In Response to: “Systemic Racism and Health Disparities: A Statement From Editors of Family Medicine Journals”

We, the inaugural participants in the Society of Teachers of Family Medicine (STFM) Leadership through Scholarship Fellowship (a group of early-career underrepresented in medicine [URM] minority faculty), commend the editors of family medicine journals for a powerful statement of commitment to eliminate structural racism in the editorial process of manuscript review and to sponsor scholarly talent among URM physicians. In the editorial, six key steps toward the advancement of equity within our specialty were identified.1 Among those, encouraging and mentoring authors from URM groups, defined as physicians who are Black or African American, Latinx, or Native American, deserves further discussion as currently not much is written on models that go beyond skills-based training to address the specific needs and challenges encountered by URM.2

Developing an effective approach to mentoring and providing faculty development for URM physicians requires acknowledging and addressing the “minority tax.” As described by Campbell and Rodríguez, the minority tax impacts URM faculty when they are disproportionately tasked with professional responsibilities that may not contribute to their academic advancement.3 Included in this tax are disparities in diversity efforts, a paucity of mentorship, lack of faculty development, and racism, causing the few URM faculty who persist in academic medicine to suffer a lack of psychological safe space, bias, isolation, and discrimination.3 The need for targeted faculty development that encourages and supports authors from underrepresented groups for scholarly advancement is well established. Therefore, providing training in technical scholarly skills is not enough without (1) targeting the unique challenges faced by URM faculty, (2) holding academic institutions accountable for identifying and addressing the minority tax, and (3) providing financial support to protect faculty’s scholarly time and professional development.

As identified in the statement, editorial boards are not exempt from contributing to systemic racism. We are thankful that family medicine is taking a stand to promote equity for URM faculty and value the critical steps the editors are taking toward addressing the disparities in academic authorship. Additionally, editorial boards should reflect the racial and ethnic make-up of our nation. There are talented URM scholars capable of serving as editors who would bring diverse perspectives to the editorial process. When they are absent, a true peer-review process is not achieved, and submissions by URM authors are at risk of being misunderstood or inadequately evaluated. It is worth noting that URM physicians disproportionately have higher educational debt and come from lower-income families and may not have the generational wealth to participate in such processes on a volunteer basis, therefore appropriate compensation for editors is important and would help mitigate the minority tax.5,6 Commitments from all editorial boards to address these concerns will further equity in manuscript review and publication.

As URM Scholars in family medicine, we applaud the editors of family medicine journals for the significant steps toward promoting equity. We call on editors of other academic journals to do the same.