Rethinking traditional mentorship
For Dr. Florez-Pollack, the door almost shut when she began to hear from fellow medical students that dermatology is “too competitive ... a field for only the top people in the class.” She felt doubt settling in.
“I had peers who were throwing a lot of money toward prep materials ... peers who had siblings in medicine and had started studying from day one [for the step 1 exam],” she said. “I thought, was it really worth the effort? Do I really want to be perfect to get into the field when other fields would be happy to have me as I am right now?”
Her immense enjoyment of an “Art of Observation” elective course helped renew her interest in the field; it reinforced her visual abilities as well as the potential for her to address implicit bias as a dermatologist. She sought Dr. Pandya’s guidance and sponsorship to help her grow connections, polish her resume, and present herself to other faculty.
Doors were opened, she said, for her to secure a 1-year research experience before her final year of medical school with UTSW faculty, and then a 1-month rotation/mentorship with William D. James, MD, professor of dermatology at the University of Pennsylvania, an institution with a history of diversity initiatives and a longstanding skin of color program.
Dr. Florez-Pollack sees her experience reflected in the findings of a recently published study – a thematic content analysis of telephone interviews with applicants to the UTSW dermatology residency program during the 2013-14 and 2014-15 application cycles. Of the 44 applicants who participated in the study, 13 were UIM applicants.
Six of the seven UIM applicants who matched were involved in a pipeline or enrichment program – and were exposed to the field early – compared with one or two of the six UIM applicants who did not match. Underrepresented applicants were more often discouraged from applying (54%) – told, for instance, that they could better serve their communities through other specialties – than were non-UIM applicants (13%). They also were affected more often by a lack of equitable resources, according to comments made by 70% of applicants (UIM and non-UIM).
Also notably, the investigators said, all of the UIM applicants who matched (and the majority of non-UIMs who matched) reported having a mentor during the process of applying, compared with 44% of those who didn’t match.
Rebecca Vasquez, MD, assistant professor of dermatology at UTSW, who led the study, was herself a mentee of Dr. Pandya. “He believed in me and gave me the courage to consider dermatology,” she said. (Dr. Vasquez was one of the Latinx women who inspired Dr. Florez-Pollack, in turn, when they met at Dr. Pandya’s pizza party. Dr. Florez-Pollack assisted with the research and was a coauthor of the study.)
Dr. Amy McMichael
Amy McMichael, MD, professor and chair of dermatology at Wake Forest University, Winston-Salem, N.C., said that dermatology as a field has traditionally been “very good at mentoring.” Many of the dermatology societies have long had mentorship programs, for instance, that guide medical students, and sometimes residents, through defined experiences or through periods of time.
But she advocates going deeper. “When it comes to sponsorship, we fall a little short,” she said. “Sponsorship is about promoting that person to the next level, making sure they achieve what they want to achieve ... putting them up for opportunities they may not have known existed. It’s continuous and focused.”
Dr. Olabola Awosika
Dr. Olabola Awosika
Olabola Awosika, MD, a fourth-year dermatology resident at Henry Ford Health System, Detroit, said her interest in dermatology was solidified during her participation in the AAD’s month-long mentorship program after her second year of medical school at Howard University, Washington. However, it wasn’t until her fourth year, when she did an away rotation at Wake Forest, that she realized that “gaining access to the field” takes years of mentorship, research opportunities, and networking. It was too late.
After initially not matching, she did a rotation at Johns Hopkins in dermatology during an internship year, followed by a 2-year research fellowship at George Washington University, Washington. As does Dr. Florez-Pollack, who now mentors medical students. She also serves on the Women’s Dermatologic Society diversity committee, which is now developing initiatives to help UIM dermatologists “become upwardly mobile in dermatology [after residency], so they have a seat at the table in various settings.”