Survival tips for Underrepresented Minorities in Academic Medicine

Survival tips for Underrepresented Minorities in Academic Medicine José E Rodríguez MD, Kendall M Campbell MD, Lisa Johnson MD, Janet Townsend MD

Disclosures The authors have nothing to disclose

Objectives Upon completion of this session, participants will be able to: • Describe successful mentoring models for junior faculty (URMM and others) • List areas of academic practice that adversely affect URMM faculty • Identify specific ways URMM and other faculty can continue underserved practice • Define clinical legitimacy and its implications for URMM faculty

Tips • Taken from the 12 tips model in the medical teacher • Each tip addresses an issue, challenge, or advantage that URMM faculty may face or address • Tried to make the tips easy to remember— using alliteration and other techniques

Mentoring You need a mentor, but not a monster • URMM faculty frequently find themselves without mentors • Mentoring is associated with longevity in academic medicine and career satisfaction • A bad mentor (monster) – – Supervisor Gives non individualized advice Manipulates Asks for inappropriate things • URMM faculty don’t know what they don’t know – Leaves room for the monster to offer bad advice in the guise of “helping out. ”

Diversity Don’t forget that diversity is diluting • Medical colleges have many diversity efforts, but their URMM faculty are very few • They tend to put URMM faculty in all diversity efforts, thus diluting their ability to work in areas that have academic “value” • Diversity does not equal minority, and because of that many minority issues get lost in the “diversity mission” of the school

Racism Recognize that racism is real • Leadership in academic medicine is one of the last areas where diversity is rare • Part of that is silent or covert racism • Can take the form of unequal assignments • Wastes URMM faculty energy constantly trying to prove themselves • URMM faculty can find solace in the literature – They are not alone in their experience of racism – It is not their fault that promotions, opportunities, etc. go elsewhere.

Mission Make margin over mission • URMM faculty (especially black) are in higher concentrations at schools with socially conscious missions • Every mission needs to be paid for, so URMM faculty need to do “their share” in the revenue generation • URMM faculty also work with poor and underserved patients more often, so they are paid less per patient and find themselves with more clinical time. • Institutions value profit margin over mission, and understanding that can help URMM faculty find their “niche. ”

Clinical Assignment Carefully consider clinical cost • URMM faculty spend more time in clinic than their peers • Clinical time is inversely related to scholarly production • Negotiate for the least amount of clinical time with the patients that you want to see

Clinical Legitimacy Strive for clinical legitimacy • Too much clinical time prohibits progression • Too little clinical time diminishes credibility and takes from who we are • Make sure all academic positions have clinical time built in 20 -60% • After 60% there is no productivity, and less than 20% there is little credibility

Academic Advancement Don’t kick away the ladder • Power is concentrated in the hands of chairs and deans in the academic center • Achieve power patiently • URMM faculty need to earn these positions and avoid premature promotion as it makes it impossible for others to follow. • URMM senior faculty need to consciously understand their path to leadership and share the steps with the next generation

Scholarly Productivity Publish passion prior to promotion • Most URMM faculty are in clinical jobs, so there is not much time for writing • Identify areas of passion and write about them, starting with letters to the editor and narratives • Identify a “writing mentor” • Use active voice

Coordination Avoid jobs that are described with the word “coordination” • Like clinical time, coordination is inversely related to scholarly production • Coordinating positions, (i. e. dean of diversity) are designed to be capstone positions • URMM junior faculty in those positions tend to remain at a junior rank for the remainder of their careers

Work life balance Use your own time and your own dime • Success in this career requires night and weekend work when you are not in clinic or on call • It is ok to use personal resources to advance toward career goals • URMM faculty tend to have extended family responsibilities more often than other faculty, and these must be kept in check to ensure time and energy for advancement.

Connections Create connections to join the conversation • URMM faculty spend much time away from the academic institution for clinical endeavors • URMM senior faculty need to use their connections to advance the careers of junior faculty • URMM junior faculty can advance the careers of residents and medical students in the same way— connecting them with decision-makers in our field

Communication Bleach communications to remove the stains • URMM faculty have had a host of negative experiences within the academy • Sharing them is important, but the negative emotions (stains) need to be bleached out • Sharing the URMM negative experiences needs to be fact and numbers based, and as authors we need to be “reporters”

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