"Under-represented minorities, especially under-represented minority women physician-scientists, are faced with walking a tight rope in academic medicine that requires excellence in both clinical and scholarly domains, typically with insufficient academic support, social capital and attainment of senior leadership roles that would turn their zeal and commitment into progress," writes Michelle A. Albert, MD, MPH, in a perspective published May 22 in Circulation.

Albert highlights data from the American Association of Medical Colleges showing a limited number of under-represented minorities as a whole (29 vs. 137) serving as internal medicine chairs. Of both totals, only 24 chairs are women. Additionally, among the top 40 ranked cardiology programs, there are no female chairs and while there are more under-represented minority women than under-represented minorities in total, these women are less likely to be professors and occupy leadership positions in academia.

According to Albert, lack of racial/ethnic diversity, racial/ethnic discrimination from parents and families, bias from superiors and colleagues, hypervigilance from stereotype threat, and reactions to tokenism are among the drivers of isolation felt by under-represented minorities, especially women. She also notes that women are “more frequently faced with insufficient family resources/wealth to help manage family-work conflicts,” as well as limited mentorship and leadership opportunities.

An authentic approach to diversity and inclusion is paramount to not only ensuring the success and professional well-being of under-represented minorities and women today, but in also building an equitable pipeline of future leaders, Albert writes. She recommends that institutional and organizational leaders be required to champion diversity and inclusion and evaluated on their results. She also suggests the creation of hybrid career opportunities that “interdigitate academics with private practice.” Other recommendations include bias training and identification, creation and nurturing of peer networks, and diversity funding targeted at under-represented minority well-being.

"Albert's #MeWho article serves as a great reminder of why a comprehensive approach to diversity and inclusion is so critical for not only cardiology, but medicine as a whole," says Pamela S. Douglas, MD, MACC, chair of ACC's Diversity and Inclusion Task Force. "The ACC has developed a Diversity and Inclusion Strategic Plan that gets at the core of many of Albert's recommendations. Our goal: to harness the power of the diversity of ACC members to advance patient care, spur innovation, and improve health equity among individual patients and populations. In doing so, ACC will ensure opportunity for all cardiovascular providers by working towards a fully inclusive organization and profession."

Keywords: Mentors, Leadership, Physicians, Women, Minority Groups, Ethnic Groups, Racism, Family Conflict, Internal Medicine, Private Practice, Anxiety, Patient Care

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