The New England Journal of MedicineDismantling the Overpolicing of Black Residents

Addressing Disproportionate Disciplinary Actions and Creating a Supportive Environment for Black Medical Trainees

In the face of disproportionate disciplinary actions against Black medical trainees in the United States, a new framework has been proposed to foster a more supportive and equitable environment. This approach aims to reduce overpolicing, enhance transparency, and promote mental health among Black residents, ultimately improving their experience and retention in residency programs.

HCN Medical Memo
This framework provides a roadmap for healthcare professionals to create a more inclusive and supportive environment for Black trainees. By understanding and addressing the challenges faced by these trainees, healthcare professionals can contribute to a more equitable medical education system that benefits all residents.

Key Points

• Black trainees face higher rates of remedial interventions and dismissal from their programs than their White counterparts, leading to concerns of overpolicing in medical education.
• Overpolicing begins as early as primary education and continues through high school, college, medical education, and the workforce.
• In graduate medical education, biased scrutiny begins with the use of metrics that disadvantage Black applicants in the residency selection process.
• Increased scrutiny and expectations can lead to damaging effects such as symptoms of depression and anxiety among Black residents.
• The proposed framework emphasizes transparency in feedback and remediation processes, use of objective measurements, normalization of supplemental help, nonpunitive education, privacy of remediation plans, mental health support, and nurturing areas of excellence.

“I think if he was a White resident, I don’t think it would have gotten to that point, I think someone would have stopped and said, ‘You need to do this, this, and that.’ And given him support and help instead of more and more bad reports. Finally, he just got kicked out.”
– Anonymous surveyed medical student

More on Healthcare Disparities