Getting Into “Good Trouble” for a Worthy Cause

ADEA Holds a Men of Color in the Health Professions Summit to Increase Academic Participation of Underrepresented Groups

Historically, men of color—particularly African American/Black, American Indian and Alaska Native, Hispanic/LatinX and Native Hawaiian and Other Pacific Islander men—are woefully underrepresented in the health professions, not even coming close to their representation in the general U.S. population. This underrepresentation can be attributed to many factors, including structural racism, biased institutions, health inequities and health disparities.

Even though there have been initiatives and pathway programs to help increase applicants, the enrollment and graduation of these historically underrepresented men in the health professions since the 1970s has changed little. For example, according to the Association of American Medical Colleges report Altering the Course: Black Males in Medicine, while many initiatives and programs supported by foundations, medical schools and government have contributed to increasing diversity in the physician pool, the number of applicants from one major demographic group—Black males—has stayed the same since 1978.

Some leaders in the health professions believe these low numbers call for a reexamination of what is working, what isn’t and what steps can be taken to bring about more substantial and long-term change for historically underrepresented men of color in the health professions. In an effort to “move the needle forward,” ADEA has convened two Men of Color in the Health Professions events, the second of which took place at its Washington, DC, headquarters on Aug. 10-11, 2022. Both events were held with the generous financial support of the Robert Wood Johnson Foundation.

The ADEA Men of Color in the Health Professions Summit in August brought together representatives from the academic health profession associations, health professions schools, health-related research associations and other organizations. Experts and leaders in dentistry, medicine, pharmacy, nursing, social work, public health, optometry and biomedical research came together in order to discuss collective strategies and action items “to increase the academic participation of men of color in the health professions,” said Karen P. West, D.M.D., M.P.H., ADEA President and CEO.

“As a man of color, myself, in the health profession, this conversation is very important to me, and I’m excited about the next two days,” Nader A. Nadershahi, D.D.S., M.B.A., Ed.D., Chair of the ADEA Board of Directors and Dean of the University of the Pacific, Arthur A. Dugoni School of Dentistry during his opening remarks.

Dr. West highlighted previous efforts that ADEA has taken to help diversify both the dental education student body and faculty during her tenure as ADEA President and CEO, including the release of the ADEA Faculty Diversity Toolkit, the Slow to Change: HURE Groups in Dental Education report, the ADEA President’s Symposium on Men of Color in the Health Professions at the March 2022 Annual Session & Exhibition and outreach to health career advisors at minority-serving institutions.

Dr. West highlighted previous efforts that ADEA has taken to help diversify both the dental education student body and faculty during her tenure as ADEA President and CEO, including the release of the ADEA Faculty Diversity Toolkit, the Slow to Change: HURE Groups in Dental Education report, the ADEA President’s Symposium on Men of Color in the Health Professions at the March 2022 Annual Session & Exhibition and outreach to health career advisors at minority-serving institutions.

In discussing a follow-up Summit as a next step, Dr. West said, “We tried to do this for many years, but the time wasn’t right. It all had to line up. We needed the right time and the right people.”

“We put out the bat signal and you all are the heroes that responded to our call,” Ryan Quock, D.D.S., Distinguished Teacher Professor at University of Texas School of Dentistry at Houston and one of the Summit moderators said while looking around the room of the more than 80 people assembled. “We’re here to get into some ‘good trouble’,” said Todd Ester, D.D.S., Assistant Dean of Diversity, Equity and Inclusion at the University of Michigan School of Dentistry who also served as a moderator.

An Inspiring Life in Medicine and Public Service

In addition to pre-Summit readings and responding to Summit poll questions, Summit attendees also conducted workgroup brainstorming sessions regarding a potential consensus statement on underrepresented men of color in the health professions, the top challenges and opportunities in developing a coalition of health professions organizations to support men of color and a further exploration of coalition building. During the two days, as inspiration, they also listened to pathway success stories and personal accounts of leadership and service.

