Increasing diversity in medicine requires commitment - and action

Dr. Ima Ebong, a neurologist who specializes in the treatment of epilepsy and neuromuscular disorders at the Kentucky Neuroscience Institute at UK HealthCare, shares her ideas for increasing diversity in medicine and in the field of neurology. She was recently appointed to serve on the Special Commission on Racism, Equity, and Social Justice for the American Academy of Neurology.

In 2018, I was the first Black woman neurologist hired by the Department of Neurology at the University of Kentucky College of Medicine. My appointment brought the total number of Black faculty in the department to two. While some may see doubling the number of Black faculty as an achievement, I see it as a sign of the work we need to do.

While Black or African American people make up 13.5 percent of the U.S. population, we represent approximately 5 percent of all physicians and less than 3 percent of all neurologists. The numbers are similar for those who identify as Hispanic or Latinx, who are 18 percent of the population but only 5.8 and 7.2 percent of all physicians and neurologists, respectively. We must do better. Medical institutions should take steps to ensure more people from underrepresented groups pursue careers in medicine, particularly neurology.

In the words of Marian Wright Edleman, founder of the Children’s Defense Fund: “You can’t be what you can’t see.” Representation matters. Students need to see physicians who look like them. Unfortunately, there are too few physicians from underrepresented groups to take on this task alone. All physician allies — regardless of race or ethnicity — need to provide mentorship. 

Although I am a Black woman and a physician now living in the United States, I am also an immigrant and recognize that I was afforded certain privileges in my upbringing. I was born and raised in The Bahamas, a country where the majority of the population is Black (of West African descent). I was surrounded by Black excellence. I grew up knowing I could be whatever I wanted to be, and I was never told that the color of my skin would be an obstacle to achieving my goals.

When I went to college in the United States, I saw this is not the norm for other students from underrepresented backgrounds. This was particularly true for many Black or African American students who may have grown up with constant reminders of the “minority status” their skin color represented. This eye-opening experience is one of the reasons I am so passionate about fighting racism. As a Black woman, I am determined to ensure the next generation has the opportunities and confidence to pursue and achieve their goals.

With the support of the UK College of Medicine, while in medical school, I launched the UK Medical Education Development (UKMED) program for prospective medical students in 2010. It focuses on nurturing premedical students from underrepresented racial and ethnic groups, including those from Appalachia and other underserved rural areas, and recruits them to the UK College of Medicine. UKMED has been student-led for over a decade and includes a mini-medical school with hands-on learning and lectures. One of the first program participants went on to become the first African American woman to graduate from UK with an MD/PhD in neuroscience. We recently participated together in a national roundtable discussion on diversity in neurology with the Women Neurologists Group. Her achievements are a testament to the success of pipelines such as UKMED.

Now, as the Director of Diversity and Inclusion for the UK Department of Neurology, one of my tasks is to ensure that our department takes an active stance against the racism, bigotry and injustice that have historically been part of the institution of medicine. I am proud that the faculty, residents and staff of our department united to write a Statement for Equity, Diversity and Inclusion that condemns racism and pledges to actively recruit, retain and advance the careers of neurologists at all levels of training and develop an anti-racist recruitment and retention policy. We have also incorporated an Antiracism and Social Justice didactic series as part of the Neurology residency curriculum This was a critical sep in improving the education we provide future physicians. Trainees, as well as current faculty, need to learn about the history of racism in medicine — a history from a not-so-distant past and one we must address so it does not continue.  

Steps to take now

Medical schools can boost participation in neurology and neuroscience, and at the same time advance institutional diversity initiatives, by getting involved at every level. Light a spark in young people early on and nurture and build that flame:

• Middle and high school: Expose young students to medical careers. Encourage their interests early in the education process, before students go to college. Start mentorship programs to attract middle and high school students to neurology and neuroscience. Engage school principals to provide activities that teach about medicine and neuroanatomy, and build programs out based on successes.
• Undergraduate: Guide college students with mentoring. Ensure students meet the necessary requirements and have the experiences to explore research and medicine. This support can be strengthened by providing scholarships to underrepresented students who conduct research in neurology and neuroscience, as well as clinical shadowing opportunities.
• Medical school: Take steps to help medical students continue their career exploration and ensure exposure to the diversity of opportunities within neurology. Provide research and publication opportunities and motivate students to get involved in national organizations so they can establish relationships with experts in the field.   
• Residency: When recruiting residents, holistically review applications beyond test scores and honor societies, both of which have been shown to be inherently biased. Consider other attributes that speak toward resilience and varied lived experiences that will allow them to contribute to building the diverse teams we need within medicine.

There is so much work for us all to do. It’s not enough to say your institution is anti-racist. Our statements must be followed with actions — actions that meet our goal of helping underrepresented students not only survive but thrive.

Learn more about UKMED, the UK College of Medicine recruitment program to attract underrepresented groups to the study of medicine, by clicking here. The program, for rising college juniors who plan to apply to medical school, will be held June 21 and 22.