The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Perspectives

Watch Your Career Like You Watch Your Money: Minority Tax Mitigation Strategies

Authors: Edgar Figueroa, MD, MPH, Julie E. Lucero, PhD, MPH, José E. Rodríguez, MD

Abstract

Academic medical center faculty members from historically underrepresented backgrounds in medicine in the United States face multiple factors that limit their recruitment, retention, and advancement in academic medicine. Although high-level system changes are needed to achieve an equitable and diverse academic workforce, academic health systems do not change rapidly. Faculty from minoritized backgrounds must learn how to continue working in the system while advocating for and implementing system redesign. One approach to career utilizes the metaphor of personal finance management. The authors identified 10 areas in which personal finance and career management overlap: get organized (learn requirements for success in academic medicine); establish goals (identify your career aspirations); craft a budget (link your actions to the goals); maintain a diverse portfolio (participate in activities that meet all academic missions); invest or save? (saving is citizenship tasks, while investing is accepting career-building assignments); keep good debt (minimize minority tax activities or use them to fuel your scholarship); check balances and run credit reports (evaluate your career progress often); meet with an expert (learn from mentors and late-career faculty); refinance or seek credit line adjustments (negotiate the terms of your job to concentrate on career-building activities); and change institutions (align your mission with your institution, sometimes by changing institutions). Although there may be many more pieces to a financial management plan, the illustrated steps can help those who are new to academic medicine.

 

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References

1. Gao Y, Fulk T, Mori W, et al. Diversity and career goals of graduating allopathic medical students pursuing careers in dermatology. JAMA Dermatol 2023;159:47–55.
 
2. Yoo A, Auinger P, Tolbert J, et al. Institutional variability in representation of women and racial and ethnic minority groups among medical school faculty. JAMA Netw Open 2022;5: e2247640.
 
3. Shaikh AT, Lall MD, Jalal S, et al. Trends in racial and gender profiles of United States academic emergency medicine faculty: cross-sectional survey from 2007 to 2018. J Emerg Med 2022;63:617–628.
 
4. Saboor S, Naveed S, Chaudhary AMD, et al. Gender and racial disparity among US forensic psychiatry fellows: broken system by default. Psychiatr Q 2022;93:651–662.
 
5. Rahal HK, Tabibian JH, Issaka R, et al. Diversity, equity, and inclusion in gastroenterology and hepatology: a survey of where we stand. Am J Gastroenterol 2022;117:1954–1962.
 
6. Odonkor CA, Tucker-Bartley A, Leitner B, et al. Closing the gap in representation of racial and ethnic minorities in pain medicine: a 2018-2019 status report. J Natl Med Assoc 2022; 113:612–615.
 
7. Kamran SC, Niemierko A, Deville C Jr, et al. Diversity trends by sex and underrepresented in medicine status among US radiation and medical oncology faculty over 5 decades. JAMA Oncol 2022;8:221–229.
 
8. Jahshan A, Aoun M, Dekhou A, Folbe A. The underrepresentation of women and ethnic minorities in anesthesiology. J Natl Med Assoc 2022;114:26–29.
 
9. Duma N, Velazquez AI, Franco I, et al. Donde estan? Latinx/Hispanic representation in the oncology workforce: present and future. JCO Oncol Pract 2022;18:388–395.
 
10. Adetoye M, Gold K. Race and gender disparities among leadership in academic family medicine. J Am Board Fam Med 2022;12:12.
 
11. Sanchez AN, Martinez CI, Stampas A, et al. Ethnic and racial diversity in academic physical medicine and rehabilitation compared with all other medical specialties. Comparative study. Am J Phys Med Rehabil 2021;100(2 Suppl 1):S12–S16.
 
12. Chawla S, Chawla A, Hussain M, et al. The state of diversity in academic plastic surgery faculty across North America. Plast Reconstr Surg Glob Open 2021;9:e3928.
 
13. Wooding DJ, Das P, Tiwana S, et al. Race, ethnicity, and gender in academic obstetrics and gynecology: 12-year trends. Am J Obstet Gynecol MFM 2020;2:100178.
 
14. Lett E, Orji WU, Sebro R. Declining racial and ethnic representation in clinical academic medicine: a longitudinal study of 16 US medical specialties. PLoS One 2018;13:e0207274.
 
15. Xierali IM, Nivet MA, Gaglioti AH, et al. Increasing family medicine faculty diversity still lags population trends. J Am Board Fam Med 2017;30:100–103.
 
16. Rodriguez JE, Campbell KM, Fogarty JP, et al. Underrepresented minority faculty in academic medicine: a systematic review of URM faculty development. Fam Med 2014;46: 100–104.
 
17. Campbell KM, Rodriguez JE. Addressing the minority tax: perspectives from two diversity leaders on building minority faculty success in academic medicine. Acad Med 2019;94: 1854–1857.
 
18. Rodriguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: what of the minority tax? BMC Med Educ 2015;15:6.
 
19. Amuzie AU, Jia JL. Supporting students of color: balancing the challenges of activism and the minority tax. Acad Med 2021;96:773.
 
20. Thomas B, Booth-McCoy AN. Blackface, implicit bias, and the informal curriculum: shaping the healthcare workforce, and improving health. J Natl Med Assoc 2020;112:533–540.
 
21. Osseo-Asare A, Balasuriya L, Huot SJ, et al. Minority resident physicians' views on the role of race/ethnicity in their training experiences in the workplace. JAMA Netw Open 2018;1: e182723.
 
22. Cyrus KD. A piece of my mind: medical education and the minority tax. JAMA 2017;317: 1833–1834.
 
23. Betancourt RM, Baluchi D, Dortche K, et al. Minority tax on medical students: a review of the literature and mitigation recommendations. Fam Med 2024;56:169–175.
 
24. Armijo PR, Silver JK, Larson AR, et al. Citizenship tasks and women physicians: additional woman tax in academic medicine? J Womens Health (Larchmt) 2021;30:935–943.
 
25. Al Achkar M, Rogers TS, Weidner A, et al. How to sponsor, coach, and mentor: a qualitative study with family medicine department chairs. Fam Med 2023;55:143–151.
 
26. Berman RA, Gottlieb AS. Job negotiations in academic medicine: building a competency-based roadmap for residents and fellows. J Gen Intern Med 2019;34:146–149.
 
27. Sambuco D, Dabrowska A, Decastro R, et al. Negotiation in academic medicine: narratives of faculty researchers and their mentors. Acad Med 2013;88:505–511.