Black women in medical education publishing: Bibliometric and testimonio accounts using intersectionality methodology

Abstract

Introduction: Black women in academic medicine experience racial and gender discrimination with bias from colleagues, patients, and institutions, all while being tasked with improving a flawed system. Representation of Black women in medicine remains low, yet they bear the burden of fostering diversity and mentoring trainees, exacerbating their minority tax and emotional labor, and negatively impacting their career progression. This study seeks to examine how epistemic oppression-reduced access to knowledge consumption and creation-manifests for Black women in medical education publishing. Methods: Adapting intersectionality methodology, we employed a bibliometric analysis of US-based journal articles published in 22 medical education journals between 2000 and 2020. Author race was determined using a probability-based algorithm incorporating US Census data, and author gender was ascribed based on Social Security Administration records. We conducted two negative binomial generalized linear models to estimate the average effect of epistemic oppression on Black women, from 2000-2020, by both first author publications and last author publications. Metadata for each article was retrieved from Web of Science and PubMed to include author names, country of institutional affiliation, and medical subject headings. Results: The analytic sample consisted of 21,945 unique authors. Overall, Black authors average only 9.0% of the analytic sample, whereas white authors average 69.3% of the analytic sample. Taken together, the analysis reveals that white women and men dominate publications, with Black women (and other racially minoritized groups) publishing far fewer first and last authors papers. In addition, major Medical Subject Headings used by Black women authors reveal little overlap of eminent (highly ranked) topics within medical education. Discussion: This research underscores the underrepresentation and epistemic oppression of Black women in medical education publishing, stemming from several forms of epistemic injustice. To address these challenges, we advocate for changes within the publishing ecosystem to address these disparities, as we believe that dismantling these oppressive structures is imperative for achieving equity and inclusivity in academic medicine. Additionally, we believe that qualitative research is needed to complement these quantitative findings and provide a more holistic perspective on Black women's experiences in the publishing process.