From the moment I entered my career in medicine, being a Black woman has worked against me. While I have known in my life that both my race and gender could be prohibitive, it was only during my time in medicine that I learned that no matter how much I achieved, I would still be questioned. I call it being "too much, but not enough."
My Experience With Racism in Medicine
I started my medical career almost 20 years ago as a non-traditional medical student. After completing my undergraduate degree, I went on to complete my master's in public health and began my work career at the American Cancer Society, the CDC, and a rape crisis center in the Atlanta area. I felt truly ready to embark upon medical school so I could achieve my lifelong dream of becoming a physician. Never one to shy away from a challenge, when I began medical school, I decided to run for president of the medical school class. When I announced my run, I was approached by a classmate who stated, "Why don't you just run for social chair? I think you're very social, but I'm not sure I see you as president." I was not sure what he meant when he said this but I quickly learned in the following months. While my bid for class president was successful, it came with its own burdens.
I was the of the Medical College of Georgia School of Medicine, a school founded in 1828. When the historian of the university found out about my election as class president, she was thrilled and invited me to tour the archives of our medical school. On our tour, I quickly noticed that there was one Black gentleman in the back of all the early medical school pictures. As my medical school was in the antebellum South, I asked the historian, one of the first female graduates of the medical school, who this gentleman was. She seemed thrilled by my inquiry. She responded that this was none other than Grandison Harris, a slave purchased by the anatomy and physiology department for the sole purpose of robbing Black grave sites so that the white students would have bodies on which to learn anatomy. This was appalling, but unfortunately, it wasn't that surprising. As a Black woman, I knew that my Blackness often would define me. It was at the age of three, that I woke to the Ku Klux Klan burning a cross on my family's lawn in the suburbs of Atlanta. I have been equipped to know that I would be judged not by my value and worth, but by the color of my skin.
I asked the historian if Harris's contributions to the early education of my predecessors had ever been acknowledged. She stated they had not. As president of the first-year class, I felt it was my duty to acknowledge this gentleman and his contributions. One of the pivotal events of the first-year medical school is the cadaver memorial ceremony, and I thought this would be the ideal forum to acknowledge Harris. When I brought this up with the other 17 class officers, they resisted. "Why bring up our dirty laundry?" they asked. After my decision to acknowledge him, I faced significant backlash. In most classes I attended after this decision, I had random items thrown at me. My classmates went on to publish an anonymous newsletter that talked about my Black features: the size of my nose, my rear, and the contrast of my teeth with my skin color.
When we say racism is not in medicine, I ask us to think again.
Have Things Changed at All?
I'd like to highlight some recent instances of racism particularly toward my Black female physician colleagues, which signify that little has changed. One of my colleagues faced such significant racism that it cost her her life.
During our nation's reckoning with racism in the aftermath of the murder of George Floyd, we saw medicine take up the mantle of addressing racism and inequity. During the same time, several of my colleagues were being forced out of their positions in their respective institutions. Princess Dennar, MD, was forced out of her role as residency program director of the internal medicine and pediatrics residency program at Tulane Medical School. was forced out of her role at the Kaiser Permanente School of Medicine. Finally, before she died, Susan Moore, MD, a family physician who documented her fight with COVID, said that racism had affected her care. As Black women in medicine, we are undervalued and often face significant adversity as we try to raise our voice to fight the challenges we must navigate.
Medicine is hard enough. When you are a Black woman in medicine, hard becomes nearly impossible.
What Should Be Done to Fight Racism in Medicine?
So, what are we supposed to do? If you don't eat, live, and breathe as a Black woman in medicine, how can you possibly empathize and/or work to change the current narrative. First, I ask you to do a deep dive into your own biases against your colleagues who have worked tremendously hard and often jumped over significantly greater hurdles than the majority physicians to be here. Have you taken the to see if you have biases against your Black colleagues? Have you completed an objective evaluation of promotion and pay parity for your colleagues who happen to be from underrepresented groups, particularly those with intersectional identities (i.e., Black and woman)?
I am a Black woman physician scientist with five degrees. I have completed two residencies and two fellowships. I've published over 100 peer reviewed articles. I have given over 300 lectures in the U.S. and worldwide. People presume that I am immune to racism because of my so-called status. I am not. If you are in a position of power in your academic institution, your hospital, or other healthcare setting, I challenge you to change the narrative by working to ensure equity within your walls. Being a Black woman in medicine doesn't hide you from racism, it heightens your exposure. We've become so complacent with this fairy tale that medicine is virtuous, that we often neglect the fact that we are most harmful to those we call our colleagues. Are you a part of the problem or will you be part of the solution? It will take those in power, those that often do not look like me, to work to help change the status quo. Being a Black woman in medicine is actually harmful to my health, but I use my faith, family, and commitment to a healthy lifestyle to help mitigate the harm I experience on a daily basis.
Am I disappointed I chose a career in medicine? Absolutely not. I feel I was put here to help make the path for those coming behind me better. However, I can't do this alone. There needs to be significant change. Medicine, as a profession, should not be a threat to my health. It should be a place where I seek solace as I work to provide the best possible care to my patients. I will not give up. I will not give in. As I said to the late Congressman John Lewis when he bestowed upon me the Gold Congressional Award 20 years ago, "I will never stop fighting injustice."
Fatima Cody Stanford, MD, MPH, MPA, MBA, is an internist, pediatrician, and obesity medicine physician scientist at Massachusetts General Hospital (MGH) and Harvard Medical School (HMS). She is the director of Equity for the Endocrine Division of Medicine for MGH, the director of Diversity for the Nutrition Obesity Research Center at Harvard, and the director of Anti-Racism Initiatives for the Neuroendocrine Unit. She is also the senior advisor for Diversity Equity and Inclusion for NIH Nutrition Obesity Research Centers.