Day one began with a Q&A conducted by Drs. Quock and Ester with David Satcher, M.D., Ph.D., 16th Surgeon General of the United States, Founding Director and Senior Advisor of the Satcher Health Leadership Institute at the Morehouse College of School of Medicine and author of My Quest for Health Equity, Notes on Learning While Leading.

“It’s an honor to sit next to such an icon of public health and public service,” said Dr. Ester of Dr. Satcher. “I consider him a mentor from afar.” During the wide-ranging Q&A, Dr. Satcher discussed his years as not only Director of the Centers for Disease Control and Prevention and later as U.S. Surgeon General, during which he commissioned the first Surgeon General Report on Oral Health, but also his childhood in rural Alabama, his years at Morehouse College and his participation in the Civil Rights movement as a student organizer. Dr. Satcher shared his firsthand knowledge of what it was like to be a young black man entering medicine and the challenges he faced. He also shared feedback on the ways more men like himself could be brought into the health professions in the future.

“I almost died when I was two, but that doesn’t mean that I stopped believing in myself,” Dr. Satcher said, when discussing his background, showing that even he had been a victim of health disparities due to racism because a local white hospital refused to treat him as a child.

He noted that he grew up in the cotton fields of Alabama and neither of his parents graduated from elementary school. “My mother still made sure her children read,” Dr. Satcher said.

Dr. Satcher admitted he had never been particularly good at test taking. (Similar disparities in standardized test-taking have led many states and Ivy League schools to go test optional in the college admission process.) Dr. Satcher also shared that Morehouse even questioned why they should admit him, but after being admitted, he would later prove himself and eventually become president of the student body and organize student civil rights protests with the likes of A.D. King, brother to Martin Luther King, Jr.

Dr. Satcher recalled when he was asked to speak at an event commemorating the 1963 bombing of the 16th Street Baptist Church in Birmingham that killed four girls, he saw many like himself in the crowd who persevered despite all the adversities they faced growing in up in the segregated South. “There were physicians and teachers in that audience,” he said. “It showed that they didn’t give up.”

And not giving up is what will be key to getting more underrepresented men of color in the health professions, Dr. Satcher said.

“Even though we don’t like to admit it, many [students] don’t qualify for dental school because they gave up a long time ago,” he said. “We have to be able to say there’s hope for you. You can do science, math and reading. You can do well. We support you.”

Dr. Satcher said encouragement must start as early as elementary and high school. “Right now, we need to invest in their excitement about learning, so students invest more in themselves. We have to ask, ‘How can I make sure our students care about learning?’”

And though the focus of the Summit was on men of color in the health professions, he noted that any coalition must involve women as well. “Holistically, we need to be working together,” he said.

Dr. Satcher ended by saying, “We need people who care enough to know enough and have the courage to do enough to persevere until the job is done!”

Planting the Seeds Early

While day one’s presentation tackled men of color in the health professions from the prospective of a preeminent physician who managed to overcome odds to become prominent in both medicine and public health, day two’s presentation focused on the Determined to be a Doctor Someday (D.D.S.) Pathway Program.

Determined to be Doctor Someday (D.D.S.) is held in conjunction with the University of Tennessee Health Science Center (UTHSC) in Memphis, TN, and serves as an example of a successful, grassroots pathway program that caters to underrepresented students in the health professions. The program is the brainchild of Christina Rosenthal, D.D.S., a practicing dentist who grew up in a disenfranchised area of Memphis and in a single-parent household with limited resources. In 1995, as a high school student, Dr. Rosenthal got into a University of Tennessee apprenticeship program. She said she was excited but also nervous.

“I didn’t know if I would fit in,” she admitted, due to her pronounced Southern accent and use of AAVE. But she said she was embraced by her mentors, one of which purchased Dr. Rosenthal her very first white coat.

