Race and gender equity in academic medicine — a fireside chat with Harvard's Dr. Uzma Shah

Academic medicine, like society more broadly, has a problem with race and gender equity. While underrepresented in top leadership roles in academic medicine, women make up more than 50 percent of medical students. This suggests the bulk of our nation's potential future physicians are learning in institutions that are not reflective of their ambitions.

On Sept. 9, during Becker's Clinical Leadership Virtual Event, Uzma Shah, MD, associate professor in pediatrics at Harvard Medical School and the clinical chief of pediatric gastroenterology and nutrition at Massachusetts General Hospital in Boston, participated in a fireside chat about racial and gender bias in academic medicine. Dr. Shah also serves as director of MGH's pediatric hepatobiliary and pancreatic disease center and the hospital's pediatric liver transplant program.

Here is an excerpt from the conversation, edited for clarity. To view the full session on-demand, click here. 

Question: How would you describe academic medicine's progress with intersectionality as it relates to creating cultures where women and people of color are treated?    

Dr. Uzma Shah: We've come a long way. It's been a long journey for women and people of color in academic medicine. Yes, things have changed for the better in a big way, but, having said that, there is a great deal of progress that still needs to be made. Women of color, in particular, have been living in fear of speaking out to people about some of these issues in academic medicine. And that has led to complacency. It's the idea that "this is just how it is and I'm never going to be able to do anything about it." And this leads to attrition among these groups in academic medicine — fewer people coming into the field, which is a sad thing. It's become extremely important to actually highlight the issues that have been there for a very long time.

Q: What would you say to an academic medical center CEO, who's taking the step of issuing a glossy PR statement about the importance of racial justice, but hasn't really gotten their own house in order? What actionable changes should that CEO make?

US: There's so much at stake at this moment. From an academic medicine perspective, if we don't do this well, there will be a lot of people who will not want to come into medicine. We are going to lose fantastic minds, researchers, teachers, role models, physicians, surgeons. In order to ensure that we get the best of the best, retain them and cultivate that beautiful knowledge, we have to embrace that spirit of nurturing and inclusivity.

If I was a CEO, I would make sure that certain things happen. I'd support a cultural change by training people to recognize unconscious bias. And I'd encourage leaders to take action in the moment. If something happens that hinders this nurturing culture, like someone makes a sexist comment, leaders need to speak up in the moment. Most importantly, I'd support the creation of something like a report card or an annual review on leaders' efforts to support a culture of inclusivity. The review would ask leaders questions like, "How many women do you have in your division? How were they promoted? How many lectureships were they invited to? How many speaker arrangements did they have? How many editorial boards were they placed on? How many opportunities did they have to be on committees that matter?" This would great a report card for every leader to eliminate lip service and support action.

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