Confronting Bias and Discrimination Towards Black Premeds


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PMY 393: Confronting Bias and Discrimination Towards Black Premeds

Session 393

How can we start healing and supporting people of color? Alexis shares her experiences as a Nigerian-American premed and her advice to everyone so we can all understand each other better.

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Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[01:07] Understanding the Plight of Our Society

This episode came out a week and a half after the brutal killing of George Floyd. Some of you may not want to hear this topic on this podcast, but it’s necessary.

First, it’s necessary as a society to be able to understand what is happening to our black brothers and sisters in this country.

Secondly, as future physicians, we have to understand the biases that are out there that can potentially hurt our future patients who may not look like us or who may not come from the same background as us.

In this episode, Alexis and she ended up talking a lot about race in this country and how to move forward.

“We need to always come from a place of understanding first.”Click To Tweet

[03:08] Interest in Becoming a Physician

Very early on in childhood, less Alexis’ family is in healthcare, specifically nurses. And she felt like it was always this dream, but she never really thought she could actually become one.

She grew up in San Fernando Valley, which was predominantly white. And she just had gone through a lot of things growing up. She had been called the N-word and been spit on. So she felt very demoralized very early on. She knew she was capable and smart. But she always felt like she was 10 steps behind because her environment made her feel that way.

A year before she graduated from UCLA, she joined an organization that was for black women physicians. It was the first time she had ever seen a physician that looks like her. She had never actually just seen someone because of the absence in the environment. She actually had to go seek out an organization for women that look like her.

For Alexis, she doesn’t blame the environmental factors at play here. But she just has to remember each time that she could do this. And at that point, she just had to disconnect with family and friends and live in isolation for the next 3-4 years.

[07:01] Dealing with the Competitive Nature of Medicine as a Whole

Specifically at UCLA, the premed culture is just so toxic. She could relate with her peers where no one really felt supported or necessarily acknowledged or empowered.

She tried joining study groups with other minorities with other white students. And even though they were performing well in classes, people still think they have this connotation about intellect.

Alexis felt like she can empathize on one level that the culture that they had at UCLA probably wasn’t the best for any of them.

“Once you’ve unpacked those layers, black students are continually left out. Because even within that community where they all feel disempowered, other students aren't including them.”Click To Tweet

With the AAMC going pass/fail, they’re probably making those subtle changes. But she still thinks there’s this huge disconnect with just the undergrad premed culture. We need to start addressing things that are more relevant in our undergraduate curriculum. 

Rather than being concerned with her metrics because she knew she was going to be great academically, Alexis was more concerned about whether she was going to understand the communities she wants to serve.

We really need to actually ask ourselves what do we value when we’re selecting people to join medical school cohorts. 

Hopefully with holistic admissions, we we have gotten to a place where it’s a little bit better to look at non academic things, once you meet a certain qualification of academics.

[13:30] Challenges of Being a Premed

Having lived in a predominantly white institution all her life, Alexis still says how it hit her being the only black student in a class of 500. And no one has prepared her for that.

“It really hits you differently when you're the only black student in a class of 500.”Click To Tweet

Most friends actually grew up around people that look like them. And she was one of the few who actually grew out the suburbs. And in a majority environment, she felt like she was just a number. You don’t feel connected to your faculty and staff.

The school has great opportunities and great faculty. It’s a powerhouse. But she still felt that huge disconnect. That there’s something really, really, really rolled with the culture and she has yet to see any proper modifications being made to it.

Moreover, she felt like she was betraying her community and there was a huge cognitive dissonance. 

When 90% of the black students are failing all their majors and online and she’s the only one left, that’s not a reality she ever wants to live in. That being said, she doesn’t feel necessarily blessed to be the one that made it. Conversely, when the other 90 or 100 students that look like her did it, it’s not something she is proud about.

