PE R S PE C T IV E Why We Need Black Physicians in Academic Medicine

Fortunately, I could show them All around the country, Black
the few portraits of Black physi-
cians, including Hinton. Yet their
question troubled me deeply. Their
program had been created to ex-
pose young Black students to med-
icine and show them that they
did, in fact, belong. I realized that
even though our classes brought
Black students into this space,
the students would judge the
school by the diversity of faces
they saw, both on the walls and
on the faculty around them.
As a graduate of an HBCU (his-
torically Black colleges and uni-
versities), I know what it means
to have Black representation in
your faculty and school adminis-
tration. And I know what it means
to have a Black person teaching
you in the classroom and to see
that professor on television and
realize you can accomplish any-
thing. My experience at an HBCU
gave me not only role models in
the field I planned to pursue but
also the confidence to be a full
version of myself when I got there.
I have occasionally experienced
the power of representation in
medical school as well. When
Black professors or guest speak-
ers lecture, Black students nearly
trip down the steep amphitheater
steps to form a connection. These
moments are rare, however, since
the percentage of Black physicians
in academic medicine has hov-
ered around 4% for the past 20
years. At the current rate of in-
crease, it would take nearly 1000
years to catch up to the percent-
age of Black people in the general
population.4
of mine described his work with
medical students decry the lack of
Black physicians in the classroom
and in their hospital training. This
dearth is felt most in the clinical
setting, where Black students often
face racially charged encounters
with preceptors and patients, with-
out Black faculty who understand
their experiences. Therefore, to
provide inclusive environments
for Black students and trainees,
academic medical institutions
must hire and retain Black doctors.
But retaining Black faculty
means creating an inclusive envi-
ronment for them, too. Black doc-
tors often contend with a lack of
mentorship and work environ-
ments that call into question
their worth, capabilities, and qual-
ifications. They are promoted at
much lower rates than their
White colleagues, even as they
find themselves charged a “minor-
ity tax” — demands to lead diver-
sity efforts without proper com-
pensation or recognition.5 Creating
inclusive environments will mean
reexamining the institutional cul-
ture and establishing spaces where
Black physicians can speak out
against racism. Work to recruit
minority faculty and serve minor-
ity communities will have to be
compensated and considered in
promotion decisions. Institutions
must fairly evaluate Black faculty
members and improve diversity on
all rungs of the academic ladder.
Only then will Black medical stu-
dents feel truly supported through-
out our academic journeys.
Soon after the portrait unveil-
ing, a Black friend and classmate
the AP Biology Hinton Scholars
program, which exposes young
high schoolers, many of them
Black, to medicine and laboratory
research. Every now and then, I
would walk by to see him engag-
ing these enthusiastic students in
a lab experiment and realize that
he had become their image to
strive for — their inspiration to
believe that they, too, can accom-
plish anything. I hope that if and
when some of these students en-
ter medical school in the years to
come, they’ll see more Black role
models on the journey to becom-
ing physicians.
Disclosure forms provided by the author
are available at NEJM.org.
From Harvard Medical School, Boston.
This article was published on November 28,
2020, at NEJM.org.
1. Association of American Medical Colleg-
es. Table A-12: applicants, first-time appli-
cants, acceptees, and matriculants to U.S.
medical schools by race/ethnicity, 2017-2018
through 2020-2021 (https://www​.­aamc​.­org/​
­system/​­f iles/​­2019​-­10/​­2019_FACTS_Table_A​-­12​
.­pdf).
2. EdBuild. Nonwhite school districts get
$23 billion less than white districts despite
serving the same number of students
(https://edbuild​.­org/​­content/​­23​-­billion).
3. Association of American Medical Col-
leges. Figure 15. Percentage of full-time
U.S. medical school faculty by race/ethnic-
ity, 2018 (https://www​.­aamc​.­org/​­data​-­reports/​
­workforce/​­i nteractive​-­d ata/​­f igure​-­15​
-­percentage​-­f ull​-­t ime​-­us​-­medical​-­school​
-­f aculty​-­r ace/​­ethnicity​-­2018).
4. Yu PT, Parsa PV, Hassanein O, Rogers SO,
Chang DC. Minorities struggle to advance in
academic medicine: a 12-y review of diversi-
ty at the highest levels of America’s teaching
institutions. J Surg Res 2013;​182:​212-8.
5. Rodríguez JE, Campbell KM, Pololi LH.
Addressing disparities in academic medicine:
what of the minority tax? BMC Med Educ
2015;​15:​6.
DOI: 10.1056/NEJMp2027850
Copyright © 2020 Massachusetts Medical Society.
Why We Need Black Physicians in Academic Medicine

Interactive Perspective — Mapping Racial and Ethnic

Inequities in Health and Opportunity
Throughout the United States, health status and outcomes, access to care, and socioeconomic
status vary by race and ethnic group. This Interactive ­Perspective, which uses data aggregated
by the Health Opportunity and E ­ quity (HOPE) Initiative, allows readers to view and compare
data on a range of indicators for each state and for six racial and ethnic groups.

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