Jacobs School event examines barriers to Black men in white coats

Recognizing and overcoming systemic barriers preventing Black men from becoming medical doctors was the focus of a recent documentary film screening and panel discussion at the Jacobs School of Medicine and Biomedical Science at UB.

The event, held March 24 in the M&T Auditorium at the Jacobs School, featured a showing of the film “Black Men in White Coats.” The film was borne from a national movement founded in 2013 by Dale Okorodudu, an award-winning physician, speaker and best-selling author.

The organization, which produces a podcast and videos, aims to increase the number of Black men in the field of medicine through exposure, inspiration and mentoring.

It partners with various medical schools across the country to produce short documentary videos that bring awareness to this issue, which not only affects the Black male population, but also the nation as a whole.

Okorodudu said he was spurred to action after an alarming 2013 report by the Association of American Medical Colleges that found that the already low number of Black male applicants to medical schools was declining.

Thought-provoking statistics are presented throughout the documentary, which features interviews with, among others, former U.S. Surgeon General Jerome Adams; William McDade, chief diversity and inclusion officer at the Accreditation Council for Graduate Medical Education; and Valerie Montgomery Rice, president and CEO of the Morehouse School of Medicine in Atlanta.

Among the statistics cited:

• Fewer Black men applied to U.S. medical schools in 2014 than in 1978.
• About 13% of the U.S. population is Black, but only 2.6 % of physicians are Black males.
• There were 100 fewer Black males in U.S. medical schools in 2012 than in 1978.
• Black men in America today have a greater than 1 in 4 chance of going to prison during their lifetime.

The movie examines the systemic barriers preventing Black men from becoming physicians and the consequences on society at large, and asks such questions as “Why is it easier to visualize a Black man in an orange jumpsuit than it is in a white coat?”

Members of the Jacobs School panel, moderated by David A. Milling, senior associate dean for student and academic affairs, and associate professor of medicine, provided their own perspective on some of the issues raised in the film and reacted to some of the more provocative statements.

The panelists were:

• Fred D. Archer III, clinical assistant professor of pediatrics.
• Shawn Gibson, a third-year medical student.
• Aswad Lemar Jackson, a fourth-year medical student.
• Anthony J. Wright, a third-year trainee in the anesthesiology residency program.

In the film, Adams, the former U.S. surgeon general, was quoted as saying, “your zip code is more important than your genetic code in terms of your health.”

Wright, who grew up in Virginia, said he did not know much about Buffalo before coming here for his residency training, but that he did some research online and was surprised to see how many Black people lived in Buffalo.

“So, I moved up here and settled in the Elmwood Village area and my first thought was, ‘where are all the Black people?’

“I come to find out the history of Buffalo and east of Main Street is a different Buffalo than South Buffalo, North Buffalo or the West Side,” he said. “Seeing the patient population that I do, I think there is a stark difference between different parts of the same city.”

Gibson, who grew up in Queens, said playing sports as a youth allowed him to travel to the other New York City boroughs, where he saw a clear disparity between neighborhoods.

“I had the opportunity through playing football and basketball to see the differences amongst various zip codes of New York City,” he said. “For instance, traveling to certain neighborhoods in Staten Island, you can clearly see a different level of community support for local sports teams in comparison to other boroughs and neighborhoods.”

One of the recurring themes in the film is that of the need for more Black male role models and the idea of “you can’t be what you can’t see.”

Gibson, a first-generation college student, said a career in medicine was not really on his radar when he was growing up.

“My father is an auto mechanic. Growing up, I learned a lot about cars and found them very interesting. I thought I was going to be a mechanic just like him,” he said.

Milling asked the panelists if they could recall the first time they encountered a Black male physician.

Most indicated it was when they were high school students, including Jackson, who grew up in Mississippi.

“The first Black male physician I saw was in Jackson, which is the capital of Mississippi,” he said. “I was a patient, but he also became a mentor to me. Role models play a big role in your interests and trajectory.”

Milling said he had a different experience growing up in Jamaica, where all the physicians around him were Black men or Black women — a stark contrast to what he found when he came to the United States.

“For example, one of our psychology residents who was an undergraduate at Canisius College came over to speak to me and told me I was the first Black male physician they had ever spoken to,” he said.

