Racial Privilege and Medical Student Awards: Addressing Racial Disparities in Alpha Omega Alpha Honor Society Membership

Boatright, Dowin; O’Connor, Patrick G.; Miller, Jennifer E.

doi:10.1007/s11606-020-06161-x

Cited by 27 publications

(20 citation statements)

References 30 publications

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“…If merit criteria are subject to implicit biases and consistently reinforce exclusion, then it is important to re-evaluate these measures of merit and the culture that they perpetuate [11]. As an example, several studies have shown that racial and gender minorities are far less likely to receive awards such as National Institutes of Health research grants and medical society recognition than their White male counterparts [12,13]. Often the work of addressing health care disparities and community efforts that UiM groups may lean toward are undervalued as measures of academic accomplishment.…”

Section: Barriersmentioning

confidence: 99%

Underrepresentation in Oncology: Identifying and Addressing Structural Barriers

Owoyemi

Aakhus

2021

The Oncologist

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Underrepresentation of minority groups in the oncology physician workforce is a pressing issue that may contribute to disparities in cancer research, clinical care, and patient outcomes. To address this, we highlight the role of medical culture and institutions in perpetuating a range of barriers that lead to the persistent underrepresentation of minority medical trainees and physicians. These barriers include an exclusionary medical culture, bias in measures of merit, financial barriers to medical subspecialty training, underrecognition of achievement, and poor representation and satisfaction among underrepresented faculty. Furthermore, we suggest a more intentional approach to diversity that values both recruitment of underrepresented undergraduates and early medical students and retention of internal medicine trainees, hematology-oncology fellows, and faculty. To counteract deeply embedded structural racism that hampers diversity efforts, this multifaceted approach will require cultural transformation of our medical institutions at all levels, including increased institutional transparency, mandatory evidence-based bias training, acknowledgment of varied achievements, changes in recruitment practices, and reinvigoration of pipeline development programs with a focus on financial support. Taken in combination, programs should recognize the scope of deterrents to representation and develop program-specific, longitudinal interventions to promote more successful diversity initiatives within the field of oncology. The Oncologist 2021;26:630-634 Implications for Practice: The medical profession recognizes the value of physician workforce diversity in improving the quality of both medical education and patient care. In return, medical schools and training programs invest in recruitment programs focused on candidates who are underrepresented in medicine. In the field of oncology, where stark racial and ethnic disparities in care and health outcomes are well-defined, measures of minority physician representation remain especially stagnant. This study clearly defines the barriers that limit the effectiveness of such programs and provides recommendations to achieve the necessary workforce diversity in oncology.

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Section: Barriersmentioning

confidence: 99%

Underrepresentation in Oncology: Identifying and Addressing Structural Barriers

Owoyemi

Aakhus

2021

The Oncologist

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“…For example, significant differences in negative descriptive words on medical students’ evaluations have been found across different racial and gender groups ( 91 ). Membership in AOA, conferred to only 16% of each graduating medical school class, has effectively barred diversity in many specialties and may represent a longstanding form of structural racism ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs

Vela

Erondu

Smith

et al. 2022

Annu. Rev. Public Health

148

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Health care providers hold negative explicit and implicit biases against marginalized groups of people such as racial and ethnic minoritized populations. These biases permeate the health care system and affect patients via patient–clinician communication, clinical decision making, and institutionalized practices. Addressing bias remains a fundamental professional responsibility of those accountable for the health and wellness of our populations. Current interventions include instruction on the existence and harmful role of bias in perpetuating health disparities, as well as skills training for the management of bias. These interventions can raise awareness of provider bias and engage health care providers in establishing egalitarian goals for care delivery, but these changes are not sustained, and the interventions have not demonstrated change in behavior in the clinical or learning environment. Unfortunately, the efficacy of these interventions may be hampered by health care providers’ work and learning environments, which are rife with discriminatory practices that sustain the very biases US health care professions are seeking to diminish. We offer a conceptual model demonstrating that provider-level implicit bias interventions should be accompanied by interventions that systemically change structures inside and outside the health care system if the country is to succeed in influencing biases and reducing health inequities. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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“…We reiterate the authors' point: physician activistsskilled clinicians who challenge medical leadership and systems to dismantle racismface retaliation because neither nondominant cultural authenticity nor equity-focused advocacy are systematically valued in, incorporated into, or safeguarded by current medical professionalism standards.The Alpha Omega Alpha (AOA) Honor Society, medicine's elitist society, membership in which is by nomination only, publishes a highly referenced monograph of medical professionalism standards. 1 Racism currently limits Black representation to 3.6% of medical school faculty members, 2 and AOA membership further limits Black representation by being preferentially offered to economically privileged, White physicians 3,4,5 who may be unattuned to and are invulnerable to racism. The monograph's standards therefore center their dominant values and interests, even for minoritized and would-be activist physicians.…”

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confidence: 99%

“…The Alpha Omega Alpha (AOA) Honor Society, medicine's elitist society, membership in which is by nomination only, publishes a highly referenced monograph of medical professionalism standards. 1 Racism currently limits Black representation to 3.6% of medical school faculty members, 2 and AOA membership further limits Black representation by being preferentially offered to economically privileged, White physicians 3,4,5 who may be unattuned to and are invulnerable to racism. The monograph's standards therefore center their dominant values and interests, even for minoritized and would-be activist physicians.…”

mentioning

confidence: 99%

Response to “Should Clinicians Be Activists?”

2022

AMA Journal of Ethics

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s "Should Clinicians Be Activists?" highlights how physician activists risk retaliation from "economically and socially" privileged physician leaders and organizational leadership who "have been trained to comply" with structural inequity. We write as Black Yale medical faculty with personal and professional expertise in racial equity-focused advocacy. We reiterate the authors' point: physician activistsskilled clinicians who challenge medical leadership and systems to dismantle racismface retaliation because neither nondominant cultural authenticity nor equity-focused advocacy are systematically valued in, incorporated into, or safeguarded by current medical professionalism standards.The Alpha Omega Alpha (AOA) Honor Society, medicine's elitist society, membership in which is by nomination only, publishes a highly referenced monograph of medical professionalism standards. 1 Racism currently limits Black representation to 3.6% of medical school faculty members, 2 and AOA membership further limits Black representation by being preferentially offered to economically privileged, White physicians 3,4,5 who may be unattuned to and are invulnerable to racism. The monograph's standards therefore center their dominant values and interests, even for minoritized and would-be activist physicians. For example, this 171-page monograph implores "a commitment to service, altruism, and advocacy" 1 yet never even mentions the words race, racism, prejudice, or equity. These standards generated by predominately White physicians vaguely praise advocacy while failing to intentionally and explicitly denounce health care's own racism. Racial equity is literally omitted from medical professionalism, which places physicians who challenge health care's structural and cultural racism outside the accepted boundaries of "professional" behavior.

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Racial Privilege and Medical Student Awards: Addressing Racial Disparities in Alpha Omega Alpha Honor Society Membership

Cited by 27 publications

References 30 publications

Underrepresentation in Oncology: Identifying and Addressing Structural Barriers

Underrepresentation in Oncology: Identifying and Addressing Structural Barriers

Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs

Response to “Should Clinicians Be Activists?”

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