Aug 26, 2020
Anique K. Forrester, MD, joins host Lorenzo Norris, MD, to
discuss the importance of continuing to work in academic
Forrester is assistant professor at the University of Maryland,
Baltimore. She also serves as director of the consultation-liaison
psychiatry fellowship at the university.
Norris and Dr. Forrester have no conflicts of interest.
- Dr. Forrester recently wrote an article in
the New England Journal of Medicine discussing minority
underrepresentation in academic medicine and the persistent labor
of love required to stay in departments that do not explicitly
- Underrepresented minority colleagues leave for many reasons,
and Dr. Forrester highlights the issues of invisibility, lack of
mentorship and support, and burden of microaggressions.
- Dr. Forrester focused her article on why she stays in academic
medicine, feeling that it is critical her voice is heard; she knows
her presence has changed the tone and outcome of issues. As she
says: “One of the things about representation is that someone has
to be there to represent.”
- Staying in academic medicine with the presence of systemic
racism is a difficult road; however, Dr. Forrester has stayed
because of her desire to educate and mold the future of
- Underrepresented minority (URM) colleagues leave for many
reasons, and Dr. Forrester highlights the issues of invisibility,
lack of mentorship and support, and burden of microaggressions. The
Chester Pierce, MD, a psychiatrist and the first African
American full professor at Massachusetts General Hospital, Boston,
coined the term “microaggression” to describe subtle slights or
snubs directed at minority and historically stigmatized groups. The
cumulative effect of microaggressions is toxic and can lead to
self-doubt, damaged self-esteem, and momentum that pushes a URM
colleague to leave.
- When a URM colleague leaves a department, there is a
short-lived conversation about what could have been done
differently to retain them.
- Forrester speaks of the “double hit” that occurs when a URM
colleague leaves because it is not just the loss of a colleague,
but the additional connection about the shared sense of mission and
about progressing conversations about equity and diversity in the
- Medical trainees at every level benefit from a diverse core
faculty because such diversity provides different perspectives to
situations and thus might also provoke an alternative response that
is essential to growth. Research has also shown that patient
outcomes improve in the presence of diverse medical teams.
- Dr. Forrester talks about using self-reflection to identify
one’s core mission as the commitment to stay in academic medicine
and/or an underrepresented department. When we are stressed, it’s
instinctive to be reactive to negative situations. Identifying
one’s intention for being in academic medicine in the first place
can reinforce the strength to stay and reach out for support.
Forester A. N Engl J Med.
2020 Jul 23;383:e24.
DeAngelis T. Unmasking ‘racial microaggressions.’ American
Psychological Association. Monitor on
Galinsky AD et al.
Perspect Psychol Sci. 2015 Nov;10(6):742-8.
Gomez LE, Bernet P.
J Nat Med Assoc. 2009 Aug;111(4):383-92.
Show notes by Jacqueline Posada, MD, who is associate producer
of the Psychcast and consultation-liaison psychiatry fellow with
the Inova Fairfax Hospital/George Washington University program in
Falls Church, Va. Dr. Posada has no conflicts of interest.
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