APA Board Discusses ‘Roadmap for the Future,’ M/UR Nomenclature

Board members also heard a report from Maria A. Oquendo, M.D., Ph.D., past APA president and chair of the Presidential Workgroup Exploring Minority and Underrepresented (M/UR) Group Nomenclature. The workgroup is charged with reviewing and rethinking current nomenclature regarding the term M/UR and developing recommendations for new language.

Oquendo noted that under APA's current nomenclature, minorities include American Indian/Alaska Native/Native Hawaiian, Asian American, Black/African American, and Hispanic members. Underrepresented groups include international medical graduates (IMGs), LGBTQIA+, and women. Each group has its own caucus under the APA Assembly, and all seven are collectively referred to as the M/UR caucuses.

However, Oquendo noted that a review of the literature has shown that words like “minor” (minority/underrepresented) can reflect that a group is viewed as inferior or less favorably and that racial/ethnic groups, including African Americans/Blacks, Hispanics/Latino(a), American Indian, and Alaska Natives, do not self-identify as underrepresented minorities.

Oquendo said, “The current APA nomenclature—M/UR—unnecessarily aggregates and confounds the experiences of diverse groups—racial/ethnic, gender, gender identity, international education, and training—and has the potential to perpetuate a negative and/or inferior stereotype of the groups included in this category.”

The workgroup acknowledged that addressing the M/UR nomenclature should occur as a multiphase process, that captures and represents a diverse and inclusive organization that encourages, supports, and engages all its members.

The first phase focuses on developing nomenclature and collecting data and metrics on groups within psychiatry who have low representation relative to their representation in the population. These include the following:

The workgroup proposed two terms to address the first phase of this process—Population Share in Psychiatry or Percent Representation in Psychiatry. These two terms were not suggested as a substitute for the M/UR nomenclature, but rather a way to identify and collect data on those racial and ethnic populations that are underrepresented in the psychiatric profession relative to their numbers in the general population. This data would provide the most current statistics available about active psychiatrists and psychiatrists in training who are members of APA, which can then be used to develop and evaluate policies and programs to create a physician workforce that is demographically representative of the U.S. population.

The second phase would involve receiving input on a name that is inclusive and supports members of groups who may not have low percent representation in psychiatry relative to their representation in the general population, but who have not achieved full voice and equity and/or face discrimination and inequity within the profession.

“This nomenclature would remove the subordinate, negative connotations of ‘minority’ and provide a term that accommodates including and removing racial/ethnic groups on the basis of changing demographics in society and in the psychiatric profession,” Oquendo said.

The third phase is to constitute a workgroup with expertise in APA governance to address the needs of all seven groups.

Immediate next steps include scheduling listening sessions with all seven groups to obtain their input and feedback on the term “M/UR” and in the phase one definitions.

In other business, the Board approved the following: