By Nikita Deval, OMS-IV, Arkansas College of Osteopathic Medicine
Growing up, I never questioned why my pediatrician was Indian. It was a given that every year I would meet Dr. Joshi in her office where she would converse with me and my parents about my health in our native language, Telugu. My parents would bond with her over their shared upbringing, and each appointment would end with a chat about our local Indian community. In suburban Minnesota, Dr. Joshi was one of the few physicians that understood my parents’ Ayurvedic remedies, their distrust of medications and our cultural norms at home. It wasn’t until I reached an older age that I realized this was a privilege.
My grandfather was a freedom fighter for Indian independence and instilled in my mother a strong sense of national pride. Though my parents moved to America in their 20s, they continued to honor our Indian heritage. Growing up in a primarily Caucasian community as a first-generation Indian-American, I did not feel the same pride. Overwhelmed by bullying and microaggressions, I was embarrassed by my ethnic clothing, food and accent. My parents encouraged me to connect with my roots through Indian classical music. After years of spending Sunday after Sunday silently resenting music class, it finally took. As I realized that I was learning the stories of my ancestors, I began actively embracing my culture. As an undergrad, I became president of our Indian Student Association on campus, which allowed me to collaborate with cultural student organizations, and to appreciate one another’s food, history and personal experiences. The bullying and microaggressions that I experienced motivated me to be the representation that I needed as a child. I learned how important it was for all of us to explore our identities as well as gain insight into the cultural experiences of others.
This passion for representation led my classmates and me to form the South Asian Medical Student Association (SAMSA) at the Arkansas College of Osteopathic Medicine. Our chapter is now one of the founding members of a national SAMSA organization. We wanted to create a space for students and faculty to learn about health disparities, research and advocacy efforts pertaining to the South Asian community locally and globally. We joined with other multicultural student groups to hold community-building events exploring the critical need for diversity and cultural competency in medicine.
Recently, I read a quote from Dr. Camera Jones, a family physician and epidemiologist who focuses on addressing racial disparities in health. She defines racism as a system of tiered opportunities and value assignments based on the social interpretation of how a person looks. In such a system, some individuals are unfairly disadvantaged while others are illogically advantaged, and healthcare is plagued with examples. One of the widest-reaching stories is that of Mrs. Henrietta Lacks, a Black woman whose cancer cells were harvested without her consent. Her cells, known as HeLa cells, for Henrietta Lacks, contributed to the creation of groundbreaking medicine, including the Polio and HPV vaccines, with little compensation, until very recently, for her or her family. Another infamous example is the long-term study of untreated syphilis in Black men at Tuskegee University in Macon, AL. The participants were told that they were receiving free healthcare treatment for “bad blood” from the federal government, but when penicillin was discovered to treat syphilis about 15 years into the study, it was not offered to them.
It is important to note that biased treatment in healthcare remains today. Centers for Disease Control and Prevention data show that COVID-19 has disproportionately affected communities of color. One recent tragic story is that of Dr. Susan Moore, a Black physician who was hospitalized and died from COVID-19. She posted a video from her deathbed explaining that her complaints of sickness and pain had been downplayed over and over again, preventing her from receiving the care she needed. Her story asks the question that if a well-educated Black woman and physician is treated like this, what is the state of our healthcare system?
Creating a diverse physician workforce that understands and values our racial and cultural differences is imperative to improving healthcare, and this starts by building diversity in higher education. Black students, particularly Black male students, remain largely underrepresented in medical education. One key issue that consistently bars students from racial and ethnic minorities from entering the medical field is cost. The average debt taken on by an osteopathic medical student is roughly $250,000, but many students’ debt is higher than this. This is why it is so important for us to advocate for programs like Public Service Loan Forgiveness and Grad PLUS loans, which create higher education opportunities for all students regardless of their financial and socioeconomic background.
Racial disparities in healthcare have contributed to a disproportionate distribution of resources and a mistrust of health institutions by marginalized communities. The onus is on all of us to create equitable pathways for students from diverse backgrounds to seek and complete medical education. This is the only way to ensure a future where every patient is greeted by a familiar face.
The views and opinions expressed are those of the author(s) and do not imply endorsement by AACOM.