Changing the Face of American Medicine: AAMC Conference Addresses the Need to Diversify the Ranks of Medical School Faculty

Article excerpt

If the mission of the Association of American Medical Colleges is clear--"to change the face of medicine to reflect the face of America," said Dr. Charles Terrell, the group's vice president for diversity policy and programs, at the opening of AAMC's recent conference on career development for minority faculty--then another fact is equally clear: The barriers are high.

Racial and ethnic minorities--especially African-Americans, Latinos of Mexican American and Puerto Rican descent and American Indians--are a small proportion of academic faculty at U.S. medical schools, a proportion that appears to be growing at only a glacial pace, Terrell said. American academic medicine, he continued, seems to be "afraid of the dark."

Indeed, while Whites comprise 76.3 percent of the general population, they make up more than 79 percent of all medical faculty and nearly 89 percent of all full professors in academic medicine, said Dr. Denise Cora-Bramble, executive director of the Goldberg Center for Community Pediatric Health at Children's National Medical Center in Washington, D.C.

Minorities, meanwhile, are more than 23 percent of the population, but only hold 4.9 percent of all medical faculty positions and 2.2 percent of full-time positions.

None of this, of course, was exactly news to the men and women gathered at the Georgetown University conference center for AAMC's annual Minority Faculty Career Development Seminar.

The group--mostly composed of mid-career faculty but also including a sprinkling of senior faculty looking to improve the minority numbers at their academic organizations--nodded and sighed as conferees discussed the barriers facing people of color, including the low numbers in the pipeline, the desire to pay off school indebtedness and the lack of role models or mentors who could steer them to opportunities in academic medicine.

Even when minorities find their way into faculty ranks, "we're not happy campers," Cora-Bramble said. She ran off a quick list of reasons: lower rates of promotion experienced by under-represented minorities; "toxic" competitive environments where harassment and bias are the rule rather than the exception; the "Black tax" of committee assignments that eat up time that could be more profitably spent in research; and conflicting desires for career advancement and for a satisfying family life. The discussion of these issues and annoyances drew the strongest reactions from the audience at AAMC's conference.

But unlike other conferences on ethnic and racial disparities, the bad news was simply the place where the discussion began, a way of "keeping it real," said Cora-Bramble. For the two and a half days that followed, conference attendees received a crash course in navigating the tricky environment of academic medicine--both the rules of the game and the "hidden rules" that trip the unwary.

An essential first step was outlined by Dr. Valerie Williams, associate dean for faculty affairs at the University of Oklahoma College of Medicine and director of the Health Sciences Center Faculty Leadership Program: "You have to have a framework for your academic career," she said. "You have to be able to state clearly what your interest is, and you have to consider how you might share that with other people."

Indeed, she noted, many an academic career has gone off the rails for lack of a simple plan. "You don't want to end up with a life that is, in the words of Sir Walter Scott, 'unwept, unhonored and unsung,'" Williams said.

Career planning requires facing fundamental questions about one's relationship to academia. The questions can be as simple as, "How do I reasonably fit in?" or as complex as "How do I maintain my integrity around issues that are important to me?"

But Williams' concept of career planning begins with finding an individual's passion--that spark that brought them to medicine and kept them motivated during the long years of training. …