by Jane Bailey, MD, ABO Vice Chair
“History will have to record that the greatest tragedy of this period of social transition was not the strident clamor of the bad people, but the appalling silence of the good people.”-- Martin Luther King Jr.
Events of the year 2020 confronted Americans with the pernicious effects of centuries of systemic racism. Police brutality as well as gaps in health, wealth, justice, and opportunity brought long overdue attention to racial inequality, calling for education, acknowledgement, understanding, and action in all areas of our society. The painful events engendered newfound empathy for the daily subtle and overt discrimination faced by patients, health care workers, and colleagues of color.
The ABO pledges to serve the public and our profession by promoting anti-racism through our assessments, policies, affiliations, and all that we do. Our commitment to diversity and inclusion, minimizing bias, and incentivizing education about racial and gender disparities is manifested through the following actions in 2021 and 2022:
Expanding the volunteer recruitment process so that diplomates from varied backgrounds, practice settings, and parts of the country have the opportunity to contribute to our mission of assessing, certifying, and inspiring the next generation of ophthalmologists. Although many professions and organizations depend on collegial referrals for recruitment, these networks can leave out underrepresented individuals and perpetuate privilege. Our goal is that ABO volunteers reflect the diversity of our profession, and eventually mirror the truly diverse patient population we serve.
Collecting demographic data including gender identity, race, first language, and ethnicity to better understand the candidates’ and diplomates’ backgrounds. This will enable us to scrutinize ABO assessments, programs, and policies to ensure they are free from bias. Ibram Kendi, author of How to Be an Anti-Racist, writes that the heartbeat of racism is denial, that one cannot change what one chooses not to see.
Evaluating ABO assessments for potential bias, including conducting differential item functioning analyses on the Written Qualifying Examination, the Oral Examination, and Quarterly Questions once adequate demographic information has been gathered.
Providing unconscious bias education and de-biasing training for directors, volunteers, and staff on a recurring basis, and educating ABO directors about organizational best practices for promoting equity and inclusion.
Promoting understanding of social determinants of health by incorporating new American Academy of Ophthalmology Basic Clinical Science Course content into written and oral exam items, and through Quarterly Questions articles. A Health Care Equity section was added to the 2021 article-based Quarterly Questions, which includes the following three articles:
- Preserving Vision in the COVID-19 Pandemic: Focus on Health Equity: Author(s): Mike EV, Laroche D.; Publication: Clinical Ophthalmology
- Lighting a Pathway: The Minority Ophthalmology Mentoring Program: Author(s): Olivier MMG, Forster S, Carter KD, Cruz OA, Lee PP, Publication: Ophthalmology
- Vision health disparities in the United States by race/ethnicity, education, and economic status: findings from two nationally representative surveys: Author(s): Zhang X, Cotch MF, Ryskulova A, Primo SA, Nair P, Chou CF, Geiss LS, Barker LE, Elliott AF, Crews JE, Saaddine JB.; Publication: American Journal of Ophthalmology
6. Accommodating candidates with disabilities and nursing mothers during examinations.
7. Supporting the American Academy of Ophthalmology (AAO) and Association of University Professors of Ophthalmology (AUPO) Minority Ophthalmology Mentoring program, which helps students who are underrepresented in medicine (URiM) become competitive ophthalmology residency applicants. Students receive one-to-one mentorship, career guidance, networking opportunities, and access to educational resources.
8. Recruiting diverse directors, staff, and contractors. The tangible benefits to the ABO of organizational diversity include increased creativity and problem solving, productivity, flexibility, intercultural competence, and improved ability to continue attracting exceptional staff, volunteers, and directors.
The ABO’s history inspires us to find new ways to protect the public from unsafe or inequitable eye care in this dynamic century. The ABO’s commitment to serving the public through verification of competencies remains steadfast, even as competencies evolve.
Anti-racism is life-long work, and we must continue to view our policies through this lens moving forward. We are committed to ongoing listening, learning, and self-reflection. Our goal is for every candidate and board-certified ophthalmologist to feel respected, heard, and valued; pride in certification; and a sense of belonging. We embrace this historic opportunity to put anti-racism into action and help bring about positive change in the years ahead.