Black Women in Medical Education Publishing: Bibliometric and Testimonio Accounts Using Intersectionality Methodology

Abstract

Background: Black women in academic medicine experience racial and gender discrimination, all while being tasked with improving a flawed system. Representation of Black women in medicine remains low, yet they bear the burden of fostering diversity and mentoring trainees, exacerbating their minority tax and emotional labor, and negatively impacting career progression.

Objective: To complement qualitative accounts of Black women authors in the medical education literature with a quantitative account of their representation. We used statistical modeling to estimate the representation of Black women authors in medical education publishing as compared to other groups.

Design: An intersectional methodology employing bibliometric analysis and testimonio reflection.

Subjects: US-based authors of journal articles published in medical education journals between 2000 and 2020.

Main measures: Author race was determined using a probability-based algorithm incorporating US Census data, and author gender was ascribed using Social Security Administration records. We conducted two negative binomial generalized linear models by first and last author publications. Metadata for each article was retrieved from Web of Science and PubMed to include author names, country of institutional affiliation, and Medical Subject Headings (MeSH). Results were contextualized via the "testimonio" account of a Black woman author.

Key results: Of 21,945 unique authors, Black women (and other racially minoritized groups) published far fewer first and last author papers than white women and men. In addition, major MeSH terms used by Black women authors reveal little overlap with highly ranked medical education topics. The testimonio further narrated struggles with belonging and racial identity.

Conclusion: This study revealed that Black women are underrepresented in medical education publishing. We believe that dismantling oppressive structures in the publishing ecosystem and the field is imperative for achieving equity. Additionally, further experiential accounts are needed to contextualize this quantitative account and understand underrepresentation in medical education publishing.

Keywords: Black women; intersectional/ity; medical education; scholarly communication.

Figure 1

The complexity of intersectionality for Black women in medical education publishing. Note: This figure shows the complexity of intersectionality for Black women in medical education publishing and Haynes’ intersectional methodology (IM) and tools from QuantCrit work as our approach to understanding this complexity. At the core of this approach are Black women’s stories, hence our foregrounding of Black women’s complexity through our authorial testimonio. Then, there are three intersecting sets of investigative tools that we use: first, we focus on the intersectionality of racism and sexism as it applies to Black women, making them the core of our analysis; second, we attend particularly to the mechanisms of power in publishing and medical education, providing context for these mechanisms in our introduction and conclusion; third, we also surface research and its history of oppressive practices as another aspect of our context, foreground past oppressions so that readers interpret the current study’s findings with that history in mind.

Figure 2

Extrapolated manuscripts by author type, gender, and race/racism. Note: The y-axes in the faceted plots have free-floating scales.