When your institution has a less than 1% hiring rate for Black residents

The other day I was in the main hallway outside of our radiology reading rooms, which is lined with picture frames of all the residency senior classes dating back to the 1980s. I’m new to the institution, so it was nice to see all the prior residents. I found myself wondering what they were up to now after graduating and what fellowship or jobs they landed into. As I kept going back in time, something became glaringly alarming. I kept going back, the year before, 3 years before, 9 years before, 15 years before.

Where were all the Black residents?

I walked further down the hall back to 30 years and was able to find one Black resident in 2012. One. In thirty years. That meant out of 174 residents, we had a hiring rate of only 0.6% for Black residents.

I then went back to my reading station and went down a rabbit hole to find any Black or African American residents in any current program at our institution. I managed to find a handful across 10 different residencies at my major academic center before my studies list became too abysmal to ignore. Of course, just like the radiology residency photos, I could only quickly judge based on photos alone and that there were probably more Black residents or ones that may have been mixed race. But it was blatantly obvious that Black residents were rather few and far between compared to our residents’ other ethnic makeup.

Later that day, I brought it up to my husband, a hospitalist working at the same hospital. He was also appalled when he recently realized the same thing. Of the close to 80 residents in internal medicine, they also had very few Black residents.

What made it disconcerting for me was that where I did 10 years of my medical training had more Black residents and attendings on staff, including in leadership roles. And although I’m sure there are more, in my short time at my new job I have only met one Black attending because he kindly reached out to help me with a project. The demographics of Black residents in my current home state is 6% while it is 8% where I trained – not enough of a difference to explain the discrepancy.

And unfortunately, the demographics of our institution are considerably worse than the nationwide statistics. Currently, Black or African American students make up 7.5% of U.S. medical schools’ demographics, 5% of physicians actively in practice, and 12.7% of the U.S. demographics.

As soon as I realized we had so few Black residents, I began to ask around to find out if there were reasons why. One person brought up the fact that we happen to be the smaller institution between 3 other larger universities within an hour away and even bigger world-class institutions just 6 hours away. So, there is always a chance that Black residents may be choosing to go to more urban and populous cities for more job opportunities and networking. Another attending explained that the county we are in is in the top ten most populous counties in all of the United States, but Black or African Americans make up only 1.7% of the demographics. There are some odds that black applicants may not have family close enough for support and choose to go elsewhere. But despite these potential reasons, even though our county’s demographic makeup is admittedly small, it’s still better than our institution’s hiring rate.

But after speaking to many different colleagues, I was relieved to find out that everyone at my hospital found our lack of Black representation across our residencies and faculty disappointing. And I was glad that it’s an issue that my institution has completely acknowledged and has been actively trying to improve.

My husband and I are now involved in recruiting residents and fellows into our respective programs and are dedicated to inclusion. My radiology colleagues and I have done virtual meet and greets with over 150 medical students across the nation to provide guidance and promote our program’s commitment to diversity. I personally know the radiology residency program director is genuinely dedicated to improving diversity. If we all support and encourage young Black and African American physicians, we will continue to confront and actively solve this problem.

I’m also very proud to say that our university has recently launched “The Black Thriving Initiative” to address systemic anti-Blackness as an existential threat, promote Black student success, and hire Black candidates in all areas of the university, including the medical center. There’s even a place to take a pledge to help shape the future of all undergraduate/graduate students, medical student, residents, fellows, faculty and staff, and alumni. Hopefully, this will also lead to the hiring of more Black attending physicians because it is essential for young doctors to have role models and mentors that they can relate to and share similar life experiences with.

Although the lack of Black residents at our institution is pretty dismal, the number of women and minorities at our hospital is better. So, I believe that we, just like many other hospitals across the U.S., can promote diversity and hire many more Black and African American physicians at our institutions.

I sincerely hope that the hallway of radiology fame at my institution will include even more diversity in the next few years. And that I’ll be able to look up at much more smiling, graduated Black senior residents and wonder what many great things my colleague is now up to.