My proposed plan for diversity in dermatology

When I was President of the AAD, one of my highest priorities was to develop an educational program that could help mentor younger dermatologists who might have an interest in developing organizational or academic leadership skills for the successful future of our specialty. With the assistance of many others, this turned out to be an extremely well-received program with excellent reviews. After having recently read several articles about the great disparity in representation by minorities not only in medical school but also in dermatology training programs and among the number of practicing dermatologists, I began to wonder if a similar type of mentoring program could be developed that would help improve the ethnic diversity in medical schools, dermatology residencies and ultimately among practicing and academic dermatologists.

After thinking about this for a while, I came to the conclusion that with some significant changes, especially starting early in the lives of minority children, this type of mentoring program could be modified to accommodate their needs. If one truly believes, as I do, that greater diversity improves the overall quality of every occupation by bringing new ideas, experiences and perspectives to the table, then this issue is certainly deserving of much greater attention.

Where do we start?

How do we begin this process and what can we do to start moving forward? From personal experience, I know that a great deal of my success is a direct result of the encouragement and support I received early in life from my parents and family, and later by teachers, athletic coaches, employers, as well as a host of other people who served as role models.

As the first physician in my family, I did not have someone close who could serve as a role model or mentor to help me develop an interest in medicine. As I was growing up, it was my good fortune to have had contact with a number of physicians who unknowingly served as role models for me simply by their caring manner. While certainly not universally true, many minorities do not have the same opportunities I did when I was young. Furthermore, with the existing underrepresentation of minorities in medicine, many kids do not have the chance to see physicians with the same skin color as theirs. Thus, the opportunities to have role models that they can look up to and try to emulate are also reduced. Therein lies the dog chasing its tail part of this story:

How to simultaneously increase the number of minority physicians who can also serve as role models for younger minority children? 

The unfortunate answer appears to be that we can’t do both things at once. As a consequence, this situation can only change using a unified approach of communication, education and volunteerism. Recognizing that this is a very complex and longstanding problem having elements of both discrimination and poverty helps explain why there will not be a “quick fix.” 

The turnaround time is likely to require at least a generation of change and hard work to be effective, but we cannot give up because of that. I truly believe that the small size of our membership might be an advantage as we develop small manageable programs to implement change. As success is achieved it can be more easily measured than a huge program with so many moving parts it becomes hard to track. Additionally, the more beneficial parts of our plan can be easily measured and augmented by other larger groups to hasten the changes that will follow.

These are the basic elements of my proposal:

• Start the program at the elementary school level where young children are more easily stimulated to learn about the “STEM” areas of education.

• Provide interested teachers with exciting electronic format learning materials that can be easily upgraded as children learn and want more opportunities to learn.

• Request physician volunteers make frequent visits to schools to give short talks on the subject of their choice. [Note: Since there are an insufficient number of minority physicians to handle this task, all interested physicians should be encouraged to participate.]  This must be done frequently enough to try and develop a possible “role model” relationship.

• As the children advance, the programs will need to be updated to remain pertinent, exciting and interesting.  Volunteer physicians will continue their involvement as mentors and role models.

• In middle school, the one-on-one interactions between students and volunteer physicians become more frequent as counseling about a career path in medicine becomes more vital. Mentoring will include discussions on what subjects to take, the need for high academic performance, and even available tutoring where needed.

• In high school and beyond, these interactions will continue. Mentoring will include all aspects of college, including the best choice of an institution, seeking financial support, writing a resume and applying for scholarships.

• During college, in those cases where a mentorship relationship has developed, contact to offer support and encouragement will also continue. Involvement in the volunteer physician’s office and perhaps assisting doing research or writing will also be beneficial. Simple suggestions like meeting with the pre-med advisor might offer additional beneficial avenues of communication for the student.

I realize this proposal may seem either incredibly naïve or like an impossible goal that will be exceedingly difficult to achieve. However, I believe that the only way to increase diversity in medicine and particularly dermatology is to begin this process early in school age children. By providing exciting and interesting information in a digital format that helps supplement the curriculum, we can capture their interest early and hopefully keep it. With the recruitment of a significant number of interested volunteer physicians acting as mentors and role models, the evolution can continue. This plan has the potential to be successful but only if it receives the attention and support it deserves.

If you agree that there is a great need for increasing diversity everywhere, but especially in medicine and dermatology, please get involved and do it now!