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Why Are BIPOC Physicians Leaving Academia?

Dame Idossa, MD · Duma Lab

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September 07, 2021

I was lucky enough to have a childhood in which people who looked like me were doctors, scientists, teachers, or anything else they wanted to be. I grew up watching people in my community go into various professions. This normalized Black excellence, achievement, and choice for me. When I moved to the United States at the age of 8, I suddenly became racially minoritized, and finding people who looked like me in medicine became nearly impossible. I did not come across a Black physician until almost a decade later when I started college. Fortunately, my formative years and the support I had from my family allowed me to continue to dream that I could one day become a physician.

As I reflect back on my journey so far, I realize that lack of diversity, especially in academic medicine, remains a problem. The importance of workforce diversity has been increasingly recognized in academic medicine, but this has not translated in increased number of BIPOC (Black, Indigenous, and people of color) physicians. For example, hematology/oncology fellowship has consistently ranked last of all internal medicine subspecialties in racial/ethnic diversity. Historically excluded fellows in hem/onc, such as African American, Hispanic/Latinx, and American Indian/Alaskan Natives, make up only 3.8%, 6.1%, and 0.1% of hem/onc fellows, respectively.

As a Black woman in oncology, this often means that I am the "only one" in the many spaces I occupy. Spaces that were not meant for me to be in. And this often leaves me feeling isolated. So, I always seek out mentors and try to form a community wherever I go. More recently, I have watched many BIPOC colleagues consider leaving or actually leave academic medicine. After making it through the challenging pathways in academic medicine, many have been left to deal with the negative impact of microaggressions and disparities in promotions/pay. I have watched as they have faced the "minority tax" — the burden of extra responsibilities in the name of diversity, which is often unrecognized/unpaid work and is linked to burnout. This has contributed to their departure from academic medicine. It leaves me wondering how this affects the next generation of rising academic BIPOC physicians.

We know that mentorship can have a positive impact on academic productivity, advancement, and career satisfaction. Unfortunately, for BIPOC trainees and early-career faculty, lack of mentorship and sponsorship is often a major challenge. Mentorship of BIPOC trainees in academic medicine is often delegated to faculty with similar backgrounds. However, there aren't enough faculty who share a similar background to serve as their mentors/sponsors, so this leaves historically excluded trainees and early-career faculty without mentors and sponsors.

It's imperative for non-BIPOC allies to understand that they too have to step up and be mentors and sponsors for trainees and early-career faculty who may not share their background. We need people from all parts of academia to be advocates and form mentoring teams around their BIPOC trainees and early-career faculty. Without intentional support from our allies, academic medicine will not be reflective of the diversity of the populations we serve.

If you are a BIPOC physician considering leaving academic medicine, I would love to hear about your experiences. Contact me at mentorshipstudy2021@gmail.com or reach out on Twitter @Idossa_MD.

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About Dr Dame Idossa
Dame Idossa is a medical oncology fellow in the division of hematology and oncology at UCSF. She is a new mom, amateur baker, and aspiring health equity researcher in breast cancer. Connect with her on Twitter: @Idossa_MD

The Duma Lab, formerly known as the Social Justice League, was founded in August 2019 and focuses on social justice issues in medicine, including discrimination and gender bias in academic and clinical medicine, cancer health disparities, and medical education.

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