According to the American Academy of Dermatology (AAD) website, the AAD’s Diversity, Equity, and Inclusion (DEI) initiative aims to foster diversity in the dermatology specialty and develop strategies to increase dermatological services to underserved populations.  Recently, a resolution was submitted to the AAD board requesting removal of the current DEI initiative alleging that it has become a political movement that supports division among racial groups, promotes antisemitism. and hinders the delivery of healthcare. We the undersigned deny these accusations and state emphatically that the AAD DEI initiative serves a critical purpose and must continue.  

A 2020 article in Clinics in Dermatology cited Dermatology as the second least diverse medical specialty, after orthopedic surgery, with a minority of physicians identifying as underrepresented in medicine (UIM).  The Association of American Medical Colleges defines UIM as "…those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population”.  That is consistent with the data today: despite making up 13.6% of the USA population, Black or African Americans made up only 3.6.% of practicing dermatologists and 5.7% of graduating dermatology residents.  Hispanic or Latinos are also underrepresented in Dermatology. 

The lack of representation of a particular subgroup of the population impacts public health.  Research shows that patients are less fearful of doctors with whom they can relate and are therefore more likely to see them.  In particular, the lack of Black physicians promotes medical mistrust and thus late diagnosis and poorer health outcomes in a group already distrustful of the medical establishment. The same is true for other UIM.  These patient subgroups are also less represented in clinical trials increasing disparities.  The imbalance is self-perpetuating.  With fewer relatable mentors in dermatology, it is less likely that medical students will feel confident applying for and entering the specialty. This undermines the assertion by those seeking to remove the AAD DEI initiative’s that it ‘contribute[s] to a decrease in the ability to provide unbiased and equal medical care for everyone’.

The AAD DEI initiative was launched in 2022 to address and correct these longstanding deficiencies Current programs include diversity mentorship, recognition of academic research through Investigator Awards, and providing resources for select residents and young physicians to attend the AAD annual meeting. The program is small but has already shown results: over 30% of diversity mentorship participants got into dermatology residencies. As they graduate it is hoped that they too will participate as mentors.  These new dermatologists will increase access to dermatology and positively affect patient outcomes.

The authors of the resolution against DEI claim that this AAD initiative creates a ‘binary system’ of ‘oppressors’ and ‘oppressed’, “racist and nonracist without allowance for neutrality”.  This statement has two objective problems.  The first relates to ‘binary’.  For example, the language of the mission statement of the Women’s Dermatologic Society “to empower and connect women dermatologists through personal and professional development, mentorship, service and leadership” does not disempower male, nonbinary or transgender dermatologists. Similarly, the mission of the AAD DEI initiative to foster diversity in dermatology, and provide support to groups that are underrepresented, does not undermine other groups. The second is the statement that the initiative does not allow for neutrality.  ‘Neutrality’ suggests that there is a state between racism and nonracism.  Oxford Languages defines racism as ‘prejudice, discrimination, or antagonism by an individual, community, or institution against a person or people on the basis of their membership in a particular racial or ethnic group, typically one that is a minority or marginalized.’ Nonracism is the absence of said prejudice, discrimination, or antagonism.  Given the polarity of these definitions, so called neutrality is inconsistent with the stated goal of the resolution’s authors to improve diversity and inclusivity,

The resolution to remove the AAD DEI initiative states that the DEI has “seemingly led to control of speech and the stifling of thought and professional conversations regarding difficult issues.”  Further it asserts ‘there have been instances where the DEI movement has been perceived as being filled with antisemitism’ including labelling Jews oppressors and justifying hate speech and violence. ‘Perception’, and ‘seemingly’ are subjective terms.  We condemn terrorism.  The unprecedented 337% increase in antisemitism since October 7, 2023, is unacceptable.  It must be noted that these are unrelated to the official DEI initiative programs within the AAD which have not incorporated political, antisemetic or anti-zionist activities.  The resolution does not describe where, when and whose speech has been controlled or antisemitism appeared within the Academy’s DEI programs.

 The AAD DEI statement of intent dated March 28, 2022, states: “The Academy believes in creating a diverse and inclusive environment where all its members have opportunities that enable them to succeed and thrive and is committed to ensuring quality medical care for all our patients regardless of race, ethnicity, religion, gender, or sexual orientation.” Implicit in that definition is intolerance of prejudice, hate speech, and attacks toward any minority, including antisemitism.  Therefore, we recommend that specific examples of members experiencing antisemitism should be presented to the DEI committee and AAD board so that they can be addressed directly and corrected immediately. This can proceed without discontinuing its current programs.

The AAD  DEI initiative’s initial programs targeted the disparities in racial makeup of the AAD as most urgent to improving public health. We the undersigned believe that dissolution of the AAD DEI initiative would be a step backward in achieving that goal and will not reduce the antisemitism currently faced by AAD members and patients.  We suggest instead that while continuing current impactful programs, the Academy’s DEI develop a program to address protection of religious against hate and prejudice in our specialty and the flexibility to react to the needs of our members for example during national or global events. 

We see an opportunity to fulfill the final paragraph of the AAD DEI statement of intent: ‘Inclusion fosters belonging, respect, cultural humility, and value for all and encourages engagement and connection throughout for the benefit of the physician community, and its patients as the intentional practice of bringing together different perspectives. build additional impactful bridges between our members to strengthen all minorities.”  The AAD DEI initiative can be used to fight both racism and antisemitism.

Please join us in promoting excellence in dermatologic care for all and sign this petition AGAINST DISSOLVING the existing AAD DEI Initiative.