7

Reality-Based Observations from Those on the Pathway

Planning committee co-chair Evelynn Hammonds, Ph.D. (Harvard University), facilitated a discussion with three scholars who shared their

experiences in recognizing their early interest in science, earning their undergraduate degrees, and moving forward in their careers. At the time of the workshop, they were at three different stages: a master’s student planning to apply to M.D./Ph.D. programs, Courtney Hoggard (University of Pennsylvania); a doctoral student, Annica Harriot (University of Maryland School of Medicine); and a medical resident specializing in psychiatry, Gabriel Felix, M.D. (Cambridge Health Alliance/Harvard Medical School).

PRE-MED JOURNEY

Ms. Hoggard began by describing her undergraduate experience at Brown University. “What I noted was that advising committees at predominantly white institutions are afraid of naming the unique challenges faced by Black applicants, and it becomes an attempt to whitewash our experience and lived narrative,” she said. “On the flip side, when we say we are going to apply to med school or M.D./Ph.D. programs, we don’t get support about how we can utilize the power that comes with being young Black people.” Assaults can come in many contexts. She related that when she sat down to take the MCAT (Medical College Admission Test), she had to analyze a passage about a Black woman doctor being mistaken for a nurse—“while I was a young Black woman taking one of the most nerve-wracking tests in my life, trying to become a Black woman doctor.”

She said what has gotten her through is to look for Black scholars and doctors who have made it. As an M.D./Ph.D. applicant, she said there is “nothing more gut-wrenching than not seeing anyone on M.D./Ph.D. committees that looks like me, on either the student or faculty levels.” When she does see a leading Black professional, she said their position seems unattainable because of its rarity. “Black mentors become the guiding directions. I truly don’t know what we would do without them,” she said.

Reflecting on her early interests, she recalled choosing a doctor’s costume one Halloween, which her father used as an opportunity to talk about and encourage her goal. Over time, she realized it was a dream to become the physician that she wished she always had as a patient—a Black woman.

DOCTORAL STUDIES

“I feel privileged as a Ph.D. candidate in STEM [science, technology, engineering, and mathematics] because my experience has been overwhelmingly positive,” Ms. Harriot said, but she added, “When I look back, a lot of

labor has been involved in making it a positive experience.” She said the biggest contributing factor in shaping her career trajectory was discovering the body of literature that exists on mentorship and experiences of Black people, which she learned about through her involvement with #VanguardStem, an online community for women of color in STEM.¹ That knowledge enabled her to choose a mentor and shape the conversations with him about her expectations. She noted her principal investigator (PI) is an older white man who has committed to helping her feel a sense of belonging in her work.

The biggest challenge, Ms. Harriot said, is that the burden of developing positive experiences is placed on young scholars themselves. “This manifests in the imposter syndrome; we talk about ‘what can I do to affirm my belonging’ rather than talk to peers and colleagues about what they can do to affirm that sense of belonging.” The extra labor is placed on her and other scholars of color in addition to the work to obtain a Ph.D., she added.

Ms. Harriot studies skeletal-muscular atrophy and injury in aging, and her personal passion is space flight. She said she feels fortunate because of the sense of wonder she derives from science, and specifically space flight. As a child, when she declared she wanted to be a cardiovascular surgeon and astronaut, her father suggested she study the heart in space, which is now an aspect of her research. She attended a magnet public high school with female Ph.D. science teachers who fostered her interest in science as a career.

A RESIDENT’S EXPERIENCE

As the most senior member of the panel, Dr. Felix related that he had a nontraditional journey into medicine. He took time between undergraduate and medical school, which he commented has been reflected in other discussions throughout the workshop. He said he did not attend a rigorous high school and struggled in college. Meanwhile, he looked around to see majority peers were primed and ready to navigate the pre-med process, and he did not get into medical school the first time he applied. He had no early mentors or coaches, but what made the difference was involvement in the Student National Medical Association (SNMA).² The first time he met a Black doctor was in his sophomore year of college at an SNMA conference.

___________________

¹ For more information about #VanguardSTEM, see https://www.vanguardstem.com.

² The Student National Medical Association “is committed to supporting current and future underrepresented minority medical students, addressing the needs of underserved communities, and increasing the number of clinically excellent, culturally competent, and socially conscious physicians.” For more information, see http://snma.org.

After college, he worked as a research lab assistant at Howard University, where a co-worker who was a neurology fellow helped him navigate the medical school process. The financial burden was a big challenge, beginning with the cost of applying to medical school.

EXPERIENCE WITH MENTORS

Dr. Hammonds emphasized the panelists’ experiences with mentors. Dr. Felix reported that he has several mentors. “It started with me imagining where I saw myself several years down the line,” he explained. He said he identified people who were in positions he would like to be in and also would be honest with him. One is the physician he met at the SNMA conference mentioned above. Dr. Felix stressed the value of “getting encouragement from someone who can pour back into you.”

