I’ve written about my reasons for leaving UCSF. And while it was painful to feel unsupported, isolated, undervalued, and gaslighted—including by Black leadership within the institution—I was already a published author, recipient of multiple coveted grants and fellowships, and double board-certified in nephrology and internal medicine. I’ve since learned that my story pales in comparison to so many other young Black physicians who are being disproportionately pushed out of medicine at a time in their career when they have no license to practice independently but do have $240,000 of debt on average after completing medical school. Only 5% of physicians in training in the US are Black, but account for 20% of program dismissals. And this doesn’t even count those who are convinced to resign to avoid the damaging mark of dismissal on their record.
I wouldn’t be making a stink about it if the dismissals were because they killed a patient or two due to incompetence or showing up to work high or not showing up at all. But this ain’t the case.
Rather, the story lines are eerily similar, like some horror movie being remade over and over again. In the opening scene is the Black medical school applicant, heavily recruited and welcomed into the program. It’s a demonstration of the program’s commitment to diversity. But within weeks there is a perceived slight. Perhaps they challenged the decision to hold a resident-faculty mixer on a plantation; or refused to live in hospital-owned housing; or questioned the appropriateness of a senior White male attending physician’s care plan; or elicited tears from a White female nurse. The slight results in a blinding light being cast on the young doctor.
The light discovers all kinds of acts that build a case of “unprofessionalism.” Perhaps they failed to sign all their clinic notes within 24 hours; or reportedly arrived 10 minutes late to clinic; or left their shift without informing a particularly attending. No matter the validity of the reports, nor that their White peers have committed the same, if not worse, offenses without the “unprofessional” label.
Soon thereafter, the young Black doctor is called into the program director’s office and pressured to sign a piece of paper then and there. The paper lists vague, highly subjective milestones they must meet to regain their professional standing. The milestones are never met. At least not in the eyes of the program director.
Some of them try to fight back, but that only makes it worse. Besides, no legal representation or even faculty advisor are allowed to battle at their side. Hospital policy. Ultimately, the young Black doctor is fired anywhere from 6 months to 3 weeks shy of completing their intern year, or their contract to complete their training is simply not renewed. So much for commitment to diversity.
Mind you, all of this falls upon the background of Black people dying disproportionately—predominantly in the hands of non-Black doctors, because as has been shown repeatedly, when Black patients are cared for by Black doctors their outcomes are better. Yet, Black physicians make up only 5% of the entire physician workforce, which has been the case for decades.
This is the house that White supremacy built. I’ve decided to spend the rest of my working life knocking this mother fucker down and rebuilding something equitable in its place.
I made this decision after witnessing first-hand a young doctor experience her own version of the horror movie. A Haitian-born US citizen who spoke and wrote English, French, French Creole and Spanish, the worst documented thing she had done—based upon her plentiful receipts in the form of recordings, emails, and evaluations—was an occasional noun-verb disagreement in her clinical notes. I’ve seen worse from folks born and raised in English. But when she should have been completing clinical notes or studying like her peers, myself and a few other Black doctors offering support watched her spend administrative time on tasks like trying to find a lawyer willing to take her case.
Enough, I thought. We could not allow this system to continue picking us off, one by one and without accountability. There was no organization charged with ensuring the rights and safety of resident physicians. We had to be the organization.
Hence, Black Doc Village, Inc, a 501(c)(3) non-profit organization that I founded in April of this year.
The name is intentional.
Black—and unapologetically so—because this society has proven from its inception, that Black people are at the bottom of this hierarchy that White supremacy built. Our unique experience will have my undivided focus, similar to how the Asian, Latinx, Muslim, and Jewish communities do without the “well, what about the [insert other racial group here]” that is seemingly only asked when Black people organize. And I don’t care what other identities exist, be it sexual, gender, or religious. All I insist is that one of the identities is Black. Besides, everybody benefits when the bottom is lifted.
Doc, though Black physician experience is not unique. Black people in every profession, not just health care profession, are experiencing similar mistreatment. But doctoring is what I know. Others will have to take up those charges and I will happily support.
Village from the African proverb “it takes a village to raise a child,” because expecting young people to make it through alone will not raise the number of Black doctors our community needs. And while Black Doc Village’s inner circle, the board, will be Blackity-Black-cuz-ain’t-nothing-wrong-with-that, the Village is open to all who want to be helpful. Helpful with their time, their money, their voices, their expertise.
Dear reader, I sincerely hope that is you.