As I traverse the halls of Howard University College of Medicine, one of only four historically Black colleges and universities (HBCUs) with a medical school, I’m inspired by decades of photographs displaying visionaries who became powerful Black leaders in healthcare. Then, here I am, an HBCU medical student with motivation and a tremendous desire to pursue otolaryngology–head and neck surgery, a specialty for which my school has no residency program.
The ability of otolaryngologists to secure emergency airways, restore hearing to kids who have never enjoyed the voices of their favorite cartoon characters, and give hope to patients with diagnoses of head and neck cancers, makes otolaryngology surgeons my heroes—I would be thrilled to join their ranks.
However, challenges to my pursuit are magnified by factors that I feel contribute to the shockingly low percentage of Blacks and women in the otolaryngology specialty. The fact that my institution doesn’t have a residency program is alarming in light of the scarcity of Blacks in otolaryngology and because HBCU medical schools currently aren’t, but could be, a pipeline for Blacks into the specialty. In short, otolaryngology doesn’t accurately reflect the population it serves. I want to be among those helping to change the current makeup of the field.
To achieve my goal, I recognize that I must triumph over circumstances outside of academic performance, interpersonal skills, and motivation. In addition to the limited mentorship and resources typical of a home residency program,
- I’m Black and seeking to join a specialty that, as of today, has admitted less than 1% of its complement;
- I’m a woman, and fewer than 20% of us are practicing otolaryngologists; and
- I attend an HBCU medical school that may be frequently overlooked when it comes to applications.
Despite these hurdles, I’m reminded of the success of the minorities who preceded me. I plan to press forward, believing that the picture depicting the tiny number of Blacks and women in otolaryngology accentuates an underserved population needing me to be steadfast in my pursuit and enter the field ready to provide skilled, professional services. I’m encouraged, knowing that this is the course I must pursue and believing that someone out there will see, understand, and be receptive to my situation. Thus, my story begins.
Challenges and Solutions
I remember attending a meeting with an academic advisor of my institution, and his statement, “Only four students have matched into otolaryngology in the last decade.” It penetrated my thoughts like a gust of cold wind on a stormy day.
Stunned by this reality, many students eliminated otolaryngology from their area of interest—quite frankly, we’re often encouraged not to apply in the first place. For me, on the other hand, this implicit discouragement signaled a challenge likely connected to the near absence of Blacks in the field.
Focused on excellence, historically Black colleges and universities provide a student resource pool of well-trained prospects to increase the presence of Blacks in otolaryngology.
In truth, I’ve never been the type of student to stagnate in the face of adversity. Whenever someone tells me something will be difficult as if to discourage me, my next immediate thought is, “What can I do to meet this challenge and succeed?” I cannot tell you how many times I’ve had patients comment on how pleased they were to see a young Black student doctor, and how few they had encountered during their otolaryngologic interactions. While I’m hopeful to one day fulfill this role, I’m aware of the fact that even the patients we serve make note of the scarcity of Black otolaryngology providers and the abundant need to diversify training programs.
I can also foresee the likelihood that, if given the opportunity to train in otolaryngology residency, I may be the only Black person in the program. For me, however, this reality is quite familiar. As a graduate of outstanding predominantly white institutions prior to my arrival at medical school, I’m certainly no stranger to being productive in academic environments as “the only” Black student. Despite this, I feel both comfortable and successful.
Too often, it is my belief that excellent HBCU medical programs and the outstanding students graduating from them are overlooked or unintentionally denied consideration to some specialty programs within the medical field. Sometimes it appears that the very existence of HBCUs with medical schools is unrecognized or overlooked. An illustration of this reality confronted me during a third-year clerkship when the resident on my service asked me what medical school I attended. “I attend Howard University College of Medicine,” I answered proudly.
The intern’s face immediately lit up as she exclaimed, “Congratulations on your attendance at Harvard! That is a top institution!”
Careful not to interrupt, I let her finish singing my praises before saying, “Not Harvard. Howard. I attend Howard University College of Medicine, right here in Washington, D.C.”
“Oh, Howard,” she replied. “I was unaware they had a medical school.” Unfortunately, I wasn’t surprised by this encounter, as I’ve heard similar comments by others in the medical field, including attendings.
From my perspective, although HBCUs are the richest source of Black students matriculating to medical school, many of those students are discouraged from pursuing otolaryngology as a career, and few will ultimately apply. Focused on excellence, these HBCUs provide a student resource pool of well-trained prospects to increase the presence of Blacks in otolaryngology. Those who control the specialty by policing its gates through the residency application process must have the vision and willingness to broaden their consideration and be receptive to students in situations like mine.
Though I recognize these requirements are fundamental to a student like me gaining acceptance into otolaryngology, I’m certain that I’ve done everything within my power to pursue my dream. As otolaryngology leaders gear up to evaluate hundreds of applications for residency, I’m hopeful some will read this story and determine to make sure their programs include a holistic review of applications this year.
Corinne Pittman, BA, is a fourth-year medical student at Howard University College of Medicine in Washington, D.C., applying for residency this year.
HBCU History
Historically Black colleges and universities (HBCUs) have served an important role in U.S. higher education. According to the Higher Education Act of 1965, HBCUs are “…any historically black college or university that was established prior to 1964, whose principal mission was, and is, the education of black Americans, and that is accredited by a nationally recognized accrediting agency or association determined by the Secretary [of Education]…” At the time of the Act, Black students weren’t always welcome at existing public and private institutions of higher education. HBCUs provided undergraduate and graduate level educational opportunities to people of African descent.
The majority of all HBCUs are in the southern United States, although they are also located in Delaware, Illinois, Maryland, New York, Ohio, Pennsylvania, and West Virginia. Cheyney University, the oldest HBCU in the country, was established by Richard Humphreys in 1837 in Pennsylvania. HBCUs can be classified in a variety of ways, as public, private, denominational, liberal arts, land-grant, independent university systems, single-gender serving, and research-based. As of 2017, there are 101 HBCU institutions.
HBCUs differ from predominantly Black institutions (PBIs), which were first recognized in 2007 and incorporated as part the Higher Education Opportunity Act of 2008. PBIs may apply for federal funding to assist in serving low- and middle-income Black students. To qualify as a PBI, an institution’s student body must be at least 40% Black, it must have a minimum of 1,000 graduates, and 50% of its undergraduate students must be low-income or first-generation college students. As of 2019, there are 104 PBIs in the U.S. —Amy E. Hamaker