Ms. Harriot said her mentors fall into three categories. First is Dr. Jedidah Isler, the first Black woman to earn a Ph.D. in astrophysics from Yale. “Foundational to our relationship is shared identity,” Ms. Harriot commented. Dr. Isler has helped her navigate as a Black woman who is often the “only” in a group and suggested ways to put her best foot forward, she related. Second is her PI, who she said has helped shape her as a scientist. He is also open to her perspective in shaping his mentoring style. Third, she finds value in peer-to-peer mentoring, which she characterized as undervalued but incredibly important in STEM fields.

Ms. Hoggard agreed with the value of different types of mentors. She was a student-athlete in college, and her coach remains one of her closest mentors, although she does not have STEM experience. Ms. Hoggard noted that “student-athletes and coaches can have a unique relationship of them telling us when we are wrong, and telling us when to rest and when to activate energy.” Her second group of mentors is past teammates who have become doctors, and the third group is two professors in the Department of Africana at Brown who helped her craft her undergraduate study interests.

Dr. Hammonds observed that none of the presenters explicitly mentioned faculty members within their undergraduate major departments. Dr. Felix concurred that he did not have a mentor within his department and had to look elsewhere. “That’s one of the major issues when we talk about a lot of undergraduate institutions,” he said. “There are not many options, and a lot of legwork has to be done to find them.”

Ms. Harriot reported negative experiences as an undergraduate that made her seek mentors outside her institution. Ms. Hoggard described

a white male professor who taught a first-year seminar on Health of Hispaniola in which she was the only student of Haitian-Dominican descent. The relationship evolved to the point where she could challenge some of his assumptions, and he became the secondary reader on her undergraduate thesis.

RELATIONSHIPS WITH WHITE STUDENTS

In responding to a question from Dr. Hammonds, Dr. Felix commented on the “pressure to make yourself more palatable in white spaces.” It becomes tiring, for example, to listen to stereotypical comments about Black patients or other patients of color and figure out how to address those comments. In summary, he said his experiences with white colleagues have varied, ranging from allies to traumatic, disrespectful interactions.

Ms. Harriot attended a private, conservative Christian, predominantly white institution. “My voice was silenced and dismissed, and that was tough to deal with,” she said. “I wanted to push back, less for my voice to be heard but because I felt a responsibility to make my [white] peers aware about other perspectives. It was exhausting.” In contrast, at the University of Maryland School of Medicine, where she is a Meyerhoff fellow, she said she is in a diverse environment and in a lab space that champions equity and belonging. Ms. Hoggard commented that being a Black student-athlete at an institution like Brown University is a “recipe for a lot of stereotyping and comments,” especially her first year when others on campus assumed she was pursuing a less rigorous path than pre-med. Hearing those comments pushed her white teammates to step in. “They saw it happening and asked me about it, and we would reflect on it,” she said. She added that white teammates also receive negative comments as athletes at elite institutions, which caused them to “see themselves for once in a way that we feel all the time and on amplitude levels.”

ADVICE TO YOUNGER STUDENTS

Dr. Hammonds asked each scholar to reflect on what they would tell students who are considering the paths that they have chosen and why they should persist.

Ms. Hoggard began. “I would tell them it is going to be hard. I wish someone had been honest with me upfront. I would also tell them there are resources and mentors. Why stay? In my experience, nothing feels more

peaceful than knowing that if I stay and plant my feet, that gives someone else another person to look to. The more we stand in our right to be physicians, the more likely there are more of us to stand with us. Plant your feet and don’t let someone move you.”

Ms. Harriot continued. “To whittle down my feelings, I stay because I matter, and they [younger students] should stay because they do, too. I love science. One of the greatest feelings is when I am in the lab, imaging a new target, and there is a moment when I am doing an experiment before I share the results with my PI where I am the only person who knows the thing I just found. That’s amazing. My contributions matter, and the things that only I can do matter—and each one of us has that same capacity.”

Dr. Felix added his thoughts. “What I say to students now is, We need you. Our communities need you; they need us. Dr. Stewart put it best: We have to be our own protective factors. In my line of work, one of the most gratifying factors is when I have a patient of color—that look of relief when they see someone who looks like them. We are needed to heal our community. That’s one of the reasons we need Black students to stay in STEM.”

Dr. Hammonds praised the courage of the panelists in speaking about their personal experiences at a public workshop. “At the same time,” she continued, “I would like to have thought in the almost 30 years since I earned my Ph.D., that there would be less of a sense of isolation and less of a need to do so much yourselves. We still have a lot of work to do.”

Dr. Pinn asked the presenters for recommendations in overcoming the kinds of psychological barriers discussed at the workshop. Ms. Harriot suggested reevaluating styles and responsibilities of STEM mentorship across such intersections as race and sex, something she has explored with her mentor and written about (Harriot, 2021). Ms. Hoggard noted she is in the medical school cycle, and the labor to find diversity statistics and faculty mentors falls on young people of color. She suggested facilitating this search. Dr. Felix suggested learning how to set healthy boundaries for mentees and mentors, and communicate expectations clearly. “It’s important to protect our mental health while we help to cultivate the future,” he said.

REFERENCE