Start With Individuals, but Ensure That Antiracism Becomes an Institutional Value

Angela T. Echiverri, MD, MPH | Yury Parra, MD, AAHIVS | José Rodríguez, MD

Fam Med. 2023;55(1):67-68.

DOI: 10.22454/FamMed.55.689129

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To the Editor:

We were excited to read the article, “Teaching About Racism in Medical Education: A Mixed-method Analysis of a Train-the-Trainer Faculty Development Workshop,” by Dr Edgoose et al. 1 We applaud the authors for curating a day-long faculty development workshop that provided vocabulary, resources, and tools to address racism. We encourage the authors to continue leading this workshop so that more of us can learn from their expertise and wisdom, ground ourselves with a shared language, engage in crucial conversations, and participate in best-practice activities that deepen our awareness around this work. Furthermore, we applaud the leadership of STFM for their commitment to providing a vision and platform for such workshops, as part of their Underrepresented in Medicine (URIM) Initiative. These efforts to train individuals to develop skills in antiracism are meaningful, but policy changes that lead to institutional transformation ensure that practices change, move toward antiracism, and hold us accountable overall.

Critical components to organizational change include embracing a collective commitment to antiracism; dismantling policies, practices, and structures rooted in racism; embedding antiracism principles in all facets of the organization; funding and supporting time for this critical work; and raising a collective consciousness to unearth our deeply rooted values and beliefs. As stated in the work by Dr Lynch et al, “anti-racist education is comprised of three interconnected components—making systemic oppression visible, recognizing personal complicity in oppression through unearned privilege, and developing strategies to transform structural inequalities.” 2 Using this framework, we have included recommendations from recent publications to move organizations forward in their antiracism efforts:

Make Systemic Oppression Visible

  • Listen to Black people, Indigenous people, and People of Color.3
  • Actively learn about and teach the roots of systemic and institutionalized racism in the United States.3
  • Ensure leadership addresses constituents annually on systemic oppression and antiracist efforts.
  • Implement transparent platforms that demonstrate the demographic composition of decision-making leadership, faculty, staff, resident, and student bodies.4
  • Amplify policy changes that increase the practice of antiracism within institutions.4

Recognize Complicity in Oppression

  • Ensure the organization develops a robust racial literacy foundation and raises constituents’ consciousness of their collective role in dismantling racism.
  • Implement policies requiring transformational experiences exploring how anti-Black racism benefits those who are more proximal to whiteness and its associated power and privilege. Create a space where this dialogue can take place openly, and focus the dialogue on elimination of racism rather than racial blaming.5

Develop Strategies to Transform Organizations

  • Foster greater inclusion and equity at all levels of the organization through policy change.6
  • Increase representation of individuals from historically marginalized and systemically excluded backgrounds to ensure multiple voices of color are reflected in all decision-making bodies.3 , 6
  • Train institutional leaders, specifically deans and chairs, to prioritize antiracism transformation, and include accountability for these activities in annual evaluations.4

We encourage individuals to catalyze institutional transformation and ensure that antiracism is practiced at the institutional level.


  1. Edgoose J, Brown Speights J, White-Davis T, et al. Teaching about racism in medical education: a mixed-method analysis of a train-the-trainer faculty development workshop. Fam Med. 2021;53(1):23-31. doi:10.22454/FamMed.2021.408300
  2. Lynch I, Swartz S, Isaacs D. Anti-racist moral education: a review of approaches, impact and theoretical underpinnings from 2000 to 2015. J of Moral Edu. 2017;46(2):129-144.

  3. Foster KE, Johnson CN, Carvajal DN, et al. Dear white people. Ann Fam Med. 2021;19(1):66-69. doi:10.1370/afm.2634
  4. Olayiwola JN, Glover AR, Paz HL, Gray DM, II. Making anti-racism a core value in academic medicine. Health Affairs Forefront. August 25, 2020. Accessed March 24, 2020. https://www.healthaffairs.org/do/10.1377/forefront.20200820.931674/full/

  5. Guh J, Krinsky L, White-Davis T, Sethi T, Hayon R, Edgoose J. Teaching racial affinity caucusing as a tool to learn about racial health inequity through an experiential workshop. Fam Med. 2020;52(9):656-660. doi:10.22454/FamMed.2020.596649

  6. Rodríguez JE, Tumin D, Campbell KM. Sharing the power of white privilege to catalyze  positive change in academic medicine. J Racial Ethn Health Disparities. 2021;8(3):539-542. doi:10.1007/s40615-020-00947-9

Lead Author

Angela T. Echiverri, MD, MPH

Affiliations: Contra Costa Family Medicine Residency, San Francisco, CA


Yury Parra, MD, AAHIVS - Contra Costa Family Medicine Residency, San Francisco, CA

José Rodríguez, MD - University of Utah Health, Salt Lake City, UT

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