'Superhuman, but never enough': Essay details inequities experienced by Black women physicians in the US

Black women physicians in the United States face hurdles and inequities that contribute toward their underrepresentation in medicine, argues an essay in The Lancet by Massachusetts General Hospital (MGH) physician Fatima Cody Stanford, MD, MPH, MPA, MBA, and two colleagues. The essay, titled "Superhuman, But Never Enough: Black Women in Medicine," gives voice to "the frustrations I deal with and that I talk about with my Black women physician colleagues," says Stanford, an obesity medicine physician-scientist at MGH.

Black Americans make up 13 percent of the U.S. population, but just 2.8 percent of physicians in this country are Black women. Those Black women who choose a career in medicine encounter often-disheartening paradoxes such as the one described in the essay's title. "We obtain additional degrees and training, earn various accolades, and yet that's still never quite enough for whomever is evaluating us," says Stanford. "I have five degrees. I've done two residencies and two fellowships. My CV is over 140 pages. Yet I've been told: 'We don't know if you're quite qualified'. How is that possible?"

Black women physicians earn less than their colleagues and have a harder time getting promoted. "Why is that if we have the same training and expertise as our colleagues?" asks Stanford. Black women also hold relatively few leadership positions in academic medicine, which limits role models for Black female medical students.

Likewise, the low number of Black female physicians in the United States reduces the options for Black women who prefer to be seen by a clinician of their race and gender. Stanford treats women patients who wait months for appointments. She understands why, since she's a patient, too, and prefers Black women physicians. "I feel like I'm being heard in a different way, like my medical concerns are being taken at face value, instead of undervalued or brushed under the rug," says Stanford. But she worries that delaying care can lead to worse outcomes, especially in a patient population at risk for chronic diseases such as obesity, heart disease, diabetes and kidney disease.

The Lancet essay, coauthored by MGH research fellows Simar Singh Bajaj and Lucy Tu, notes that Black women have long faced discrimination in the United States, even within the early 20th century's women's suffrage movement and at historically Black universities and colleges. "You can't escape history," says Bajaj. "Black women are still seen as lesser than men. That's why we have these disparities."

The authors of "Superhuman, But Never Enough" note programs currently in place within academic medicine that are designed to promote diversity, equity and inclusion are promising, but Stanford says it remains to be seen whether these efforts can be sustained and make a long-term difference. However, she hopes the essay will help start a conversation about the inequities experienced by Black women in medicine and sees glimmers of hope that cultural transformation is possible in the faces of her coauthors Bajaj and Tu, who are of Indian and Chinese heritage, respectively. "Seeing people who don't look like me doing this work gives me significant joy," says Stanford, "because I feel like times are changing."