So You Want to be an Ally? The ABC’s of Allyship, BIPOC, Conscious Bias and More

As a PCCM educator and leader, we have a responsibility to stand up for our colleagues, our trainees, our patients, and ourselves. First, we need to understand the terms involved to know that we are all speaking the same language. In our workshop at the APCCMPD 2021 Virtual Annual Conference, we will discuss how PCCM educators and leaders can be better allies and help confront and dismantle sexism and racism in our institutions. Here are a few key terms as a ‘glossary’ to help learn the ABC’s of Allyship, with concrete examples from PCCM, to get the conversation started.

Glossary of Terms from Stanford University (Credit: discriminationsupport.stanford.edu)

“Allyship is active behavior by a member of a dominant group to dismantle the oppression of a target/non-majority group.”

PCCM Example: A male fellow helps to advocate to a clinic director for a female co-fellow to get protected time for lactation during her continuity clinic.

“Microaggressions are everyday verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or unintentional, which communicate hostile, derogatory, or negative messages to target persons based solely upon a marginalized class or characteristic.”

PCCM Example: An ICU attending seems to constantly interrupt a first-year fellow who is a woman of color when she is teaching on ICU rounds.

“Privilege refers to benefits, awards, or advantages that accrue to dominant groups based upon skin color, gender, sex, class, ability, religion, etc., that they have received without earning and/or asking for them; privilege is usually invisible to the receiver.”

PCCM Example: I acknowledge as an author of this piece that I benefit every day from the privileges of being a cis-gender heterosexual able-bodied physician who is not from an underrepresented group. I intend to use these privileges to advocate as an ally for those who do not benefit from these same privileges. So I can walk into the ICU at night to see a patient and not be denied entrance or questioned as to the reasons I am there by the security at the hospital entrance or a charge nurse I have not yet met.

“Systemic, structural, or institutional racism refers to the complex interactions of culture, policy, and institutions that create and maintain racial inequality in nearly every facet of life for non-majority groups.”

PCCM Example: Segregation, redlining (the practice of banks refusing to loan money or inflate costs of loans for homes), and other historic discriminatory practices have led to worsened rates of asthma among children and adults living in certain predominantly Black and LatinX neighborhoods.

We hope that this Glossary of terms with PCCM examples will help us start a conversation together so we may all be better allies to advocate for our colleagues, trainees, and patients.

Lekshmi Santhosh, MD, MAEd specializes in pulmonary and critical care medicine with a focus on medical education. She attends in the Medical ICU, the Neuro ICU, and on the Internal Medicine teaching wards, and has clinic in the Pulmonary Outpatient Faculty Practice at UCSF-Parnassus. She is the founder and physician faculty lead of the multidisciplinary post-COVID OPTIMAL Clinic at UCSF Health.

She serves as the Associate Program Director for the Pulmonary and Critical Care Medicine Fellowship. She obtained her Master’s in Health Professions Education from UC-Berkeley. She gives clinical lectures to students, residents and fellows as well as interprofessional team members. Her primary interests in medical educational research are related to ICU transitions of care, women in leadership development, clinical reasoning, and subspecialty education career choice. This author spoke to this topic at the 2021 APCCMPD Annual Spring Conference. Click here to view the associated Training Tool.