Our lives begin to end the day we become silent about things that matter.  Martin Luther King, Jr.

“Our generation became too complacent and wealthy. We lost track of what we were marching for back in the 60s and 70s.” This statement was the refection of a white colleague. I graduated from HS in 1975 and finished medical school in 1983. It became very apparent to me that white males dominated medicine, and they dominated the leadership positions in academic medicine. I had planned to be a Urologist.

There were many obstacles to achieving this goal. General Surgery was a white male specialty, and when I interviewed, it was apparent. At one program, when I showed up on the interview date, they told me I had not been scheduled for an interview. I had a letter, but they said I had been rescheduled. I never received that letter. At another program, I witnessed the side conversation of “Have we ever had a colored woman in this program? No, wait a minute, one, but she was only here a year”. When I did get into a program, it was not easy. I had the skills and knowledge but not acceptance. When I applied to Urology programs, I was told that they only were accepting men into the program. Even now, in academic medicine, as of 2017, of the 15,671 US medical school surgical faculty, 123 (0.79%) were Black/AA women surgeons, with only 11 (0.54%) being tenured faculty.

I decided to go into Family Medicine and then academic family medicine. For me, this was not a path to wealth but one of service. It became quite evident that even when I was negotiating contracts, that I was not aware of all the information that my white colleagues had. They had the advantage of inside information. It is no accident that even now, African Americans make up only 3.6 % of US medical school faculty as of 2018 AAMC data. Fed up with the politics of an academic medical school position, I left my position. My department chair told me I could come back if I met three criteria; increased scholarship, gain national recognition, and meet the institutional promotion requirements. I had to figure out how to do this because it was the criteria for all institutions. I had barely met these. For URM physicians and especially African Americans, it is hard because we spend most of our time in the patient care and community service areas, and we must learn to turn this into scholarly projects that meet criteria for promotion and tenure.

My path was different and often met with roadblocks that prevented movement into leadership positions that could lead to higher pay and recognition. After completing my FM residency, I was not offered a position in any of the practices. I was naïve to think that as an African American couple, the community would embrace us. We met racism in the small town we moved to and then again, when I entered academic medicine, not from the institution but patients. A smart African American husband is not readily accepted into many places, even if his wife is the new African American female physician. The assumption was that we would find friends in the African American community. We lived in a non-African American neighborhood for the school system, and this set us apart and often meant not being in places where the leaders were gathering and having your ideas used by others to promote themselves. I realized that some of my colleagues had generational wealth and privilege.

Unfortunately, many White leaders lose sight of how to create an organization that has a diverse workforce because it is a matter of self-preservation for many. It would help if you practiced conscious inclusion and equity-mindedness, which could lead to having URM colleagues that are “fully integrated, fully engaged, and fully empowered.” However, out of fear or ignorance, they dismiss us and the knowledge and skills we have acquired from the best institutions in the country. I have never lost sight of my goal and what was needed but met opposition from the White males and females in the room. My ideas and contributions dismissed.

I often wish I had the privilege of complacency, but this will never happen because I am the mother of two African Ameican males and an African American female. I mentor several URM faculty in many areas of the country.  I spend countless minutes fielding texts and calls from those who need support as they navigate racist environments. They are a constant reminder that I must continue to speak up when I get the opportunity too. I cannot forget them.