We are honored to introduce you to our 12th Voices from Black Women in Medicine blog post written by Rebekah D. Fenton MD, FAAP. Dr. Fenton is an Adolescent Medicine Fellow at Lurie Children's Hospital of Chicago and the Feinberg School of Medicine at Northwestern University in Chicago. Fenton's clinical work is centered around providing healthcare for marginalized youth populations with a focus on cultural humility and health equity. As an avid writer, Fenton uses writing as a platform for advocacy to communicate topics such as public health, adolescent medicine, and diversity in medicine.
Becoming a doctor as a Black woman is like running a race with hurdles that you can’t see and didn’t train for. I doubt I would have succeeded if I didn’t have a track coach: my father. My dad, Dr. Michael Lucien, is a general pediatrician and first-generation college student. He is passionate about his work with children and their families. He commonly joked about his job, “I wouldn’t do this for free, but I would do it for a lot less.” Watching him excitedly leave for his clinic each day and return home with stories of the difference he made inspired my own path.
He was also open about his personal failures and the systemic barriers Black people experience in medicine. He reminded me that he did not get into medical school the first time he applied. He succeeded the second time after pursuing a Master of Public Health, coincidentally where my mom was studying Nursing. They met at a grad student social and the rest is history. He later shared how he completed medical school in 6 years due to failing and remediating courses and rotations. My two siblings and I were born over the course of that time. One of his deans joked that he needed to hurry up and graduate before he had any more kids.
From his experience, I learned both passion and struggle. It helped me find the former and persevere through the latter. I found my own niche in medicine in college. I wanted to be a doctor and work with teenagers, but I also loved teaching, mentoring, and mental health. My dad introduced me to Dr. Elizabeth Miller, a physician at his hospital in Adolescent Medicine. She welcomed me to a field that includes all of my interests and more. That dream carried me through the challenges ahead. I struggled in Chemistry even after getting As in my high school honors classes. I called my father after my first bad grade. “It won’t kill you,” he said. When I reminded him that I was sad and needed reassurance, he added, “you will be okay.” “I will be okay” became a mantra I carried with me on the many days where I doubted myself or my ability to get into medical school.
I also learned to steer clear of sharing my doubts with people who were not safe. I had heard from other Black and Brown students that if you told the pre-med advisors about your fears about becoming a doctor or struggles in coursework, they would talk you out of science into “less challenging” majors. This rampant practice across institutions and pre-medical/medical training disproportionately affects potential Black and Brown physicians; I call it the culture of misadvising. At every advisor meeting, I projected confidence, even if I was just faking it to get by. I saved my fears about not being good enough for the people, like my dad, who wouldn’t use them to disqualify me.
On a trip back home, I found a picture of me and my older brother wearing child-sized hospital scrubs. I had a yellow plastic stethoscope in my ears and held the diaphragm against his chest. I taped it to one of my school folders and looked at it every day, in every science class to keep my eye on the finish line. I considered every science class, every test as a hurdle to overcome. I was determined to learn how to jump over them through the use of study groups, office hours, and meticulous planning so nothing would keep me from my dream.
In medical school, I learned more about my passions and failures. I found a new adolescent medicine mentor, Dr. Nadia Dowshen, and presented my first poster at an academic conference on our work. Through service and education, I found ways to stay connected to the adolescent health topics that fired up my interest in medicine. Yet, I also failed my first pre-clinical course and, a year later, failed three successive SHELF exams. I had always defined myself as a “smart kid” and so my sense of self was threatened. I also felt isolated watching my classmates continue on with rotations while I took a pause to study for my retakes. I was deeply discouraged, afraid I would never get out of this rut, made worse by being placed on academic probation. Once again, my dad’s words provided comfort for me: “progress, not perfection, is the key to success.” With a village of encouragement, I completed all of my exams with passing grades and even matched at my first choice pediatric residency. I only recently learned that in predictive analysis, Black students receive 16 less points on STEP exams. I imagine similar inequities exist on SHELFs.
Residency in a predominantly white city and program was the first time I repeatedly experienced microaggressions. I observed Black families inappropriately perceived as angry or dangerous, was frequently mistaken for a parent (despite being dressed in scrubs), and heard providers make derogatory comments about Black families and patients. Having other Black women in my class did not buffer me from these experiences; we were frequently mistaken for each other despite our different heights and complexions. Management of these experiences with a busy schedule was exhausting. These issues are certainly not unique to one hospital. My former institution created an educational curriculum and training, some of which I helped develop, to address these systemic problems. These experiences strengthened my focus on combating the harms of medicine on both Black patients and trainees.
As I finish my fellowship in Adolescent Medicine, there is still so much work to be done. Black students face barriers to careers in medicine at every stage and every facet of their application, from lower clinical grades to inequitable descriptions in letters of recommendation. My success is not a reflection of the current system, but a resistance against it. No one, including Black and Brown students, should need a parent who is a doctor to become one themselves. The support I received should be universal and the barriers many face should be nonexistent. We cannot call a system functioning if it disadvantages those who have experienced the most hardship, yet are underrepresented among the physician workforce. Representation matters, but we need so much more. We need to think of all the potential doctors who have left the track because of insufficient training, support, or finances to continue their race.
Learning about systemic racism and how it affects medical education has helped me depersonalize a lot of the hurtful experiences I have faced. Even in the context of systemic devaluation, Black people must recognize and celebrate how valuable we truly are. I aim to advance this mission with every patient encounter and mentee connection, to leverage my privilege as the doctor who won the race for those still learning to jump hurdles. I will also tirelessly advocate for liberation, the removal of hurdles altogether.
For more information about Dr. Fenton, her career and writing, check out her blog https://rfentonmd.com/. If you are a Black woman in medicine and would like to share your story, please don’t hesitate to reach out to Kristin at kmitchener@instapathbio.com or direct message us on Twitter @instapathbio.
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