Promoting Progress or Propagating Problems: Strategic Plans and the Advancement of Academic Faculty Diversity in U.S. Medical Schools

THEORY Researchers have examined many facilitators and barriers to URM representation in the workforce.3,7,18-20 Pipeline initiatives, holistic application review and increased institutional financial support have shown efficacy in improving diversity among applicants and trainees.5,6,21,22 In fact, the gap in proportional representation with non-URM students/trainees is closing in the STEM training pipeline.23 However, improvements in student and trainee diversity have not led to proportional improvements in the representation of URMs among academic faculty.23 In 2014, URMs comprised 31% of the U.S. population, while constituting only 8.6% of the U.S. physician workforce.24 In academic medicine, URMs make up 8% of academic medical faculty, a proportion that has risen by less than 1.5% over the past 20 years.18 Studies examining barriers to URM recruitment, retention, and promotion among academic faculty suggest perceived social isolation and lack of transparency in promotion requirements as contributing factors to the lower recruitment and higher attrition rates of URMs than their non-URM peers.18-20,25 In addition, an unequitable distribution of non-career advancing obligations, also known as the "responsibility disparity," contribute to this phenomenon.19,26 While mentoring programs and faculty development programs of sufficient intensity have been shown to improve URM faculty presence in academic medicine, studies also suggest that organizational culture change can and should be used to reduce barriers.16,18,20,27 The AAMC reinforces this by making Structures and Policies a central construct in their conceptual framework for diversity and inclusion within academic medicine.6,17 Operating within this construct is strategic planning.13 Strategic planning is an organizational management activity characterized by a taskforce or committee charged by organizational leadership to establish goals in line with the mission and vision of an institution.10 Clear strategies are then assigned to goals, as well as metrics, that help guide the institution to fulfill its goals.8,9 The process of strategic planning is iterative and adaptive, meant to change with organizational needs and shifting priorities.10,14,28 One feature of strategic planning is sharing and communicating the plan with stakeholders at all levels of the institution; creative use of websites, social media, or other platforms is encouraged to facilitate dissemination and engagement.29,30 RESULTS & DIS