Every year, I glance through #MedTwitter admiring the new applicants announcing themselves, with their ERAS photographs. Its's been several years, but I remember the anxiety stricken process of positioning myself to receive an interview. Though, I was most terrified of getting interviews from dream programs and “not looking” the part. Residency programs can help applicants feel more secure in 3 simple ways.
What is Natural Hair Discrimination?
Natural hair and culture headwear discrimination, a topic of debate since 2019 passage of CROWN (Create a Respectful and Open Workplace for Natural Hair) Act in California. As of now several states, cities, medical associations have passed various forms of the CROWN Act.
To Date 18 states,
American Academy of Pediatrics (AAP), Adopted in August 2021
American Medical Association, Adopted June 2022
With the goal is to address it among children through school and sport activities, Black women in the workplace, but it has not yet cracked the glass ceiling in medicine and medical education.
Why is this important?
Medical leadership deem this is unnecessary or overblown, and they risk creating a less inclusive, diverse program by not acknowledging this issue believing this is a minute aspect in residency season, in the grand scheme of USLMEs scores, MPSEs, personal statements, and letter of recommendations. For many applicants, seeing current residents embracing their natural hair and/or cultural headwear at their programs, can tell them all they need to know about whether the culture of a program or what we love to call “the feel or vibe” of the program embraces natural hair and/or cultural headwear.
When it’s not embraced, there is an internal message whether intentional or not, programs send to applicants which is:
I need to alter my appearance whether it’s natural hair or cultural headwear) to fit into the “culture” of your program to advance my career in medicine”.
Evidence based data
In 2020, researchers at Duke’s Fuqua School of Business studied the impact of The Natural Hair Bias in Job Recruitment. They discovered that natural Black hairstyles are perceived as less professional, and this effect was most seen in industries (such as medicine) where a more “conservative” or Eurocentric appearance is common.
With the increase desire to show 2020 anti-racist statements and pledges are beyond performative, it is important for leadership involved in graduate medical education, to take the necessary steps to create environments and cultures where acceptance of natural hair and cultural headwear is a normality.
3 Ways Programs Can Support
So how can these residency programs embrace natural hair and cultural headwear? As someone who has been frontline advocate on this issue for some time, I recommend the following, inclusive acknowledgments:
Openly acknowledgment
The acknowledgment that natural hair and/or cultural headwear is accepted during interview process without the applicant having to determine themselves, will decrease their anxiety and allows them to focus more on what the programs has to offer overall to them.
How: Making statement on residency websites for applicants .
Medically Professional & Acceptable
Programs supportive of the CROWN ACT at large display a desire to combat the conservative, professionalism ideas in medicine that tend to harm applicants of color. Acknowledgement that natural hair and/or cultural headwear is considered medically professional goes a long way.
How: Making statement on residency websites for applicants, setting standard policy in interview acceptance material
Revise Diversity, Inclusion, and anti-discrimination statements
To combat natural hair and cultural headwear discrimination at large, we must embrace sustainable policy among medical education stakeholders. Passage of these policies not only protects medical students and trainees, but also creates a more inclusive physicians’ workforce that knows medicine will no longer natural hair and cultural headwear discrimination within the healthcare setting.
How: Making statement on residency websites for applicants, setting standard policy in interview acceptance material, making diversity statement include statements support natural hair .
Though residency leadership can promote inclusiveness long-term policy changes at their own institutions, an expansive movement is required in medicine to change this perception in medical professionalism.