A few months back, a colleague emailed me an essay entitled “Medical Education and the Minority Tax” from the Journal of the American Medical Association. Since that time, the content of the essay has sparked interesting conversations.

This brief essay chronicles the perspective and journey of Kali D. Cyrus, MD, MPH who, at the time, was a psychiatry resident, and is now an assistant professor at Yale School of Medicine. She connects her readers with memories and the emotional exhaustion associated with being the “only one” and the presence of “otherness.” She specifically directs our attention to the “minority tax: the additional responsibilities placed on minority faculty to achieve diversity.” The essay goes on to connect her journeys in medicine to broader hurdles across institutions of higher education that have led to student movements and demands for action. Thereafter, she makes institutional and individual recommendations that may arguably lead to improvements in the “quality of life for minority stakeholders, the quality of medical education and the quality of patient care” and a relief from the “tax” burden that stifles the joys associated with work.

Institutional recommendations include:

  1. Diversification based on “ethnic background, income status, gender identity, sexual orientation and personal experience” of academic leadership.
  2. Institutional pledges to eliminate all forms of discrimination including education on microaggressions and implicit bias as well as reporting systems and community accountability.
  3. Institutional promotion of positive curiosity regarding otherness through curricular and research efforts.

Individual recommendations include:

  1. Increasing self-awareness by acknowledging our bias, taking steps to reflect upon how this influences our actions and working to undo its manifestations.
  2. Learning more about the history of discrimination by race, gender, sexual orientation, disability and citizenship status in conjunction with diversifying our sources of media exposure and facilitating this learning across staff, students, trainees and colleagues.
  3. Accountability through proactive means of monitoring our words and actions as well as challenging those in our sphere of influence and interaction.

Read the full article here:

http://jamanetwork.com/journals/jama/fullarticle/2625322

 

-Thomas K.M. Cudjoe, fellow in Geriatrics

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