From the Experts: 3 Takeaways From the National Medical Association Convention

My first time attending the NMA 2022 Annual Convention and Scientific Assembly

I attended the 120^th National Medical Association (NMA) 2022 Annual Convention and Scientific Assembly on July 30-Aug 3 in Atlanta, GA. This year’s theme was “Centering Equity: From Policy to Practice”. NMA is the largest and oldest organization and voice of more than 50,000 African American physicians and allied health professionals. The NMA was founded in 1895 during the Jim Crow Era, a time when many African Americans faced a segregated society that impacted healthcare access and delivery, employment, housing, transportation, medical training, research, societal interactions, and life in general. At the time, African American physicians were routinely denied membership and participation in professional organizations (1-2). This was my first NMA meeting, and this is my first time being aware of this meeting, which suggests that many minority PhDs not in academic medicine are still siloed from others.

This conference was meaningful because it was not just one small session dedicated to a disparity. Many of the sessions talked broadly about health equity, implicit and explicit bias, and disparities in many diseases that heavily impact African Americans and other minority communities. There was great data, storytelling, and emphasis on underfunded areas of research and clinical practice. Of the many great takeaways from this meeting, I will highlight three.

1. The importance of mentoring and building support networks.  As a first-generation Ph.D., I thought the experiences of minority PhDs navigating academia were challenging. I quickly learned that it is just as harrowing, if not worse, for those in medicine. Minorities in medical school, training, residencies, internships, and faculty roles face burnout, marginalization, and lack of protection (3-4). The rate at which Blacks are dismissed from residences is up to 20% of all residents (3,4). There is no mechanism to speak out about the abuses for fear of retribution and additional impact on their careers. Several speakers talked about their experiences, the gaslighting, the loss of time, and the loss of their careers. Some, as the only minority in a program, have been recommended to switch to areas where there are more minorities. Based on what I heard, the Accreditation Council for Graduate Medical Education (ACGME), is still not recording how many minority trainees have been dismissed from programs relative to their peers, so no one knows the real number. However, when one gets that far into training, losing them is a loss to all of us. There are already rampant disparities and underrepresentation at all levels of the medical workforce. And those already in the medical profession should actively be retained so they can impact outcomes for minorities and all other patients. These stories emphasized the importance of the mentorship program that we are creating for thoracic oncology, as trainees and clinicians don’t just need to be recruited, but also be put into positions that will allow them to advance, excel, be retained, and get promoted.
    
2. How to stand up to racism. Dr. Camara Phyllis Jones spoke as a panelist on antiracism and how to be an antiracist as part of the Edith Irby Jones M.D. Plenary Session titled “Survival of the Black Physician: Wellness, Burnout, and the Impact of Racism”. Key takeaways were that antiracism is a three-step process: 1) we must name racism 2) understand how racism is happening at an institution, and 3) organize and strategize to act.  “When racism exists, it is a system, it saps the strength of the whole society, and we should act to dismantle racism”, noted Dr. Jones. The best analogy that she gave was sitting inside versus outside of the restaurant. “If you are outside and want to get in, often through no fault of yours, you are excluded. However, if you are inside the restaurant, you may see the sign inside saying ‘Open’ but to those outside it says ‘Closed’. Maybe some will get inside, but will they stay by the windows and bring others in, or will they try to keep the door shut?” Her metaphor captures the experience of trying to grow in spaces that may not want you.
    
3. Mentoring and Training Programs. There were numerous examples of programs that are being designed to increase training opportunities, retention of scholars, and increase workforce diversity. Morehouse School of Medicine uses an artificial intelligence-based tracking system that can tell how their students are doing at each stage of their training and if they are on par to be competitive when they leave. While residencies often seek the highest scoring students, Morehouse has found that the group in the middle is also just as likely to succeed as the highest scoring students. Morehouse gives assistance, coaching, and support to students falling behind benchmarks to ensure they stay on track. Federal organizations are also taking action. The NCI’s Acting Director, Dr. Douglas Lowy, discussed two new mechanisms for minority scholars. The Transformative Educational Advancement and Mentoring (TEAM) Network is piloting a program that uses training champions at minority-serving institutions to help underrepresented scholars navigate education and career development. The Cancer Moonshot Scholars Diversity Program (CMSDP) aims to increase the number of R01-funded early-stage investigators from underrepresented groups across the cancer continuum and promote scientific advancements through diversifying the NCI’s investigator pool.

I was excited to attend this meeting and represent LUNGevity as the Director of the Foundation’s STEM Workforce Initiatives. It opened my eyes to the possible avenues of connection and mentorship and reminded me once more of the need to create a mentoring program in thoracic oncology for underrepresented minority scientists and researchers. I am looking forward to next year’s meeting in New Orleans and sharing our own learnings.

1. https://www.nmanet.org/page/History
2. Mitchell EP. J Natl Med Assoc 2020, 112(4)-331-332
3. Wilson, S. Gaslighting of Black medical trainees makes residency something to ‘survive’. 3/10/2022 STAT News. https://www.statnews.com/2022/03/10/gaslighting-black-medical-trainees-residency/
4. McFarling, UL. ‘It was stolen from me”: Black doctors are forced out of training programs at far higher rates than white residents. 6/20/2022. STAT News. https://www.statnews.com/2022/06/20/black-doctors-forced-out-of-training-programs-at-far-higher-rates-than-white-residents/