In 2012, the Advisory Committee to the Director Working Group on Diversity (ACDWGD) at the National Institutes of Health (NIH) produced its first report. The committee stated plainly that diversity increases core scientific principles — creativity, innovation and rigor — and that the NIH had a responsibility as a publicly funded body to maintain the basic fairness of equal opportunity. To support greater representation of minorities in the biomedical sciences, the ACDWGD issued recommendations along four themes: data collection and evaluation, mentoring and career preparation for trainees, institutional support for institutions that had a track record of supporting diversity, and intervention testing. In particular, the NIH wanted to better understand the pipeline from undergraduates to senior biomedical research faculty, focusing on transition points.

Research Shows Increase in Underrepresented Minority Trainees

A recent study by Lindsay Meyers at Vanderbilt University and colleagues looked at precisely that pipeline. Using data from the U.S. Department of Education, the national Science Foundation and the NIH, Meyers and colleagues tracked the proportion of underrepresented minorities (URMs*) among undergraduate freshman who expressed an interest in biomedical research to URMs in tenure track faculty positions during the period of 2000 to 2013. The study identified attrition at the initial stage between the number of URM freshman interested in the biomedical sciences and the number of URM undergraduates that went on to earn degrees in the biomedical sciences. Yet, the outlook on trainees was more positive: The proportion of URM students entering graduate school had increased by approximately 74 percent since 2000, while the total number of students in other well-represented groups remained unchanged since 2007. In addition, the number of Ph.D.s awarded to URM trainees increased 2.7-fold from 2000 to 2013, increasing the proportion of doctorates that URM trainees earned from 7 percent to 12 percent. Moreover, the proportion of URM postdocs showed a fairly loss-less transition, with URMs making up 11–12 percent of postdocs in 2013. The proportion of URM postdocs had similarly increased about twofold from 2000 to 2013.

Trainee Progress Not Mirrored in Faculty Numbers

However, despite these advances among trainees, the percentage of URM faculty at Association of American Medical Colleges (AAMC) universities did not increase above 4 percent over the entire 2000 to 2013 period. The picture at the Johns Hopkins University School of Medicine has historically been similar to the one illustrated by Meyers and colleagues — the 2016 census for the Johns Hopkins University School of Medicine reported 4.4 percent URM faculty in the basic sciences division (3.5 percent Hispanic/Latino, 0.9 percent Black/African-American).

Meyers and colleagues remark that the drop-off between the proportion of URM postdocs and the proportion of URM faculty is an area of “deep concern.” However, because they did not have access to the number of URM faculty applicants, they could not determine the precise break point — in other words, the extent to which postdocs were electing not to pursue a tenure-track faculty position at an AAMC university versus the extent to which qualified candidates were trying and failing to secure these academic positions. Both are likely to be at play — insider perspectives written in 2016 for The New York Times and The Washington Post speak to both the uniquely draining experience of being a minority trainee and the disparities in hiring practices for minorities versus white candidates.

Beyond Hiring: Building a Community of Support

Moreover, even if the proportion of URM postdocs hired as tenure-track faculty members did increase, this is not the end of the pipeline. A supportive climate for early career faculty remains a critical issue. For instance, in 2008, The Johns Hopkins University launched the Mosaic Initiative, a five-year program focused on recruiting diverse faculty across the university. From 2009 to 2015, The Johns Hopkins University appointed 38 URM and STEM-focused women faculty, yet retention data from 2015 showed that the university had not net increase in URM faculty after the program. Exit interviews cited isolation, inadequate mentorship, limited to no networking or professional development opportunities, and perceived bias. In addition, a study the NIH commissioned in 2011 showed that investigators identifying as black or African-American who applied for RO1 grants were 13 percent less likely to receive NIH investigator-initiated research funding — and when controlling for education, training, previous publication record and research awards, black/African-American applicants were still 10 percent less likely to receive funding. Moreover, from the period of 1999 to 2009, 73 percent of applications from black/African-American applicants were not “fully discussed” — as a result, black/African-American applicants were 64 percent less likely to resubmit their proposals than white investigators.

