Over the last ten years, Emory University has become more focused on creating an inclusive and diverse atmosphere for our students, faculty, and staff members. The Department of Medicine (DOM), the largest department within Emory University, has taken this work to heart with a goal of not only intentionally recruiting more diverse faculty members and trainees but by also eliminating barriers and offering more opportunities for promotion to faculty who have been historically underrepresented in medicine to become full professors.
A historic problem addressed with an innovative approach
The medical field in the United States has historically been predominantly white and male. While Black Americans make up about 13% of the U.S. population they comprise only 5.4% of the physician workforce, and of these only 2.8% are Black women. There are even fewer Black women in academic leadership roles: only 0·8% of full professors at U.S. medical schools in 2020 were Black women. Consideration of these statistics shows that a change is long overdue to address this inequity. Emory’s DOM is working to change that one mentee, sponsor, and person at a time.
Over the last decade, Emory’s DOM has intentionally made strides to increase the number of full professors, and in particular those that identify as Black women, a group that, even as the diversity of medical students grows, has yet to see percentages commensurate with the U.S. population. While Black women are not the only racial and ethnic group that is underrepresented in medicine, we do recognize the complex history and unique barriers experienced by Black people in America, particularly those with intersecting identities. The department took a unique long-term approach to this problem with notable success. Because of their work, the number of Black female full professors has doubled from three to seven since 2019, resulting in seven out of 104 of the DOM’s full professors identifying as Black women, just under 7% of the department, high above the national average that hovers around 1%. This is only the beginning as nearly twice that number of associate professors identify as Black women, a step just below full professors, and are very likely to be promoted to full professors over the next few years.
(DOM Black Women Full Professors from right to left: Dr. Modele Ogunniyi, Dr. Jada Bussey-Jones, Dr. Kimberly Manning, Dr. Jennifer Christie*, Dr. Stacy Higgins, Dr. Janice Lea, Dr. Ugochi Ohuabunwa. Note: Dr.Jennifer Christie recently transitioned to a GI leadership position in Colorado. Photo credit: @designshowmarketing.com)
Through intentional work such as this, the department aims to be a destination and model for promoting and celebrating faculty who are considered underrepresented in medicine. In addition, the department purposefully encourages a culture of support and community that hopes to nurture a sense of belonging in spaces where Black women have traditionally felt alone, alienated, or unaccepted. This work was the focus of a recent publication in the Journal of Hospital Medicine by a group of DOM faculty members, including Danielle Jones, MD, Shelly‐Ann N. Fluker, MD, Tiffany A. Walker, MD, Kimberly D. Manning, MD, FACP, FAAP and Jada C. Bussey‐Jones, MD.
As outlined in this article, several barriers to the retention and success of women and URiM faculty perpetuate the systems within medical school faculties across this country.
When URiM are recruited to academic institutions, multiple factors, including less mentorship and fewer opportunities for advancement, affect both their promotion to senior ranks and retention in academia. The Association of American Medical Colleges (AAMC) recommends “leaders must focus their efforts on developing inclusive, equity‐minded environments” to effectively advance diversity in medical education.1 Despite these recommendations, reports of successful interventions and actions are limited mostly to national career development programs (e.g., ELAM, AAMC).13 Many US medical schools have no programs supporting gender equity among faculty, and existing programs primarily target individual or interpersonal actions rather than broader policy and/or structural change.
However, ten years ago, within Emory’s Department of Medicine’s General Internal Medicine Division, an important change began. In 2013, a new Faculty Review Committee (FRC) was formed to address low promotion rates to senior ranks, particularly among groups that identify as URiM. The FRC assesses readiness and offers support to all faculty members years in advance of their earliest possible time of promotion. By providing proactive, holistic, standardized evaluations and recommendations for promotion, this committee helped faculty to be more prepared for promotions when the time came. As the article explains, “The goal of the systematized FRC process was to reduce bias, thereby increasing promotion of all faculty to senior ranks, an outcome that would be particularly impactful among historically marginalized groups.” By combining the power of traditional mentorship (longitudinal general and project‐related guidance) with a departmental promotion committee (one‐time, retrospective review for promotion), the FRC provides individualized, actionable reviews early enough to impact faculty’s promotion timeline and career trajectory. This innovative approach has resulted in additional promotions of all faculty, but most notably the number of Black women promoted to full professors has doubled since the creation of the FRC.
Representation matters, especially as we look to the future
We know that representation matters when inspiring future physicians and aspiring medical school faculty members. While the voice and agency of Black women health professionals have been historically overlooked, by promoting Black women to leadership roles within the department, more rising women of color are inspired to strive to attain the same rank, hopefully ending the perpetuation of systemic racism and inequality in medical school faculties.
Through innovative and thoughtful ways like the FRC, encouraging mentorship, and a welcoming culture we hope the number of Black and other underrepresented female professors continues to rise at Emory’s Department of Medicine. One of these Associate Professors, Zanthia Wiley, MD, FHM, FIDSA, a rising star in the department likely to be promoted to full professor over the next few years, shares just how important the culture of acceptance is for her career. “Representation is everything. I have witnessed each of these amazing Black women Professors attain levels in their career to which I aspire. They teach me, mentor me, sponsor me, and cheer for me. They are my motivation to be to the next generation what they have been to me. In seeing them, I see myself.”
While we celebrate that we currently have the largest group of Black women full professors to date, it is clear that this progress is long overdue, and more work needs to be done. We are encouraged to see the growing diversity of leadership within the DOM, a clear result of this innovative approach. The department hopes others, like Dr. Wiley, will follow to create a brighter, more diverse future among Emory’s DOM and inspire other American medical school professors and leaders to do the same.
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