Racism in Academic EM: Finding a Way Forward by Embracing Policies That Benefit Black Physician Recruitment and Retention
RACISM AS A PUBLIC HEALTH CRISIS
By Taneisha Wilson, MD, ScM and Elizabeth Goldberg, MD, ScM
14
After weeks of serving on the front line for COVID-19 and witnessing how Black Americans are disproportionately affected by the disease, the latest videos documenting police violence against Black Americans are too much to bear. We know that Black Americans have been subject to generations of racist policies — housing discrimination, educational segregation, disproportionate imprisonment — that have led to poor health. We also know that academic medicine is not devoid of racism. Under the hashtag #BlackintheIvory, academics have been sharing personal experiences from their professional lives that expose a system that needs repair. For us it starts with making sure medicine attracts the very people harmed by racist policies — Black Americans— so our patients can
be cared for by one of their own and equitable policies can emerge that are informed by physicians who share experiences with our patients. Unfortunately, although 14 percent of Americans are Black, Blacks make up only four percent of physicians.
In addition, the cost of the medical admission test and medical school applications can run upward of $10,000 — an amount which is prohibitive to many families due to a lack of generational wealth from decades of discriminatory policies.
Three Ways We Can Change This Legacy
Empirical research also shows that implicit bias is pervasive in letters of recommendation, where Blacks are more likely to be described as “competent” compared to their white peers who are “stand-out.” In addition, membership in Alpha Omega Alpha, the honor medical society, is more likely to be bestowed upon whites even when controlled for test performance, and we’re going in the wrong direction. Sadly, there were more Blacks in Alpha Omega Alpha in 1985 (1.4 percent) than there were in 2015 (0.7 percent). White physician mentors, educators, and
1. Barriers to recruiting Black physicians should be lifted. Meaningful change cannot occur without incorporating the voices of Black Americans in medicine; unfortunately, current structures make the pursuit of medicine all but impossible for most Black adults. To apply to medical school, you must first be admitted to college — a tremendous feat considering that most African Americans attend low-income underperforming public schools.