Today I reflected upon my experiences as a black woman in medicine. Following the death of George Floyd, a lot of medical spaces have had, or are currently having, conversations on how to be an anti-racist, how to support people of color, and how to increase diversity within workspaces. All of these conversations have made me reflect on my short time in medicine and how my experiences have been different than others due to the color of my skin.
Before medical school, as a black premedical student, I found myself often discouraged by advisors or even peers in college. They would make it seem as if I was not “good enough” to get into medical school. For them, being a doctor was such a “lofty” goal, and surely, there must have been an easier career that I could attain that was more “reasonable.” However, this perspective about being “good enough” did not carry over to several of my white counterparts. For my white counterparts, medicine never appeared out of reach for them; they only needed guidance to help them attain their goals. Nevertheless, due to God and my pure doggedness, I never allowed anyone to talk me out of my desire to pursue a career in medicine.
Once admitted into medical school, I found that the number of students of color in all of the medical school classes were particularly low. Throughout my undergraduate education, there were black and brown pre-medical societies, with at least 50 students of color interested in pursuing a career in medicine. Within those societies, it was not difficult to find peers who experienced a similar struggle of trying to become a physician, especially as a minority. In medical school, I expected a similar number of students of color, similar to the pre-medical societies in which I was involved. However, what I discovered was that similar to many other medical schools, I was 1 of 7 Black students, and there was only one Latino student, in a class of approximately 200 students. There was a constant awareness between my small cohort of black students that other students within our class and individuals in the medical school administration expected black students to perform academically worse than the other students in our class. We were told by some administration that regardless of great grades, we should not expect to get into certain medical specialties. In contrast, they encouraged non-minority students with similar or lesser grades to apply to these medical specialties for residency. Just by being a student of color in medical school as an underrepresented minority automatically meant that my experience was significantly different than my non- minority counterparts.
In medical school, I served on the admissions committee with one other black medical student and other non-minority students. During one of the admissions committee meetings, while evaluating a minority candidate, a non-minority student admissions committee member stated blatantly in front of faculty that myself and other black medical students were only in our current medical school because of the color of our skin, not because of merit. Of course, our acceptance to medical school could not have been because we performed well on the Medical College Admissions Test (MCAT), or because we also had great grades and impressive experiences. It MUST have been due to our race. These comments were met by silence by our faculty, which looking back, was just as hurtful. I recognized such statements as ignorance and in some cases, due to racism and bigotry, I was always conscious of how others may view me as a black person in medicine. Despite the perception of my black colleagues by some of our classmates and some of the medical school administration, we recognized that it was up to us to attempt to change this perception. We deeply wanted to help the medical school improve diversity within the medical school classes and to improve the knowledge of the students regarding people of color and the communities where our medical school was located. We attempted to improve these things through serving on the admissions committee and through creating educational and social programming in our Student National Medical Association (SNMA), with topics including cultural competency, the local history of African Americans, and diversity showcases.
When reflecting on these experiences, it upsets me that in medical school, we as students of color needed to constantly educate our medical school about cultural competency and other issues pertaining to people of color. While we should be focusing solely on our medical education, there was always an uneasiness that we would be judged differently than our non-minority peers if we did not perform similarly. But why should we have had to “prove” ourselves to our peers that we belonged in medicine and that we were also qualified, when a board of individuals who sat on an admissions committee already determined this to be true? This burden was unfairly placed on us, and it is one that is the experience of many minorities in medicine. Similar experiences also persisted in residency training, although not as blatant. These experiences occurred in the form of microaggressions and being perceived as an “angry” black woman if you spoke up compared to your peers.
After the events of Charlottesville in 2017, the recent killing of George Floyd and many unarmed Black Americans, as one of the limited number of black physicians in medicine, we have become the primary source to initiate conversations around race. Black medical students and physicians are finding that we have to teach others about cultural competency, the importance of diversity in medicine (including diversity within medical school classes, residency, and faculty), and that medical schools and residency programs should have health equity and disparities curricula. While these are much needed conversations, and it is a privilege to have these conversations, it can be exhausting at times. My non-minority cohorts do not have to experience having to speak for an entire race of people (which are not monolithic, despite what some may think). Increasing medical education and physician workforce diversity, and increasing cultural competence, should be the responsibility of the entire medical field. As people of color, it should not be our sole responsibility to have to teach others various topics, including but not limited to the following: how to respect underrepresented minorities, how to limit microaggressions, why there should be equal pay, why opportunities may be different for underrepresented minorities, and how white privilege is a real concept. However…just when I think that maybe all of the struggles that I have faced to make it into medicine is not worth it given the above challenges, I walk into a patient’s room who happens to be African American, and they say “I’m proud of you, you are needed, I’m so happy you are here”….and it reminds me that although it is not easy being a physician of color, all of the challenges are worth it and that I was purposed to have a career in medicine.