A few weeks ago, I did a cover-to-cover read-through of the First Aid for the USMLE Step 1 2020 textbook. As the book’s illustration co-editor, I was looking for graphics to improve for our 2021 version. (1/7)

I noticed a pattern I hadn’t seen before: of the almost 70 illustrations showing skin tone or sex, every single illustration showed pink/light beige skin, and every graphic except 1 was male*. That’s 100% white & almost 100% male. *excluding reproductive anatomy graphics (2/7)

There’s got to be some cognitive load reduction for some of these, I thought. Duchenne’s muscular dystrophy? Perhaps. But asterixis? Hand anatomy? Inguinal hernias? No. And what about Tanner stages of development? (3/7)

So how should our illustration team solve this? Do we use grey (i.e., no race/ethnicity), androgynous figures to depict anatomy where race, ethnicity, and sex are not intrinsic to understanding the concept? Or do we instead start reflecting diversity in our illustrations? (4/7)

Either way, the white man as the default depiction in our medical illustrations is out. The @firstaidteam is excited that we’re addressing this in our 2021 version, and universally agrees it’s a long overdue change. I’m honored to get to work with such a great group. (5/7)

I encourage other medical illustrators + textbook authors to conduct a similar review of their graphics—I don’t think that FA is the exception to this rule. And I’m reminded of my privilege, in that after studying from this book for 4 years, I’m just now noticing the issue. (6/7)

Tweets inspired by
@gradydoctor’s Grand Rounds "From Bystander to Upstander” (it's 5, yall)—at 10:33, Dr. Manning discusses our lens, or the way each of us sees the world, and how important it is to recognize both what IS and ISN’T in our lens.
(7/7)

#MedEd #MedTwitter #DEI