title: 'Flying below the radar': a qualitative study of minority experience and management of discrimination in academic medicine.
abstract: OBJECTIVE
  This paper aims to give voice to the lived experience of faculty members who have encountered racial or ethnic discrimination in the course of their academic careers. It looks at how they describe the environment for minorities, how they manage discrimination and what institutions and majority-member faculty can do to improve medical academe for minority members.
  
  
  METHODS
  Qualitative techniques were used for semi-structured, in-depth individual telephone interviews, which were audiotaped, transcribed and analysed by reviewers. Themes expressed by multiple faculty members were studied for patterns of connection and grouped into broader categories. A description of the faculty sample is provided, in which respondents ranked the importance of discrimination in hindering academic advancement and used Likert scales to evaluate effects of discrimination. The sample was drawn from 12 of 24 academic medical centres in the National Faculty Survey and included 18 minority-member faculty staff stratified by gender, rank and degree who had experienced, or possibly experienced, work-related discrimination.
  
  
  RESULTS
  Minority faculty described the need to be strongly self-reliant, repeatedly prove themselves, develop strong supports and acquire a wide range of academic skills to succeed. Suggested responses to discrimination were to be cautious, level-headed and informed. Confronting discriminatory actions by sitting down with colleagues and raising the level of awareness were important methods of dealing with such situations.
  
  
  CONCLUSIONS
  Academic medical centres may need to make greater efforts to support minority faculty and improve understanding of the challenges confronting such faculty in order to prevent the loss and/or under-utilisation of important talent.
authors.affiliation: Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02118, USA. plcarr@bu.edu
authors.forename: Phyllis L
authors.initials: PL
authors.lastname: Carr
authors.forename: Anita
authors.initials: A
authors.lastname: Palepu
authors.forename: Laura
authors.initials: L
authors.lastname: Szalacha
authors.forename: Cheryl
authors.initials: C
authors.lastname: Caswell
authors.forename: Thomas
authors.initials: T
authors.lastname: Inui
mesh_terms: D000046:Academic Medical Centers / Q000941:ethics*; D001291:Attitude of Health Personnel; D035843:Biomedical Research; D004991:Ethics, Institutional; D005006:Ethnicity / Q000523:psychology*; D005180:Faculty, Medical / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000523:psychology*; D011287:Prejudice; D014481:United States