Are committee experiences of minoritized family medicine faculty part of the minority tax? a qualitative study | BMC Medical Education

This study was deemed exempt by the University of Utah institutional review board, IRB # 0091384, as part of a departmental educational umbrella IRB exemption. Twelve early career URiM academic family medicine fellows participating in the Society of Teachers of Family Medicine (STFM) Leadership through Scholarship Fellowship (LTSF) were asked to reflect on their experiences with committee work in their academic faculty careers. LTSF is a URiM-focused fellowship designed to help URiM faculty navigate the minority tax [13, 14]. It is a supportive fellowship which has been described elsewhere in the literature [13, 14]. LTSF fellows were selected after a nationwide application process involving a committee consisting of the LTSF faculty and STFM administrators. As LTSF is advertised as URiM faculty development, all twelve participants in the group were assistant professors or instructors, identified as members of a race/ethnic minoritized group [(75% Black or African American, 16.7% Latinx (Hispanic or Latino), and 8.3% Southeast Asian)].

During a faculty development session for the LTSF fellowship, faculty gathered with a former medical school dean for mentorship and advice. The former dean shared their perspective on promoting URiM faculty success and encouraged fellows to share their personal stories of being URiM faculty and growth and advancement in academic medicine. Comments from the LTSF fellows included experiences in their home institutions, experiences with mentorship, and interactions with institutional leadership. Significant time was spent speaking about committee service and its role in an academic medical career.

The dean who served as a mentor identifies as a white man. As is typical with URiM faculty, each of the LTSF fellows were among a handful of URiM faculty at their institutions, and many of them were the only ones in their department. The fellows were appointed to serve on departmental and college/school wide committees, but the fellows understood that service did not fulfill promotion requirements. Fellows expressed that they were the only URiM faculty in each of the committees on which they served, and because they are all early career faculty, most of them were new to the institution where they were serving.

After a robust discussion of many experiences that the medical school dean and the fellows shared in academic medicine, fellows were (re)introduced to the concept of “minority tax” and how it affects URiM faculty and institutions. This meeting was held virtually, and all the LTSF fellows (A.E., G.G., J.H., N.J., C.M., C.M., M.M., K.O., G.P., A.M., L.S., V.U.) and two of the faculty (J.C.W. and K.M.C.) participated in the discussion.

After the meeting, the faculty met and decided that there was more to be learned from the fellows regarding committee service. Fellows were then verbally asked to free text a paragraph outlining their committee experiences since beginning their careers in academic medicine. Reflection on this and other fellowship activities are integral parts of the fellowship curriculum. Fellows were intermittently reminded via email or group text to complete their paragraphs. LTSF fellows knew this was part of a qualitative research project and were interested in sharing their experiences. The LTSF fellows and faculty decided that all involved would be authors of the paper and that the fellows’ collective views would be valuable addition to the literature.

The responses to the above prompt were analyzed through rigorous qualitative methods, starting with grounded theory. Grounded theory lends itself to the creation of theory after data is analyzed. Grounded theory analysis allows the researcher to explore the data inductively, to develop codes through a series of steps, and then to finalize the codes for analysis [15,16,17]. Once the steps and analysis are complete theories may be generated regarding URiM and the committee tax. The qualitative analyst did not have contact with participants during data collection. The analysis was conducted after the training ended and after all reflections were received. The text was then analyzed and then coded. A textual analysis of the data could assist the conference coordinators in reviewing common threads and ease the review of central themes from the dataset.

The text was first read several times by the qualitative researcher (VF) and then open-coded inductively, allowing themes to emerge from the data using techniques described by Corbin, Strauss, and Saldaña [15,16,17]. Finally, a process of selective coding was conducted to look at the relationships between the coding and categories/themes. Through a process called member checking, fellows were able to review the results for accuracy and truthfulness. The fellows, however, were unaware if everyone was participating, nor did they see what their peers wrote until after the qualitative analysis of their experiences. LTSF fellows (A.E., G.G., J.H., N.J., C.M., C.M., M.M., K.O., G.P., A.M., L.S., V.U.) each contributed their experiences with committees, and they participated in the writing of the introduction and the discussion. V.F. conducted the qualitative analysis, and J.C.W., K.M.C., and J.E.R. participated in the delivery of the content in the LTSF and the production of the manuscript. LTSF fellows also reviewed this manuscript before submission.