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'This Diversity Is Not Real': How To Tell If Your Program's Diversity Is a Hologram

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During my short medical career, I have seen increased awareness about the importance of diversity in the medical workforce. More campaigns and articles are published every day. In all honesty, I have probably benefited from this movement, and I hope more minorities are incorporated into the medical workforce.

But because of this new movement, many of us have been selected as "the poster minority student," or have otherwise suffered from "tokenism."

Tokenism is the word used to describe when a minority student, resident, or fellow is used as the token of diversity in an institution. (This student is often visible in advertising materials from the institution or program.) The problem with tokenism is that no further action is taken to improve the diversity and inclusion policies of the institution. It is more like, "Look, we have a Latina," and less like, "We value diversity, and we are working on the following initiatives …”

I was not aware of this phenomenon until recently when I saw my picture in the brochure of a program I had participated in many years ago. I started investigating further. Though many students had gone through the program after me, most were not Latino or Hispanic. I called the program’s secretary and asked about the picture. She (a minority herself) told me: "We need it to look good."

Photo credit: Donald Tait, MD

One of the problems with tokenism is that other minority medical trainees may be deceived; they may select the program or school believing diversity is a priority when it is not. As a minority in medicine, I am always looking for other minorities when I interview at a new place. Even recently, while looking for my first faculty position, I was searching the premises for Latino/Hispanic faculty. Representation is important me. During my medical training, I found allies in other minorities who had had similar experiences, including the feeling of not belonging in medicine.

Tokenism can delay diversity initiatives. For example, if leadership can advertise a picture of a very diverse set of students (maybe representing every enrolled minority), the program may not feel pressure to change policies or improve recruitment efforts. That picture is a hologram—you can see it, but the diversity is not real.

My grandmother taught me how to know if a watermelon is good or not from the outside. Similarly, minority medical trainees need to be aware of tokenism—they need to know which programs prioritize diversity and inclusion policies. A few tips:

  1. During your interview, look around—ask to meet with other minority trainees
  2. Ask if minority groups like the Latino Medical Student Association (LMSA) and the Student National Medical Association (SNMA) are active within the institution
  3. Compare the list of students or trainees with the diversity picture you saw on the website.  Is this picture a diversity hologram?

Tokenism is not unique to medical programs. It can be seen across disciplines and in many forms (e.g., pictures, welcome messages, interactions during your interview).

As a final note, I want to thank everyone who is working on improving the diversity of our medical workforce, from admission committees to students’ organizations—gracias totales!


Dr. Narjust Duma has no conflicts on interest to disclose.

Dr. Narjust Duma, MD is the Chief Hematology-Medical Oncology Fellow at Mayo Clinic Rochester. She is also on Twitter (@NarjustDuma).

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