I graduated from Cornell University Medical College in 1998. To my knowledge, it was the very last year that our medical school was known by that name, as the very next year, the naming rights for the Medical College were purchased by Sanford I. Weill, for a 100 million dollar donation, and it is now known as Weill Cornell Medicine.
With the name change, and subsequent donations, the campus of the medical school I attended changed dramatically. So, you can imagine my excitement when I was invited to speak at Weill Cornell Medicine, on the topic of Preparing for a Career in Academic Medicine. This conference was sponsored by Building the Next Generation of Academic Physicians, and the audience was underrepresented in medicine medical students, residents, and faculty across all medical specialties. I was deeply honored to be invited, and I spent hours preparing for the conference and the address. Although I am comfortable speaking to large groups, this talk made me nervous.
The talk centered around six life lessons that I have learned on this journey from minority college student to tenured faculty member at the Spencer Fox Eccles School of Medicine at the University of Utah. I began by sharing my journey—from not so humble beginnings, and the enormous privilege that I have being a man, and being the child of two college graduates. The journey has taught me that success is a team sport. Anyone who tells you that they pulled themselves up by their bootstraps is likely not recognizing the head start they were given.
I then shared a story about a research elective I had in medical school. I thought I was going to work with people who knew what they were doing, but instead, I was working with people who were in the same learning stage as me when it came to publication of medical research. This made me realize the second lesson: At any stage of a career, we do not know what we do not know. In other words, our knowledge is always limited when trying new things.
The third lesson I shared was with my first real research experience. When I was a second year resident, I was invited by a faculty member, after expressing interest in working with him on his research in Guatemala, to go with him to perform research at the Hospital General San Juan de Dios. It was early in the AIDS epidemic, and the faculty member was an incredible mentor, Dr. Matthew Anderson. Once he heard I was interested, he arranged funding for me to spend four weeks in Guatemala conducting this research. After the project was completed, he ensured that I continue with the project and it resulted in my first publication—The Emergence of AIDS in Guatemala, published in the International Journal of STD/AIDS. From Dr. Anderson, I learned that faculty favor learners. He went out of his way to start me on my career.
There were many times during my career that I wanted to leave academic medicine. I was mad, many times offended, belittled and ignored. But when the anger struck, I realized I had a choice. I could run away, or I could be strategic. I learned that when I am mad, that is not the best time to make a decision. The fourth lesson is that I should “make decisions when I am calm” or “a mad decision is a bad decision.”
Lesson number five was the hardest one to learn. As I conducted more research in academic medicine and the experience of minoritized faculty in that space, it became very clear to me that I was not alone in my struggles with my career. It was also clear that the problems I was encountering were not personal failings, but were problems that were built into an academic medical system that was not intended for people who identified like I did. Our research teams summarized the experiences of minority faculty in academic medicine as the “minority tax.” To this day, “Addressing disparities in Academic Medicine: What of the Minority Tax” is our most cited paper, and the most cited paper in BMC Medical Education for the year it was published.