michelle ko md phd

Tourists bathing elephants in Thailand

A recent article in StatNews covered the (unsurprising) disappointing trend in which scholars from many fields are now jumping on the ‘health equity’ and ‘anti-racism’ bandwagon, including submitting articles, grant applications and starting new studies– when these scholars do not have prior experience in these arenas.

There is, frankly, a lot of work that needs to be done.  I am not an expert on this, and as someone who also does not necessarily come from the communities that I study, I am still learning better ways to be a scholar.

Here are some ideas that I am trying to improve upon myself (we are all a work in progress):

For students/early scholars:

• When selecting a program, look at your institution’s efforts towards DEI. Ask directly. Deliberately prioritize programs that support learning and advancing health equity, with a diverse class and inclusive environment. You need all of these for your own education. Searching for diverse student bodies is a priority for everyone, not just students of color.
• For a given equity issue, consider whether you have lived experience on the issue. If not:
  • Seek out voices and experiences of those who do.
  • Learn about community-engaged research paradigms.
  • Recognize that there are multiple ways in which to  contribute to research, not just leading or being the ‘face’
• When starting your own research, look for advisors with specific experience in health equity and a diversity of experiences- otherwise, how can you ensure you are receiving the right guidance?
  • For example, if you ultimately conduct a study on Black communities, you need Black advisors, ideally with lived experience on your topic (I did not do this- instead, I wound up with a dissertation that did not include structural racism. anywhere.)
• Accept that you will make mistakes in this work, because everyone does (no matter what their background or experiences). If you don’t make mistakes, you’re likely not genuinely engaged.
  • Learn, early, how to reflect, accept responsibility, apologize, and move on to doing better.
  • Learn about cultural humility and start your journey.

Mid-career scholars

• Reach out and ask how you can be helpful to your junior colleagues.
  • Listen. Don’t automatically assume that your work, experience, etc., will benefit them.
  • Be clear on what you can (and can’t) offer.
  • State explicitly that you do not need a response when you reach out.
  • Don’t be offended if they turn you down. Or never even respond. They are incredibly over-subscribed and over-taxed.
• Here are some potential ways to be helpful that are NOT research:
  • Explain how you got hired
    • Are there people in your networks who could provide good advice/resources/connections- and you trust them *not* to cause harm?
    • Share departments, schools, institutions with good reputations for working with scholars from marginalized communities; warn them about the people/places to avoid
    • How you searched for the job
    • What questions to ask when on the job market
  • Explain how you got promoted
    • What steps were involved
    • Specific people your junior colleagues should connect with prior to submitting
    • Nitty gritty administrative details, e.g. forms, how long it takes,
    • Hidden roadblocks/challenges at your institution, and how to navigate them
    • Offer to review tenure documents and provide constructive feedback
  • Explain how you got published in a major journal
    • See above re: unexpected challenges,
    • How to work with editors,
    • What are ‘unofficial’ channels, e.g. pre-submission inquiries, friends over editors, and so on
  • Explain how you submitted a grant
    • How to work with a program officer
    • How to work with your institutions’ grant and contracts staff
    • Identifying key information from funder websites and review processes (which are often opaque)
    • Offer to review grant application materials, and don’t ask to be on the grant unless you are actually going to commit to a substantive contribution to the study. i.e. just because you’re reviewing for them, does not mean you should be on the grant.
      • Only IF you make a substantive contribution to the questions, concepts, and methods, will commit to the project AND having your name on it will substantially increase the fundability– then do that.
    • Hidden rules (notice how many times ‘hidden’ is on this list?): for example, some funders will only return to the same awardees, and/or the same institutions, even with ‘open’ RFAs. You can help your colleagues by letting them know which opportunites are frankly, a waste of time. Better yet, if you received one of those awards yourself, coach them on preparing all of the application, not just the aims or strategy. Many scholars in health equity have great ideas–but no one has dedicated the time to explain the 25 other pages that go with the grant, e.g. Facilities. Budgets.

Senior

• See all of the above for mid-career.
• Recruit for demonstrated expertise in health equity, be expansive and inclusive about what advancing health equity looks like, and prioritize those factors
  • Outreach directly to scholars of  color
  • Revise your evaluation process for hiring to prioritize *equity* and *inclusion*
  • Resources:
• Be a sponsor.
  • Ask your junior colleagues what they need, from the institution, in terms of support. Use your years of experience in learning the hidden rules of the game to take advantage of institutional norms, policies, and so on, to advocate for your colleagues.
• Pause before you apply.
  • Just because there is a large grant opportunity, and you have built a wealth of expertise in your specific niche, stop and think. Do you actually need this money? If you are the *best* person to do this research, why haven’t you done it already?
• Look out for your colleagues.
  • There are more than enough academic environments operating under a cloud of toxic white masculinity, and oftentimes, people actually know who the bad actors are.
    • Don’t recruit a BIPOC female/ non-binary scholar to your department if this is your environment, even if you know you “need” diversity.
    • During recruitment (because we know many of you are doing it anyways): be transparent about this environment.
      • Thoughtfully explain the issues that you think could threaten the success of your prospective colleague. Explain what you will do, specifically, to remedy the situation. Be honest about how realistic you think the chances are, for change.
      • Hire three for every initial search in which you plan to hire one. (Yes, this takes money, but so does partner hiring- i.e. all sorts of things are possible, when you think about it)
    • After your organization has already hired a BIPOC female/non-binary scholar:
      • Assess what institutional policies and norms are underlying the poor climate in your department, and use your relative seniority to take action.
      • Action can include changes in policies, working on organizational climate, education and re-education, and transparent, explicit processes and consequences for those who harm colleagues, trainees and students.
  • Consider how you can intervene with problematic colleagues in your field (beyond your institution)
• Look for practices and policies at your institution, in your field, in national organizations- that are perpetuating racism in your field. Identify collaborators and work together for change.