“Ultimately, we want to create a pipeline for students of every ethnicity and race of sexual orientation, gender, and immigration status to truly feel like they can move along.”Click To Tweet

Alexis also felt some resource overload where there were actually a lot of resources, but she didn’t actually know which ones she needed to use to help her be the best that she can be.

[16:26] Where the Failure Comes From

Whether it’s a failure of the system for getting students to college and having them be prepared for college? Or is a failure of the system once students are in college, Alexis thinks it’s both.

She believes that exposure to scientific knowledge early on has a role and impact on your level of understanding and how quickly you’re going to digest information. It also has a huge impact on the level of confidence you’re going to have an engaging new knowledge. On the other end of that, the school may not also be doing a good job of advising students.

She used to work as a peer learning facilitator that was essentially between a tutor and a TA where they spread the largest diverse resource for students of color and low income LGBTQ students in the nation. And oftentimes, she would hear these horror stories of those freshmen advisors who help you choose your classes before you start college.

There even came a point where she actually had to walk to where these meetings were taking place in their dormitories and tell Black students not to take the classes their advisors told them to take. Because they don’t know where you come from. And they actually do not have the proper training nor credentials to advise you. They didn’t go tell the students to unenroll it and just take one math or maybe just take one can and see the level of understanding you have the level of competence you have.

That’s how they already have students failing out of their major by the end of the first year and changing their major and ultimately saying they don’t want to be a physician anymore. 

Some of which graduate and then have to go and do these $50,000-postbac because deep down inside they know this is their calling. This is something that she always wanted to do.

[19:42] Choosing a Supportive Environment

Alexis says that many faculty members from underrepresented minority backgrounds or tenure track at the institution are only the ones who are holding the few underrepresented minorities along the way.

She has had white faculty members and Asian and Latin x who have contributed to medical education. But when she really felt like she needed to quit, it was that faculty that she was praying to.

“You really do want a faculty member who understands your experience, because they'll help you navigate. You need to ask them what resources they already have in place.”Click To Tweet

It’s one thing to matriculate, it’s a whole nother thing to increase retention and increase graduation rates. A lot of these students or a lot of these institutions have maybe a higher matriculation rate.

But then you have to look at their graduation rates because it doesn’t tell the whole story when you only look at incoming students of color and incoming students from disadvantaged backgrounds.

[21:57] Keys to Her Success

Alexis is a sexual abuse survivor. And a lot of her friends are going through similar encounters. She never took time off in her undergraduate education. There were no gaps. She was in summer school. She had two or three jobs.

There was so much going on and it felt very dark that she felt like her face and culture are really the backbone to her success, because she couldn’t look to the world to really help her get through this.

“The people in your community are the ones who are going to constantly remind you of who you actually are.”Click To Tweet

The temptation to quit was there, but she just knew deep down inside she is gonna make it and she is glad she held on to that belief.

So she actually did a pre medical enrichment program for students that come from disadvantaged backgrounds, and it gives them different levels of mentorship. That was a key driver in her successful primary application.

She also thought she wasn’t being just a cookie cutter. She didn’t try to fit this narrative of like checking things off the boxes because she is aware that she is very authentic.

Additionally, Alexis was really big on social justice. She was really big on service. And most of her application was improving communities that look like her and improving communities that are often unheard or silenced because of the systems of oppression that are in place.

And this has set her apart from other medical school applicants who might just be checking things off of the box because they feel like they have to. 

That being said, because she is a firm advocate of fulfilling all the requirements. She still had research. She had three research experiences and two clinical shadowing opportunities. She had a 3.5 GPA after postbac and out of 75th percentile MCAT.

“Be the most competitive applicant that you can. And it's very important not only to get into medical school but to acquire funding and scholarships from these schools after you're in.”Click To Tweet

[27:14] How You Can Be an Ally for Minority Students

The best way would be to educate yourself. Listen to black academics, listen to black activists, black organizers, people who are leaders in their field. If you want to take the lazier route, go on Twitter, there’s so much information on social media.

There’s actually a large academic presence on Twitter. And so these just are by people who are not only talking about their experience, but they’re all black people who study.