Years later, after graduating from the UTHSC College of Dentistry, starting her own dental practice, earning a master’s degree in Management and Policy from Harvard University and becoming a 2017 graduate of the Presidential Leadership Scholars program, Dr. Rosenthal decided it was time to give back to her community and nurture others much like she had been nurtured decades before. She started Determined to be a Doctor Someday (D.D.S.).

“In the beginning there were two small fish and five loaves to get this thing started,” Dr. Rosenthal said, referring to the biblical verse from the Book of John. “I used my own money.”

She said she also received help from her husband—an educator—her sons and her dental practice staff who would “stuff bags for me sometimes” to give to the students.

The pathway program is now funded by many sources, including Dr. Rosenthal’s alma mater, UTHSC, and Delta Dental. She also has many volunteers from dentistry and other health professions willing to talk to students and give presentations.

Determined to be a Doctor Someday (D.D.S.) is for 14- to 18-year-olds and designed to expose students to the various health professions. According to the program’s website, it includes a D.D.S. Symposium, a one-day event designed to provide exposure to various health professional careers where students “enjoy fun, stimulating games and activities, a chance to network with local health professionals and like-minded peers” and an opportunity to compete for a scholarship. Dr. Rosenthal said the pathway program also includes six months of standardized test prep, social events, college tours and discussions about social media, how to deal with stress, proper etiquette and networking. It ends with a white coat ceremony—echoing back to when Dr. Rosenthal was gifted with a white coat by her mentor to encourage her.

Dr. Rosenthal also believes in exposing students to the health professions as early as possible, so the pathway program also has a toddler component for ages 2-5—D.D.S. Explorers. With parents present, for half a day the children participate in hands-on activities and interact with a black doctor. They also have their own white coat ceremony.

When she does the toddler program, “I purposely come in and try to sprinkle in stuff for the parents as well, saying it’s never too late… I’ve had some parents tell me that they want to go back to school.”

Dr. Rosenthal is also expanding into virtual programs. She’s done a virtual visit to a school in Wisconsin, highlighting health professions like dentistry, veterinary medicine and pharmacology with featured speakers. These virtual visits are also serving as a pilot program for expanding Determined to be a Doctor Someday to 6- to 13-year-olds.

Dr. Rosenthal said some of her biggest challenges with the pathway program have been receiving funding since many programs are often competing for the same resources. She also contends with the complexities of students from vulnerable communities who may not always have transportation to events or family support. And there is always the challenge of finding mentors.

“Doctors are busy,” said Dr. Rosenthal. “They have their own work.”

In addition, pathway programs take time to see results. “You don’t know if what you’re doing is even going to be worth it,” she said.

But she has seen results. Dr. Rosenthal said the first Determined to be a Doctor Someday class started with 21 students, and since then, one of the program graduates has become a dentist. Other classes have seen enrollees in health professional programs like nursing and veterinary medicine. She said program graduates have also seen improvement in ACT scores and have enrolled in college and technical schools.

Next Steps

At the conclusion of the ADEA Men of Color in the Health Professions Summit, participants voiced optimism regarding next steps, future collaborative strategies and the information shared and learned at the two-day event.

“We are asking each other questions and finishing each other’s sentences because we are aligned mind, heart and spirit,” Dr. Ester said. “Just the fact that we’re brave enough to be here shows that we can get this done.” “This is a new thing that we’re doing together and a moment that we need to seize,” Dr. Quock agreed.

Dr. Sonya G. Smith, ADEA Chief Diversity Officer, said the ADEA Access, Diversity and Inclusion Division would take the notes gathered during the workshop discussions and try to develop actionable themes and further develop a collective consensus statement. They will then produce a document to be reviewed and edited by Summit participants.

Dr. West also plans to share the consensus statement and recommendations from the Summit with CEO/Presidents of Federation of Associations of Schools of Health Professionals, the CEO/Presidents of academic health profession associations and other health professions organizations for discussion and next steps.

“I appreciate all of you coming together here. This is an exciting time at ADEA,” Dr. West said.