In the film, Montgomery Rice, of Morehouse, said that several medical schools in the United States currently do not have any Black men in their classrooms.

Wright said it was hard to imagine why or how that is.

“There is no reason we should have the same number or less of Black male doctors than we did 40 years ago, but that is the case,” he said.

Archer said it all comes back to “you can’t be what you can’t see.”

“When you don’t have that voice in the room, that voice is missing,” he said. “A chorus without certain voices is missing something; it sounds hollow.”

Audience members were encouraged to ask the panelists questions, and one person, who said he was from the island of Trinidad, asked how members of different cultures can be encouraged to seek medical treatment.

“It’s not just an Afro-Caribbean issue. It is similar in the African American community, where there is lack of trust in the system and that makes it very difficult for people to engage in the system,” Milling said.

Gibson pointed out that “medical students who transition from the short coat to the long coat then need to become influencers in their communities.”

Another question from the audience raised the issue of the high cost of medical education.

“If you look at admissions and medical students, it is skewed to high-income families and that is part of the overall problem,” Milling said. “You may not have the parents that can afford an MCAT tutor. It is a very real problem and we have to look at ways of doing something different to help fund medical education.”

Another audience member asked how the panelists themselves are working to bridge knowledge gaps on the issues raised in the film.

Jackson said he is currently taking an elective course in which students are learning how to advocate for the pediatric population.

He noted he has matched to a residency program in rural family medicine at the Louisiana State University Family Medical Center in Bogalusa, Louisiana, and that his interest lies in sports medicine.

“I recently talked to a group of young men in middle school and I asked them what they wanted to do when they grew up,” he said. “And you know what they said? They all want to be professional basketball players.

“There is a lot of weight on my shoulders. I am just trying to figure out how I can  change their mindset,” he said. “They need to know you don’t have to be an athlete or rapper to be successful.”

Jackson said he plans to reach out to young athletes — through social media and in person — because sports medicine is his calling.

“I tell them I can run a 40-yard dash and shoot some hoops, too, but I am also a doctor, so I hope to use my voice for change,” he said.

The film also touched on the fact that Black males are more likely to follow the recommendations of their doctor if he is a Black male.

Archer agreed that “shared experiences are important.”

“Sometimes a patient sees something in me that he recognizes,” he said. “I may be able to intervene in his life in a way that another doctor can’t. That doctor still cares just as much, has empathy, has the knowledge and wants to help, but I just connect with the patient differently.”

One audience member asked how the systemic hindrances that impede the progress of Black kids are being dealt with.

Milling said medical schools continue to work on retaining Black students and helping people of color have careers after medical school.

“It is something that should be looked at by people who are in administration, people who are in admissions that make the decisions, and program directors,” he said. “It’s a conscious issue that people have to make to get this done.

“It’s not going to be easy and it is not going to happen tomorrow,” Milling said. “But I think one of the ways it’s going to happen is that you continue to press, take the Band-Aid off to make the problem transparent and to make sure people are always addressing this.

“It’s a huge problem because you are going from kindergarten all the way through graduate medical education and all along that pipeline people are getting labeled and categorized,” he added. “All those things change the trajectory.”

Archer agreed. “We don’t just need Black men in white coats,” he said. “We need Black men as social workers and counselors. That is a whole other issue right there.

“There have been things that patients have told me they have not told my colleagues just because of my appearance,” he said. “I am going to use that to my advantage. Your Blackness is a superpower. Use it to advocate for others. It’s a slow process. It’s not going to happen overnight. It has been 400 years.”

Milling said the bottom line is that the topic is a critical issue moving forward.

“I think we have lots and lots of work to do, but as we continue to hear about the problem and we continue to think about solutions, we’re going to continue to get better,” he said. “We need everyone to be advocates, to help spread the story, to keep it important and to continue the conversation.”

Allison Brashear, vice president for health sciences and dean of the Jacobs School, noted that the school “is committed to matriculating a diverse class of medical students each year by using a holistic approach during the admissions process to ensure that we turn out compassionate doctors from varying backgrounds.”

“Honest discussions at forums such as these are vitally needed,” she added, “and we all must continue to shine a light on the systemic barriers that exist as we work to eliminate them.”