A Promising Plan of Action

Nonetheless, continued research and policy development at the NIH, The Johns Hopkins University and the Johns Hopkins University School of Medicine offer promise for a better future. The NIH has already met all of its 2012 recommendations, and its 2018 recommendations pair assessment with action. In particular, the 2018 recommendations focus on developing diversity at research universities through initiatives such as developing a training grant specifically focused on diverse faculty recruitment and mentorship, partnering with universities to develop accountability metrics and fundamentally assessing whether there is “a palpable will to make change” among university leadership. At the inter-institutional level, the 2018 report suggests fostering productive competition among universities for diversity success. Finally, the 2018 report calls for self-assessment to determine whether NIH policies are barriers or facilitators. The report also calls for more demographic data on areas such as disability type, sexual orientation and gender identity to more fully understand the experiences of underrepresented groups in the biomedical sciences.

At The Johns Hopkins University, the 2016 Roadmap on Diversity and Inclusion included a faculty diversity initiative (FDI), allocating $25 million over a five-year period, which addressed increasing minority representation at the faculty level from all directions. Along the pipeline, the FDI supports the transition from postdoc to faculty through the provost’s diversity postdoctoral fellowship, which provides funding for research and professional development to prepare the recipients for faculty positions. The FDI supports URM faculty recruitment through its Target of Opportunity program, which makes it easier for departments to hire URM faculty outside of search cycles, and by inviting diverse scholars to visit the Johns Hopkins University community. The FDI also focuses on fostering a supportive climate by expanding faculty mentorship development plans — in part inspired by the Master Mentor program at the Johns Hopkins University School of Medicine — and by implementing an award for faculty excellence in diversity, the most recent recipient of which was Douglas Robinson in the Johns Hopkins University School of Medicine’s Department of Cell Biology. In addition, the FDI focuses on research and transparency by seeking to make faculty exit surveys more regular and centralized, and by releasing a progress report biannually (the first can be found here).

What’s more, the university has stipulated that each division create its own faculty diversity action plan. Implementation of the Johns Hopkins University School of Medicine’s recommendations can be seen in the Institute of Basic Biomedical Sciences Faculty Recruitment Handbook. These include more training of all search committee members by the Office of Diversity and Inclusion, a dedicated diversity advocate on each search committee, guidelines for search criteria advertisements to include statements about diversity and inclusion, support for outreach, and an initial review process of applicant material with all biasing identifiers removed.

Diversity Matters

By all accounts, diversity is integral to achieving creative, rigorous and meaningful science. Yet, perhaps more profound are the matters of basic fairness, equal opportunity and public relevance. Already, the U.S. K-12 population is majority minority, with the entire U.S. population expected to follow suit by 2050. At the same time, health disparities persist among minority groups. If the proportion of biomedical researchers who resemble the majority of the American public were to remain as small as 4 percent, to what extent can we earn the claim to address the American people’s health needs? To what extent can we hope to inspire future generations of scientists? The study Meyers and colleagues performed reminds us that time does not, on its own, beget change — rather, change demands effort and accountability from every member of the system. Though lasting change must ultimately come from the top down, students can be powerful advocates — an incredible example is the Black Student Union at The Johns Hopkins University, which made a call to action that helped shape the faculty diversity initiative. And every individual — trainee, postdoc or faculty member — can challenge bias, and practice inclusivity in everyday conversation and mentorship. Through strong institutional leadership and each person’s effort, change can happen.

*Note: URM in this article and in the literature cited refers to people who identify as black or African-American, Hispanic or Latino, and American Indian or Alaskan Native. This definition has obvious limits — for example, it fails to capture the underrepresentation of LGBTQ persons, people with disabilities, some Asian ethnicities (such as Vietnamese and Cambodian) and first generation people from low-income households. It also fails to consider the intersection of race, gender and class — for example, that Asian women are underrepresented at the faculty level but Asian men are not. The Johns Hopkins University School of Medicine recognized the failure of this limited definition in its faculty diversity action plan, as did the NIH diversity advisory committee in its 2018 recommendations.

The author would like to thank Dr. Geraldine Seydoux for sharing the 2019 IBBS Faculty Recruitment Handbook.


Browse perspectives on diversity and the practice of medicine from our bloggers:

Share This Post