Letter to the Editor in Response to “Residents’ Perspectives on Careers in Academic Medicine: Obstacles and Opportunities”

The article “Residents’ Perspectives on Careers in Academic Medicine: Obstacles and Opportunities,” by Dr Lin and colleagues is an important contribution toward understanding the needs and concerns of future faculty members as we try to identify ways to attract students to family medicine, and transform them into educators in academic family medicine.1

The participants in this small study broadly represent family medicine nationally, including the proportion of respondents from groups underrepresented in medicine (URM). While the number of residents from URM backgrounds was small (14), they represented 14.8% of the sample. This is double the national average of African American, Latino, and Native Americans in academic medicine.2 At a time when faculty recruitment committees grow frustrated in their efforts to recruit URM faculty, the demographics from this article suggest that there are more URM residents interested in academic careers than previously thought, at least in our discipline.

Family medicine continues to be the most diverse of all of the medical specialties, with a higher proportion of URM faculty and residents than any other.3 This is due in part to our shared goal of providing excellent underserved care, and to our discipline’s counter-culture history. Family medicine has embraced difference and continues to innovate precisely because of that.

When compared to non-URM faculty, URM faculty have experiences unique to this group.2 They have identified many issues (lack of mentorship, diversity pressures, isolation, inequitable distribution of clinical responsibilities) as obstacles to their success in academic medicine.2 Resident participants in the article identified similar obstacles, with lack of mentors topping the list. It was not apparent from the article, however, if participant information regarding racial and ethnic diversity was utilized to guide the development of the grounded theory and qualitative analysis, or if the demographics were simply collected and reported.4 To collect racial and ethnic demographics and then not analyze for differences in responses between populations makes us question the need to collect and report this information at all, and more importantly, forces us as readers to question what additional themes might have been identified had issues of diversity been considered in the development of the grounded theory. This is a missed opportunity to tap into URM residents identifying actionable items for improvement in URM resident recruitment into academic medicine.

Addressing the changes identified by URM faculty has led to improved faculty retention among all races and ethnicities when implemented.5 We commend the authors for their scholarly approach to identifying barriers for future family medicine faculty, and for recruiting URM residents to their workshop at double the national average. It is imperative, however, that in addition to recruiting diverse participants, family medicine researchers and educators actively seek out what those diverse participants might have to say, and use those experiences to inform our program development and diversity efforts.