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ASCI Definitions of Diversity, Equity, Inclusion, and Underrepresented in Medicine and Science (UiMS)

Approved by the Diversity, Equity, and Inclusion Committee July 1, 2021

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Considerations

  • The ASCI respects concerns about personal disclosure; thus, in the collection of any data with the purpose of determining the Society’s current state of diversity, responses will be voluntary, self-reported, and allow for multiple options. Communication will be transparent with regard to purpose, use, and limitations on sharing.
  • The ASCI recognizes that the definitions of race, ethnicity, and underrepresented in medicine and science (UiMS) are based on those used in the United States. This allows the Society to address the particular history of structural racism endemic in this country,1 including the egregious underrepresentation of Black/African American physician-scientists. In addition, in collection of data, the ASCI will consider and incorporate granular, evolving definitions of racial/ethnic categories.2
  • The ASCI aims to address gender inequity in medicine and science by expanding and ensuring meaningful representation, engagement, and participation by physician-scientists who identify as women;3 while intentionally considering UiMS identities and the range of genders and sexual orientations, including lesbian, gay, bisexual, transgender, queer, intersex, and/or asexual (LGBTQIA).4

Definitions

  • Diversity. Demographic diversity refers to the variety of differences among individuals constituting a group, including race, ethnicity, religion, nationality, geography, sex, gender identity, sexual orientation, disability, and scientific specialty.5 Implications: Valuing diversity entails recognizing the unique contributions and perspectives of individuals from different groups as well as the combined effects of one’s multiple identities (intersectionality);6 acknowledging that these differences are a valued asset; and striving for diverse representation as a critical step toward equity.7
  • Equity. Equity means the consistent and systematic fair, just, and impartial treatment of all individuals, including those in groups that have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life (see Underrepresented in Medicine and Science).8 Implications: Equity involves a systemic and dynamic process designed to achieve fairness, and focuses on outcomes that are most appropriate for a given group, recognizing different challenges, needs, and histories.9
  • Inclusion. Beyond diversity and quantitative representation, inclusion involves authentic and empowered participation, with a true sense of belonging and full access to opportunities.10 Implications: Inclusion is achieved by expanding the cultural environment of the institution through professional development, education, policy, and practice, including creation of opportunities for potentially difficult conversations regarding diversity, inclusion, and equity.11
  • Underrepresented in Medicine and Science (UiMS). Underrepresented in medicine and science (UiMS) refers to populations that are underrepresented relative to their numbers in the general US population.12 This includes, but is not necessarily limited to, physician-scientists who identify in the following racial and/or ethnic groups: Black/African American, Hispanic or Latin American, American Indian or Alaska Native, and Native Hawaiian and other Pacific Islander;13 and individuals with disabilities: physical or mental impairment that substantially limits one or more major life activities.14

Notes

1. See NIH. Ending Structural Racism. March 2021.

2. See US Department of Health and Human Services, et al. Collection of Race and Ethnicity Data in Clinical Trials: Guidance for Industry and Food and Drug Administration Staff [nonbinding recommendations. October 2016.

3. See National Science Foundation. Women, Minorities, and Persons with Disabilities in Science and Engineering, March 8, 2019; and LB Ware, Collins, KL, Hawley, JB, Ahima, RS. A deliberate path toward diversity, equity, and inclusion within the ASCI. J. Clin. Invest. 2020;130(10):5031–5032.

4. See also Freeman, J. LGBTQ Scientists Are Still Left Out. Nature. 2018;559:27–28.

5. Based on NIH Diversity in Extramural Programs. Diversity Matters. Accessed April 13, 2021.

6. Oxford Dictionary of Social Work and Social Care.

7. Based on Race Forward. Race Reporting Guide. Version 1.1. June 2015.

8. Based on The White House. Executive Order on Advancing Racial Equity and Support for Underserved Communities through the Federal Government. January 20, 2021.

9. Based on Race Forward, op. cit.

10. Race Forward, ibid.

11. Based on MedEdPORTAL: The Journal of Teaching and Learning Resources. Diversity, Inclusion, and Health Equity Collection. Accessed April 13, 2021.

12. Association of American Colleges of Medicine. Underrepresented in Medicine Definition. Adopted by the AAMC Executive Council June 26, 2003. Accessed April 13, 2021.

13. NIH Diversity in Extramural Programs. Underrepresented Racial and Ethnic Groups. Accessed April 13, 2021.

14. NIH Diversity in Extramural Programs. Individuals with Disabilities. Accessed April 13, 2021; and National Science Foundation, op. cit.