The cost of being a woman in a procedural medical field is hefty in academia, and when amplified by being Black, the cost can be incredible to bear.
Sometimes I wilfully try to envision myself as a welcomed member of this group of academicians who show up to learn, teach, and care for patients. My reality, however, is that many see so much otherness in my Black female being that they must call it out to remind me of where they think my place in their world ought to be — in the background, and beneath them. As a Black female gastroenterologist in a white male-dominated procedural field, I have come to expect the suggestions of tokenism and otherness that affirm the racist and misogynistic beliefs of those who have encompassed my professional circles during my training and career. It is because intersectional discrimination born from individual, institutional, and systemic racism and sexism is pervasive and embedded in the culture of medicine.
We are armed with tools on how to deal with racist patients, mitigate (micro)aggressions (as they are popularly euphemized), and seek out mentors who are ‘the right fit’. We are tasked with creating, promoting, and leading diversity committees and recruiting efforts while we ourselves might be drowning in the same system we are burdened to improve. These are the taxes we are unofficially asked to pay as female physicians and as Black physicians. But the burden ought not be on us to better a system not designed for us. We do it because we care. We are committed. But it behoves all within academia genuinely invested in change to accept the need for a new way of doing things.
I have leveraged leadership roles both in and outside of my institution to showcase the excellence that diversity, equity, and inclusion (DEI) bring to our field. As one example, a social media campaign I cofounded, #DiversityinGI, serves as a call to action. We have established goals that are wide and far reaching, but attainable — promoting and conceiving opportunities to enrich the pipeline for under-represented minorities in medicine from early in their education to their eventual careers, fostering a diverse and inclusive cadre of leadership within gastroenterology, and spotlighting disparities in digestive diseases and forging partnerships within the field to create healthier communities. Identifying and addressing individually and institutionally driven fault lines in academia as racism and sexism is critical.
We must pay, promote and protect Black female faculty because striving for equity in academia should be a shared undertaking. The Economic Policy Institute reports that the average hourly wage gap between Black female and non-Hispanic white male physicians is staggering; earnings are 27% less. Furthermore, when Black women in academia are doing the hard work that DEI and health equity efforts require, the work needs to be valued financially. Pay Black women. According to 2019 data from the Association of American Medical Colleges, merely 0.7% of US medical school faculty full professors are Black women. Despite Black physicians being the only racial group in which women outnumber men, there exists roughly 60% more Black male full professors than Black female physicians. Promote Black women. When colleagues and patients are surprised by our articulate speak, or our successes praised as “Black Girl Magic”, remember: we are not superheroes, nor do we have magical powers. These purported compliments are couched in race and gender-based stereotypes, and only feed an imposter syndrome that is amplified as a double minority, and a Superwoman Schema that specifically afflicts Black women. Protect Black women.
When these experiences, which are professionally stifling, become nonexistent, we will not need to look outside of academia for something better. We are needed right here. With institutional leadership buy-in, legitimate financial resource allocation to DEI efforts, and uncomfortable conversations and actionable steps to drive out systemic racism within academia, we all win. When we strive towards anti-sexism and anti-racism, it does not benefit just women or Black people, but all people. We need more women in procedural fields. We need more Black women in gastroenterology. I hope for a more equitable and inclusive future for our field to which I am incredibly committed.
The author declares no competing interests.
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Balzora, S. When the minority tax is doubled: being Black and female in academic medicine. Nat Rev Gastroenterol Hepatol 18, 1 (2021). https://doi.org/10.1038/s41575-020-00369-2
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