*Students Persevere Amid Challenges to Change Perceptions of What a Doctor Looks Like*
Oh, no, sweetie, put your hand down, we are looking for actual physicians or nurses or some type of medical personnel, we don’t have time to talk to you.
Tamika Cross, a Texas-licensed OB-GYN, received this exact response aboard a Delta Airlines flight due to her feminine characteristics and the dark color of her melanin-enriched skin. Thus the hashtag #whatadoctorlookslike was born, since apparently Black women must remind America that Black people are capable of being doctors, too.
The reality that this claim must be shouted by Black physicians can be explained by the current statistical under-representation of Black individuals in medicine and the history of racial formation in the U.S.
My wavering undergraduate aspirations to pursue medicine led me to research this question while at UC San Diego: What social and environmental factors affect the aspirations of Black UCSD students in becoming physicians? I was doing this project as a new ethnic studies major — due to not believing medicine would be a legit option and fit for my future — and ironically, answering this question paved the way to me getting into medical school.
I wanted to help myself and other aspiring Black students feel understood and confident when pursuing our goals of becoming doctors. Despite the various moments of helplessness, lack of resources, absent mentorship, and insecurity that Black students often face, we continue to persevere with intelligence, determination, unique character and heart. My hope was that the insight shared and the conclusions drawn will aid society in understanding why Black students need, and deserve, additional tools and support to reach their goals of becoming physicians. This support would allow us to show the world #whatmoredoctorswilllooklike in the near future. And by achieving our goals and increasing the representation of Black doctors, the health in Black communities will improve as a result.
To understand why such ignorant people in America would reject believing that a Black woman is a physician, Michael Omi and Howard Winant’s book Racial Formation in the United States: From the 1960s to the 1990s is a good place to start. They define “racial formation” as “the socio-historical process by which racial identities are created, lived out, transformed, and destroyed.”
One tactic has been the use of “scientific criteria” as a way “to demonstrate the ‘natural’ basis of racial hierarchy.” As a result of the process of racial formation, scientifically racist discourses such as the assumed biological inferiority of Black people can explain how Black female doctors like Tamika Cross are disrespected and undermined by peers while white male doctors like the one on the plane with Tamika are given automatic respect and authority.
My passion for becoming a doctor is not simply because I am interested in biology and medicine; it’s because I want to positively impact the health of Black communities and other communities of color. As a third-year medical student having gone through the struggles in confidence and insecurities of being Black while pursuing medicine, one thing I am certain of is that having a Black doctor makes many Black families feel at ease, respected, and less reluctant to trust the health care system.
My experience of having a Black pediatrician whom my entire family trusted and felt comforted by hid the realities of racial discrimination in medicine from me until I learned about them in my college ethnic studies courses.
In undergrad, while working in a lab on the grad school campus, I had the privilege of walking through the daily traffic of a medical and pharmacy school. Sadly, this daily walk made me feel even more alone than I already did since the only Black faces I ever saw were the hardworking custodians. Additionally, in my 16 months in a medical internship during undergrad working in various departments in multiple hospitals, I only saw one single Black doctor pass by on one single shift.
Many say that students have to imagine themselves in a career before they choose it, and that seeing other people do the job you want really makes that imagination possible. The 2018-19 AAMC Facts and Figures on Diversity in Medicine report shows Black individuals represented only 8.4% of medical school applicants, 7.1% of acceptees, 6.2% of graduates, and 5% of working physicians. Each of these figures increased by less than a percentage point from 2015-16.
Obstacles and Hesitations
How can you imagine yourself in that role if you hardly see people that look like you in that same profession? Even if a Black student could fully imagine themself going to medical school and flourishing, wouldn’t they still feel as alone as they already do simply passing through? These are the kinds of thoughts that went through my conscious and unconscious mind every day as a Black pre-medical student.
I wanted to compare my thoughts and experiences with those of my Black peers with hesitations similar to mine about entering medicine, so I interviewed several as part of my research project.
