“And when we speak, we are afraid our words will not be heard nor welcomed, but when we are silent, we are still afraid, so it is better to speak remembering we were never meant to survive.”
– Audre Lorde

Like Audre Lorde, I would rather be afraid and speak my truth than choke on my silence. Often, as I navigate my journey through medicine, I feel as though I was never meant to survive.

When you apply to medical school, people will tell you to tell a story — to let your personality shine through. You are told that it is your individuality and your unique life experiences that set you apart. You’re encouraged to lean into that uniqueness and utilize it as means to prove your worthiness for admission. It is then used to put into pretty graphics that celebrate the diversity of your class as medical schools pat themselves on the back for bringing more Black, brown, and queer people into this space than ever before, but what good does it do to get us here if we don’t want to remain.

When you arrive at the pearly white gates of your medical institution, you feel as though you have made it, but what they don’t tell you is that the hardest part is enduring the aggressions, the imposter syndrome, and the weight of expectations while all being expected to persist and excel anyways. Not only are you fighting an inner battle of questioning your worthiness, but that individuality that was championed during the admissions process is no longer seen as a strength and, more so, a nuisance or an inconvenience to those around you. You are told to blend in, not stand out.

To wear neutral colors and wear your hair in a “professional” way. You are told how doctors are supposed to look and act, but doctors weren’t supposed to be Black not too long ago. I was recently told that medicine was not the career for me if I wanted to have nails. Then who is medicine a career for exactly? Even something as small as the surgical caps not fitting all hair types excludes us. In the anatomy lab, I had to wrestle with my braids to fit them under the shower caps, and I’ve heard stories of third-year medical students, residents, and attendings having to maneuver two caps around their hair to contain it, but haven’t we learned that one size does not fit all? The guise of professionalism infringes upon our personhood and dampens our individuality. I’m starting to wonder if we were ever meant to fit in here at all.

Until we come to terms with the fact that guidelines for professionalism are rountined in white supremacy, medicine will never be an inclusive space for all. It will continue to be a place where people like me are told that they are too much, too loud, and too different. If being Black, female, and first-generation weren’t enough to make me feel othered, being from a single-parent home, not coming from wealth, and experimenting with my hair and nails definitely single me out. From hidden fees to the daily aggressions that only me or other people who look like me seem to notice, every day, I feel another oppressive force nicking away at my personhood and beating down my will to fight. Similarly to Duaa AbdelHameid, “I frequently feel I have to silence the Black woman and simply be a physician, colorless, un-Black.” I often feel as though my culture and my career are mutually exclusive.

I write today to question the current use of professionalism in medical education. We cannot expect to diversify medicine and then force all of our doctors in training to fit into an archaic mold once we get here. In a qualitative analysis study of narratives, “marginalized populations reported greater infringements on their professional boundaries, increased scrutiny over their professional actions, and a tension between inclusion vs. assimilation.”

As Audre Lorde writes, “the master’s tools will never dismantle the master’s house.” We need to push organizations to change their policies and recreate new ones from a framework of inclusivity. Just as our patients hope that we accept them as they are and care for them equally, we need to create academic systems that allow us to show up as our authentic selves rather than manufactured versions.

The author is an anonymous medical student.

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