Putting on academic armor: How Black physicians and trainees take stances to make racism visible amidst publishing constraints

Abstract

Introduction: While there are a growing number of empirical studies of Black physicians' and trainees' experiences of racism, there are still few accounts from a first-person perspective. These personal commentaries or editorials require taking a delicate stance, balancing the professional, social, and individual. Black authors in the medical publishing space, who already experience microaggressions and racial trauma in their work spaces, must put on their academic armor to further experience them in publishing spaces. Medicine and medical education interpellate each of us, including the authors and readers of this piece, as a particular kind of subject. Beginning with a narrative grounding in the authors' personal stances, this study seeks to understand the stances Black physicians and trainees take as they share their personal experiences of racism while protecting the institution of medicine from racism's irreparable harms. Methods: The authors searched four databases identifying 29 articles authored by Black physicians and trainees describing their experiences. During initial analysis, the authors identified three sets of discursive strategies: identification (introducing and tracking themselves throughout the article); intertextuality (dialoguing and drawing on other "texts" beyond the focus of the articles); and space-time (social constructions of space and time linked to a network of social practices). The authors used a Google form to capture these strategies and direct quotes from the articles. Throughout the study, the authors reflected on their own stances in relation to the experience of conducting the study and its findings. Results: Authors engaged in stance taking, which aligned with the concept of donning academic armor, by evaluating and positioning themselves with respect to racism and the norms of academic discourse in response to ongoing conversations both within medicine and in the broader US culture. They did this by (a) positioning themselves as being Black and, therefore, qualified to notice and name personal racist experiences while also aligning themselves with the reader through shared professional experiences and goals, (b) intertextual connections to other related events, people, and institutions that they-and their readers-value and (c) aligning themselves with a hoped-for future rather than a racist present. Discussion: Because the discourses of medicine and medical publishing interpellate Black authors as Others they must carefully consider the stances they take, particularly when naming racism. The academic armor they put on must not only be able to defend them from attack, but help them slip unseen through institutional bodies replete with mechanisms to eject them. In addition to analyzing their own personal stance, authors leave readers with thought provoking questions regarding this armor as they return to narrative grounding.