One student was told to change her career path by an academic advisor because her grades as an undergrad weren’t competitive enough for medical school. Another student with immigrant parents from Ghana explained to me how many Africans feel that the American medical system doesn’t know how to provide culturally competent care, creating a disconnect to the point of wanting to work towards changing that system rather than working within it as a physician.
The combination of pressures stemming from parents, extracurricular involvements, having a job, choosing a path, and academic stress contributed to making the idea of pursuing a medical degree seem overwhelming, another student said. Lastly, it was explained to me that high expectations from society and family make Black students afraid of failing and confirming negative stereotypes about Black students; therefore, pursuing the path of becoming a doctor is not worth continuing if it means compromising their general success while at a university.
These experiences are only a small sample of what Black students have to deal with at the same time as the already grueling process of applying to medical school, yet they continue to push forward in their aspirations. It should not have to be this difficult; Black students need and deserve more support in their resilience on this journey into medicine.
As a reminder of why increasing the representation of Black doctors is all so important, the trust between the American medical system and Black communities is poor. There will always be a need for health policies that increase the access and availability of medical care in Black communities. But even with increased resources, there is often a fear in Black communities of being discriminated against and receiving unequal and potentially harmful care in medical settings, making many members of those communities reluctant to even utilize the limited medical resources they have available.
#whatmoredoctorswilllooklike
This is where representation comes into play. It will bridge the gap in trust and allow folks to utilize those medical resources and improve their health. The shared experience of identifying as Black, being marginalized and taken advantage of throughout history, and being a person of color in a crude society is what will help establish that sense of trust, comfortability, and reassurance between communities and professionals within the American medical system. That ultimately improves the health of our community as a whole.
There needs to be a combination of increased resources, mentorship, and visible representation in order to increase the number of Black doctors in the health care field. With the historical unequal distribution of educational resources in Black communities, Black students are often set up to not feel confident enough to stick with the challenges of the pre-medical track. Thus, many resources can be academically focused, such as support programs for general math and science skills and pre-medical course readiness.
Many Black students are often unaware of the different career opportunities and unable to develop passions in the health care field. A next step would be early exposure to the field of medicine and creating mentorship opportunities in their early childhood and teenage years through programs at school and in the community. Whether through advising, counseling, student panels or professional shadowing, these mentorships go a long way toward helping Black students remain confident when they hit moments of self doubt, give them the strength to choose the right path when the options are overwhelming, and help them find their passions before society tries to mask their potential. Taking that a step even further would mean bringing in Black doctors in all fields of health care to show these students that there are, in fact, folks who look like them from communities similar to theirs who have successfully found a passion and created a career as a doctor, making their goals seem more attainable.
There are some amazing local and national organizations who do this work with academic resilience, exposure, mentoring and scholarships, but we need more due to the amount of young bright Black minds out there. A national example is the Student National Medical Association Pipeline Mentoring Institute, and a local example is the SSVMS Future of Medicine program. Even creative writers and executive producers who consistently cast Black doctors and leaders in their TV shows are essential to normalizing the visibility of Black doctors in society as a whole. We can always use more of these initiatives.
While reflecting on this research and insight regarding the realities of Black students with an interest in pursuing medicine, imagine how many more students out there share similar struggles, roadblocks, and insecurities yet just can’t put them into words. Imagine how many more Black doctors there could possibly be after sharing this knowledge, creating new health policies for accessible care, increasing visibility, establishing trustworthy relationships, and empowering others.
Lastly, imagine being in an airplane, thousands of feet in the air, and a passenger suddenly needs urgent medical attention. The flight attendant asks if there is a doctor on board to help, looks around frantically and sees someone stand with their hand raised in the corner of their eye. They turn around to see the most confident doctor they’ve ever seen and then immediately exhale in relief, proceeding to thank the doctor, without hesitation, for offering their expertise.
If you had to imagine what that doctor looks like, you would be correct in picturing a young Black physician. And with the support Black students deserve to follow their passion, this is #whatmoredoctorswilllooklike.
