-6
While there is increased attention to underrepresented in medicine (URiM) faculty and students, little is known about what they value in faculty development experiences. We performed a URiM-focused, 3-day family medicine faculty development program and then collected program evaluation forms. The program evaluations had open-ended questions and a reflection on the activity. We used inductive open coding using NVivo software. We analyzed open-ended responses and reflections, and identified themes. Although this faculty development experience was designed to teach writing skills to URiM junior faculty, their collective responses indicate that they found value beyond the skills taught and appreciated the approach taken in this activity.
Authors
- Krys E. Foster, MD, MPH - Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA<
- Juan Robles, MD - Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, NY
- Tanya Anim, MD - Department of Family Medicine, Lee Memorial Health and Florida State University, Ft. Meyers, FL
- Octavia Amaechi, MD - Department of Family Medicine, Spartanburg Regional Medical Center, Spartanburg, SC
- Kari-Claudia Allen, MD - Prisma Health-University of South Carolina Family Medicine Residency Program, Columbia, SC
- Yury Parra, MD - Department of Family Medicine, New York City Health and Hospitals, New York, NY
- Maria Harsha Wusu, MD, MSEd - Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA
- Donna Harp Ziegenfuss, EdD, MS - Marriott Library University of Utah, Salt Lake City, UT
- Kendall M. Campbell, MD - Brody School of Medicine, East Carolina University, Greenville, NC
- José E. Rodríguez, MD - Departments of Family Medicine and Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City
- Judy C. Washington, MD - Overlook Family Medicine Residency and Atlantic Medical Group at Atlantic Health, Morristown, NJ
Foster KE, Robles J, Anim T, et al. What Do Underrepresented in Medicine Junior Family Medicine Faculty Value From a Faculty Development Experience? Fam Med. 2022;54(9):729-733. https://doi.org/10.22454/FamMed.2022.895447.
Rejection of manuscripts by academic journals can be devastating for early-career family medicine faculty members. Taking experience from teaching early-career underrepresented in medicine faculty members writing and scholarship skills, we identify and explain five lessons to be learned from rejected manuscripts. The five lessons are: (1) rejections teach journal scope, (2) rejections teach process, (3) rejection should lead to resubmission, (4) rejections reflect writing effort, and (5) rejections happen to papers, not authors. Early-career family medicine faculty can use these lessons for reassurance and to adapt behaviors to remain in the scholarship arena.
Authors
- Kendall M. Campbell, MD - Department of Family Medicine, University of Texas Medical Branch, Galveston, TX
- Judy C. Washington, MD - Overlook Family Medicine Residency, Atlantic Medical Group at Atlantic Health, Morristown, NJ
- Donna Baluchi, MLIS - Eccles Health Sciences Library, University of Utah Health, Salt Lake City, UT
- José E. Rodríguez, MD - Department of Family and Preventive Medicine & University of Utah Health Equity Diversity and Inclusion, Salt Lake City
Campbell KM, Washington JC, Baluchi D, Rodríguez JE. Submit It Again! Learning From Rejected Manuscripts. PRiMER. 2022;6:42. https://doi.org/10.22454/PRiMER.2022.715584
Authored by Kaden Jordan, a fourth-year medical student at the Spencer Fox Eccles School of Medicine at the University of Utah, who is applying to family medicine residencies, reminding researchers that when doing surveys about equity, diversity and inclusion, the demographics of the respondent’s matter, and can affect the reliability of the data.
Authors
- Kaden Jordan - University of Utah School of Medicine, Salt Lake City
- José E. Rodríguez, MD - Departments of Family Medicine and Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City
Jordan K, Rodríguez JE. Residency Diversity Data Needed to Understand Reporting of Racism/Discrimination. Fam Med. 2022;54(9):748-749. https://doi.org/10.22454/FamMed.2022.789311.
Dr. Guillaume’s piece on Cultural Competence truly does move the conversation on health equity. When cultural competence was first introduced, it rapidly was seen as a solution to growing health disparities among racial and ethnic groups in the United States. However, to date, cultural competency training has not been associated with patient outcomes. Dr. Guillaume teaches us that racial concordance (when the patient and providers share a race/ethnicity) is associated with greater acceptance of preventive measures, greater patient satisfaction and improved show rates. Her letter is a strong argument for increasing racial and ethnic diversity in all health professions.
Authors
- Gina Guillaume, MD - North by Northeast Community Health Center, Portland, OR
- Juan Robles, MD - Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, NY
- José E. Rodríguez, MD - Departments of Family Medicine and Health Equity, Diversity and Inclusion, University of Utah Health, Salt Lake City
Guillaume G, Robles J, Rodríguez JE. Racial Concordance, Rather Than Cultural Competency Training, Can Change Outcomes. Fam Med. 2022;54(9):745-746. https://doi.org/10.22454/FamMed.2022.633693.