They will tell you what it means to be black, what it means to be disproportionately affected by police brutality and by the healthcare system. 

And so it’s not about whether or not she should be political or not. First off, who gets health care and who doesn’t. 

The quality of health care is all political. And she really hates that. Alexis doesn’t want to be neutral because this is not the time to be neutral. This is the time to show your black classmates that you are going to do what you can as someone who has been proven and has been able to move throughout society without fear because of the color of your skin.

Show up for them and start the conversation. But before you start those conversations, make sure that you’ve educated yourself. Make sure you’re amplifying black and brown and native voices and not just your own opinion.

There’s already this huge burden that underrepresented minority students, specifically black ones already have. People come from a good place and a good heart. But you want to make sure that when you’re starting these conversations, that they’re going to happen in the most effective and positive way possible.

“This has been an issue for 400 years. That means there's been people who have been talking about it, writing about it, publishing on it for 400 years.”Click To Tweet

In addition, try to check in with them. Remind them that you support them in this that you are wishing well on them love and peace. Avoid asking them how they are because let’s be honest, no one’s okay. Even if you’re not black, Alexis doesn’t think you should be okay right now.

There’s so much going on. So it’s just good to remind them that you’re there. That if they want to talk, that you’re there and that you see them, that you see their color, that you recognize the privilege that you have in these discussions.

And that anytime they say something that may offend them or may traumatize them that if they correct you on that, make sure you focus on what’s going on.

Also, remind them that they can correct you. It’s kind of scary not knowing how someone is going to receive your correction. And so by saying that you’re open to that, that is what gives room for black students to engage with you.

[35:53] Her Alarming Interview Experience

Alexis said her interview experience was very alarming, not that these people had the intention to do so. But maybe because they just came from a place of ignorance. In one of her interviews, she had a white woman comment on her skin color and hair. It was in California so this is supposed to be a progressive state. And this is a school that is widely known across the nation. The interviewer actually thought it was a compliment, but it was just off.

Ultimately, she was revealing how she sees people. Being the first generation Nigerian American, Alexis feels this would happen a lot with continental African Americans, who freshly immigrated from the continent of Africa. And they don’t appreciate this because at the end of the day, she is black. And she felt like it was really just disrespectful because in that statement when she was commenting on her hair, it was straight up the time. And she called her on the way she spoke because she spoke so well. Alexis just doesn’t tolerate that type of narrative.

Another one that really annoyed her was this constant narrative of going into Primary Care because she is a social justice warrior. But she can be a social justice warrior and be a cardiothoracic surgeon because that’s one of the specialties she is looking at.

So she doesn’t like this disconnection between these tertiary and surgical specialties that activism isn’t important. And so, she didn’t like this narrative because she felt like you were telling her what she could achieve in medical school before she even got there. They don’t need your opinions on what specialty they’re going to go into.

“Patient advocacy is important. There's disparities in just about every single specialty in terms of race and ethnicity.”Click To Tweet

In another interview, a white male also asked her about what she would do if there she had a sexual offender as a patient. This made her very uncomfortable that she started to cry. Obviously, the school had access to her information. Still, that was something very inappropriate for someone to ask.

As a medical school applicant, you can feel really disempowered but you just have to keep going. However, this goes to say that not all interviews are bad. As she had some other black friends who interviewed well, got into medical school, and they’ve had the time of their life.

Again, it’s just a lot of ignorance around these discussions. She didn’t think anyone had a bad heart or bad intentions, but it’s still just as damaging. So we need to still prioritize these types of events and scenarios.

[46:14] Final Words of Wisdom for Fellow Minority Students

There’s students out there who have gone through similar things. But as you understand what you’re going through, and even though you feel alone, just know that you’re not alone. And that means you’re going to be connected one day.

With everything going on with COVID and police brutality, if we cannot get this race issue drastically improved., we all suffer. And so just know that you’re the type of applicant that we need a medicine more than ever.

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