The American Psychiatric Association (APA) on Nov. 4 unanimously passed an action paper titled, "Addressing Racial Discrimination Against Psychiatry Trainees and Psychiatrists" authored by Jessica Isom, MD, MPH, fourth-year resident in the Yale Department of Psychiatry, and J. Corey Williams, MD, MA, former Yale Psychiatry resident.
This landmark resolution was supported by a number of current Yale residents, fellows, and faculty members along with many APA Assembly members. Through lobbying efforts spearheaded by Isom within the APA Councils, Assembly Committees and other stakeholders, including the American Association of Directors of Psychiatric Residency Training (AADPRT) and the Association for Academic Psychiatry (AAP), the action paper received a number of endorsements which bolstered its ability to pass on the Assembly floor.
During the Assembly, Isom testified to the action paper’s merits as a representative voice of Resident-Fellow Members and by speaking to her own experiences as a black psychiatric resident who has witnessed and been the target of racial discrimination.
Incidents of physician mistreatment in the form of race-based discrimination perpetrated by patients and their families are disturbingly commonplace. Resident physicians, in particular, may be at higher risk for discriminatory abuse from patients. There are studies that highlight this form of discrimination as a potential threat to personal and professional well-being during residency training as a result of the hostile learning environment these behaviors create.
Race-based discrimination of physicians has been described in various forms such as: patient’s requesting non-minority physicians, microaggressions, and overt racial slurs. Scholars have made efforts to stimulate dialogue around these issues in popular media. Kimani Paul-Emile, JD, PhD, Professor of Law and Associate Director and Head of Domestic Programs and Initiatives at Fordham Law School’s Center on Race, Law & Justice, constructed an algorithm to help hospitals navigate the legal complexity of racial discrimination by patients, specifically; however, there remains a dearth of literature in evaluation, adjudication, and responses to discriminatory behavior perpetrated by patients.
Isom and Williams decided to fill this gap in guidance and research through the creation of a volunteer workgroup, under the existing APA infrastructure, to produce a web-based toolkit addressing racial discrimination against psychiatry trainees and practicing psychiatrists. The toolkit will address all levels of this longstanding issue including interpersonal and institutional guidance.
This toolkit will be developed and maintained by the Council on Medical Education and Lifelong Learning and the Council on Minority Mental Health and Health Disparities in coordination with the Division of Education. There will also be content developed by the Division of Diversity and Health Equity.
It will be made available to all Accreditation Council for Graduate Medical Education residency program directors, psychiatry department chairs, APA members and the general public.
Isom and Williams are open to suggestions for the content of the toolkit. Isom can be reached jessica.isom@yale.edu and Williams can be reached at jwilli17@gmail.com.
Isom’s two-year term as the Area 1 RFM Representative ends at the May 2019 Assembly Meeting. If you are a PGY-1 or PGY-2, she would welcome your interest and questions. Additional PGY years are eligible should the resident pursue a fellowship program.
About the APA Assembly
The APA Assembly represents and serves the needs of the district branches (DBs) and state associations (SAs) and recommends actions to the Board of Trustees.
To ensure a wide range of voices and ideas, representatives of the Assembly are selected regionally and by special groups determined by the Assembly. The APA Assembly consists of representatives from the DB/SAs and includes resident-fellows, early-career psychiatrists, minority and underrepresented (M/UR) psychiatrists, and representatives from allied organizations approved by the Assembly. Each DB/SA elects its representatives to the Assembly through its own election process.