Answering the Call: I am a Black Man Aspiring to be a Plastic Surgeon

Dear Dr. Shay Dean,

I read your editorial with a great deal of empathy, and I am inspired by your journey from a dreamer to a private practice Plastic Surgeon in Los Angeles. ¹ Before I tell you how the editorial spoke to me, I want to tell you about myself so that you can get an idea of the impact your letter had on me.

Your concerns about the diminished representation of Black men in Plastic Surgery resonated with the challenges I face as one of the few Black men in my medical school class and the only one pursuing Plastic Surgery. I would not even be in medicine without previous mentors who pushed me to invest in my future outside of football. I owe my own first steps toward medicine to high school summer science courses that nurtured my curiosity. These programs—for young Black students in the Bronx—ignited a passion in me for math and science. In college, I was an executive leader in the Student African American Brotherhood. We created a podcast, “Men in Ten,” focused on candid dialog to increase Black presence in underrepresented careers. Now, I am a Research Fellow in Plastic Surgery, leading a monthly Cultural Complications M&M discussion during Grand Rounds.

As a 4th-year medical student, I am faced with breaking into a field that historically lacks diversity. My home institution’s Plastic Surgery Residency program has never had a Black male resident. ² While in medical school, I have had outstanding mentors. Not all of them are Black or share my background, but they are advocates who see my potential and appreciate my dreams. My Caribbean upbringing has taught me to welcome mentors like a close-knit family, embracing the idea that it “takes a village to raise a child.” At times though, I grapple with uncertainty; that I may drown in the competitiveness of Plastic Surgery because I am the only Black man in the room. I often think about the adage: “You can’t be what you can’t see.” However, despite these fears, I am determined to pursue the field that I have fallen in love with.

Dr. Dean, your editorial spoke to me on a personal level and gave me a sense of calm. I was moved by your comments about the underrepresentation of Black men in Plastic Surgery. You emphasized the historical challenges Black men face in medicine, potential solutions to these challenges, and underscored the need for mentorship and visible role models to shape an inclusive future for aspiring Black male surgeons.

The disparities highlighted in your editorial are disheartening; to learn that the number of Black men pursuing careers in medicine and surgery has remained stagnant, despite efforts to promote diversity and inclusion in the field. To my understanding, the entry rate of Black men into medicine has decreased—and not increased—since 1978. ³ This decrease made me consider the significance of historical Black Medical Schools, which have been instrumental in shaping the careers of the majority of Black male physicians. Without these institutions, one can only imagine how small the percentage of Black men in medicine would be: the literature quotes that in 2019, approximately 70% of Black/African American doctors graduated from an HBCU medical school. ⁴

You also brought up the challenge that Black men face competing against an expanding pool of other minority students. During the last four decades, medical school enrollment has seen a dramatic increase in White women, Asian men and women, and a more modest increase in Black and Latinx women. Yet, the representation gap continues to widen for Black men. ³

The dwindling number of Black male physicians denies both the medical community and our patients the voices and contributions we possess. Physicians of color have historically shown a commitment to serving underserved communities. This service is needed now more than ever, especially in the aftermath of the COVID-19 pandemic which revealed glaring health inequities faced by marginalized groups. Black males seem to be a forgotten minority in medicine and our voices are silenced. It is intimidating to witness our struggle for recognition and equity; the weight of inequality threatens to make us silent and invisible.

Your editorial highlights the need to mentor Black males early—even as young as elementary school—to engage with and enjoy the sciences, then through middle school and high school so that students are ready for the rigors of university. Beyond mentorship, I would add that sponsorship stands as an equally vital support mechanism. Sponsors level the playing field for under-represented trainees pursuing fields without diversity. Sponsors use their influence to champion the advancement and enrichment of their proteges. Though mentors may put us on the right path, sponsors unlock doors to better opportunities.

I want to close by saying that I hear your call—all the way from the East Coast—to seek out Black surgeons to mentor and sponsor me toward a career in Plastic Surgery. As I forge this path, I draw strength knowing I am preparing a path for younger Black students who will follow my footsteps.

I am resolute in earning a seat at the table; and I (we) bring an abundance of talents, perspectives, and resilience to this table. I know I am not alone. I can proudly declare, “Here I am,” humbled and ready.

Sincerely,

~Nerone Kiyoshi Omari O. Douglas, MSc