Perspective and Experiences of Minority Faculty at UCSF

Perspectives and Experiences of
Minority Faculty at the
UCSF School of Medicine
Megan Mahoney, MD
Elisabeth Wilson, MD, MPH
Kara Odom, MD, MPH
Loma Flowers, MD
Shelley Adler, PhD

Objectives
• Background
• Methods
• Results
• Conclusions
• Implications

Medical Workforce Diversity Research
• Workforce diversity and medical education
• Diversity in medical workforce improves health care quality and access to care
for ethnic minorities
• IOM and Sullivan Commission have called for measures to increase diversity in
medical schools
• Diversity in the medical student body enhances educational experience for
ALL students
• Minority academic medicine faculty
• Increase pipeline of minority medical students
• Provide role modeling, mentorship and safe environment for medical students
• Only 4.2% of medical school faculty nationwide
• Less likely to hold senior rank, promoted at lower rates, and report more
discrimination
• Physicians of African descent experience “racial fatigue” which has personal
and professional consequences.
• Ethnic majority and minority junior faculty offer useful suggestions for
addressing diversity and discrimination issues.

• Minorities on campus
UCSF
• Students (20%) > residents (9%) > fellows (7%) > faculty (5%)(
• Current number of core faculty at UCSF SOM
•1302 Caucasian
•197 Asian-American
American
•40 Latino
•38 African-American
American
•44 Native-American
• Diversity efforts in face of Prop 209
• Many committees and task forces!

Methods
• Qualitative study to explore difficult issues in-depth and
provide a voice for minority faculty
• Recruitment
• 76 invited for an interview
• 48 agreed to be interviewed
• 36 were interviewed
• Semi-structured interviews
• Questions about minority faculty experience, career
advancement, discrimination and diversity
• Transcription: identifiers removed
• Analysis: multiple investigators developed codes and
themes

Participants
(n=36)
Gender
Female
Male
Race/ Ethnicity
African American
Asian/Pacific Islander
Hispanic/Latino
Faculty Rank
Assistant Professor
Associate Professor
Full Professor
Academic track
Adjunct
Residence
Clinical
Tenure
Departments
Anesthesia
Emergency
Family and Community Medicine
Medicine, Primary Care
Medicine, Sub Specialty
Neurology
Obstetrics/Gynecology
Pathology
Pediatrics
Prevention Studies
Psychiatry
Surgery, General
Surgery, Sub Specialty
20
16
17
3
16
16
11
9
3
2
22
9
1
1
4
10
2
1
2
1
4
1
5
3
1

Results
• Themes
• Expectations
• Mentorship
• Discrimination
• Diversity Efforts

Expectations

Expectations
[Among] African Americans, if you are any kind of professional, there
is that added sense of responsibility, both at work and outside the home,
that you… need to be a role model.
• African American man, senior rank
I could show you the letter from the chancellor which said, “You’ve been
appointed to the UCSF Diversity Committee.” …There was no question
in there. It was more of, “This is when you’re going to start meeting.” eting.” I
am sure I could have done something about it, but you pick your battles.
• Latino man, senior rank

Mentorship

Mentorship
One of the things that I've been encouraged to do is find a mentor, which
I still haven't done. I feel partly it's because there aren't…there's ere's nobody
like me in the department. There aren't really that many other people p
of
color.
• African-American American woman, junior rank
Being a minority faculty member creates a psychological stress for f
a
divergence of viewpoints… in that there is always an uneasiness within
social relations in a dominant culture…I think that psychological l stress
can be relieved through appropriate mentoring, but that appropriate
ate
mentoring requires a great deal of time.
• Latina woman, senior rank

Discrimination

Discrimination
The discrimination is much more subtle. It’s just hard to put a finger on
it. It has to do with people in power, whether its your division chair, or
your clinic director, or your department chair. It’s the conversations that
take place…—it’s never a deliberate attempt to exclude anyone—that
take place in informal circles.
• African-American American woman, junior rank
There’s been both subtle and overt racism. I have made a conscious
decision about how much energy I was going to put into confronting ng those
experiences, and have elected not to pursue them as much as probably
somebody else would have.
• African-American American woman, senior rank

Diversity Efforts

Diversity Efforts
When you look at the color on the faculty, you see the lack of
commitment, and that sends a message to the people we want to attract
tract
into the university.
• African-American American man, senior rank
I think that much more needs to be done. It needs to happen at much m
more than these token levels where we have someone as a figurehead and
nothing else… We need to have some enforcement of policies. … We can
have committee after committee study the problem, but unless there’s some
meat behind the issue nothing’s going to happen.
• Latino man, senior rank

Diversity Efforts
It's important to have an office of minority affairs where there is a visible
place that is going to solve problems…when we are recruiting students
and faculty, there is a place where people can go and get information
about what else is out there…Nobody is coordinating across all the t
departments…Having an office, you can have an internal change agent
that can really keep their eye on the ball.
• African-American American woman, senior rank

Conclusions
Minority faculty members - both junior and senior - face conflicts
between their personal experiences and institutional realities:
1. In addition to a personal sense of responsibility towards their
community, minority faculty are also faced with the external
expectation that they will provide representation in various diversity
ersity-
related activities.
2. Minority mentors help minority faculty navigate the university structure s
and institutional politics, however finding a mentor is difficult t given the
lack of minority senior faculty.
3. Though subtle, racial discrimination occurs and has serious
consequences in career path, research success, and retention in faculty
roles. Minority faculty struggle with their response to experiences with
discrimination.
4. Diversity efforts are recognized, but there is gap between intention tion and
implementation of these efforts. This gap creates the perception that
diversity is not an institutional priority.

Implications
• Minority faculty are a useful resource for advising efforts to
increase diversity in medical institutions.
• An increase in the number of minority faculty is imperative to
relieve the overburdening of current minority faculty and
achieve a critical mass necessary for recruitment and retention.
• Time spent on mentorship and other diversity efforts is crucial
but demanding, and should be recognized in the promotion
process.
• An Office of Diversity Affairs might help facilitate the
development of dedicated funding and measurement
standards to apply towards diversity efforts.

Acknowledgments
• Funding
• Vice Chancellor’s Office
• LEARN
• Special Thanks
• Loma Flowers
• Eugene Washington
• Rosalia Mendoza
• Sha-nita
Jones
• Portia Jones
• Jessica Muller
• Laura Hill-Sakuri
Sakuri
• Marilyn Skaff
• PARTICIPANTS!!

For more information
contact Megan Mahoney or Elisabeth Wilson
mmahoney@nccc.ucsf.edu
ewilson@fcm.ucsf.edu