Question special

Minority tax refers to the opportunity cost minority students, trainees and faculty pay for taking on a disproportionate share of morally important activities undervalued by academic institutions. These include care for underserved communities, mentorship of minority trainees, and fighting racism in medicine. Naturally, we help our successors like our predecessors helped us, precisely because we know people who look like us are often undervalued throughout their career. Committees conferring academic advancement undervalue minority taxed services compared to other faculty activities, despite institutional statements claiming to value such diversity service.(1) Yet without this service, the diversity institutions eagerly display like trophies would, in fact, atrophy, leaving fewer minorities more motivated to pay more minority tax.

1. Will anti-racism in medicine be anything but performative(2) so long as the minority tax devalues anti-racist efforts?
2. Are there institutions where minority taxes are less burdensome?
3. How does minority tax reflect the larger culture of exploiting professionalism in medicine?(3)
4. Will there ever be a dean, department chair or other high ranking academician who ascends academic medicine by fighting racism? If so, where and how?

(1) Rodríguez JE et. al.. Addressing disparities in academic medicine: what of the minority tax? BMC Med Educ 2015;15.
(2) Gutierrez KJ. The Performance of “Antiracism” Curricula. NEJM 2020;383:e75.
(3) Ofri D. The business of health care depends on exploiting doctors and nurses. New York Times 2019;