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<p>The Flexner Report of 1910 erected persistent barriers against Black Americans becoming doctors, which diversity and community engagement initiatives endeavor to remedy. However, less than half of today’s enrolled students represent lineages enduring Flexner’s educational deprivation since 1910: Flexnerian-Deprived Black Americans (FDBAs). FDBAs represent the approximately 90% ethnic majority of Black Americans who trace their ancestry within foundational American history since enslavement, termed Ethnic Black Americans (EBAs) within the sociohistorical justice (SHJ) framework. This critical discourse analysis searched six databases from 2009 to 2024 for papers engaging the Flexner Report about physician workforce representation to apply a SHJ perspective about how Flexnerian logic may sustain institutional segregation against FDBAs/EBAs, and subsequently all Black American doctors. 11 texts were analyzed. Analysis suggested that existing Discourses in medical education reinforce nine originating Flexnerian arguments regarding Black doctors’ idealized purpose and function. Two Discourses emerge: labor-based perspectives– which present Black doctors as a commodifiable resource to treat Black patients in underserved areas and/or primary care capacities, and diversity-based perspectives – which advocate for historical justice to Black Americans while defaulting to Flexnerian logic. Neither Discourse considers Black Americans’ distinct historical identities or generational knowledges. These findings suggest that this oversimplification risks reinforcing Flexnerian segregation that devalues all Black doctors’ rights, intellectual capacity, differential lived expertise, and ideal scope of practice. True progress requires honoring the rights and educational restitutions owed to FDBAs by American history and its anti-Black harm, including the Flexner Report.</p>

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What marks the “ideal” black doctor? a critical discourse analysis of flexnerian segregation within contemporary diversity discourses

  • 期刊论文

  • 发表日期：

    2026年4月24日

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  • Carmen Black,
  • Abigail Konopasky,
  • Shavonne Temple,
  • Javeed Sukhera,
  • Jennifer Okolo,
  • Ashlynn Gray,
  • Melissa C. Funaro,
  • Christopher Fields

摘要

The Flexner Report of 1910 erected persistent barriers against Black Americans becoming doctors, which diversity and community engagement initiatives endeavor to remedy. However, less than half of today’s enrolled students represent lineages enduring Flexner’s educational deprivation since 1910: Flexnerian-Deprived Black Americans (FDBAs). FDBAs represent the approximately 90% ethnic majority of Black Americans who trace their ancestry within foundational American history since enslavement, termed Ethnic Black Americans (EBAs) within the sociohistorical justice (SHJ) framework. This critical discourse analysis searched six databases from 2009 to 2024 for papers engaging the Flexner Report about physician workforce representation to apply a SHJ perspective about how Flexnerian logic may sustain institutional segregation against FDBAs/EBAs, and subsequently all Black American doctors. 11 texts were analyzed. Analysis suggested that existing Discourses in medical education reinforce nine originating Flexnerian arguments regarding Black doctors’ idealized purpose and function. Two Discourses emerge: labor-based perspectives– which present Black doctors as a commodifiable resource to treat Black patients in underserved areas and/or primary care capacities, and diversity-based perspectives – which advocate for historical justice to Black Americans while defaulting to Flexnerian logic. Neither Discourse considers Black Americans’ distinct historical identities or generational knowledges. These findings suggest that this oversimplification risks reinforcing Flexnerian segregation that devalues all Black doctors’ rights, intellectual capacity, differential lived expertise, and ideal scope of practice. True progress requires honoring the rights and educational restitutions owed to FDBAs by American history and its anti-Black harm, including the Flexner Report.