From Evidence to Enforcement
The medical training pipeline isn’t broken. It’s working exactly as designed.
That is what two years of national research has forced us to conclude. Through a mixed-methods study of 1,755 resident physicians and 50 in-depth interviews, Black Doc Village examined how discipline, evaluation, and dismissal actually function inside residency training programs. What we found was not subtle, not anecdotal, and not new.
It was patterned.
Black physicians remain a small fraction of trainees, yet disproportionately experience disciplinary action and dismissal. Those differences do not reflect individual failure. They reflect something more entrenched: how standards are applied, how professionalism is defined, and who is afforded the benefit of the doubt — patterns that operate with or without conscious intent.
We completed this study in 2024. And until now, you haven’t seen it.
Not because it wasn’t ready. Not because it wasn’t rigorous. But because I made the choice that physician-scientists are trained to make: wait for peer review, wait for acceptance, wait for permission.
That was a mistake — and it wasn’t only mine to make. Academic publishing was not designed with urgency in mind. The timelines that govern how medical research reaches the public were not built to serve communities for whom delay has a body count. That is a structural problem, not just a personal one. I’m learning to navigate it differently: protecting the peer review process where it matters, without letting it hold this work hostage.
Because while we waited, nothing changed.
Residents continued to be pushed out of training programs with little transparency. Programs continued to operate with wide discretion and minimal accountability. The broader system continued to fund training programs that produce racially disparate outcomes without accountability.
Residency is not just another stage of training. It is a gatekeeper to the profession. When that gate is unevenly enforced, the consequences extend beyond individual careers — they determine who becomes a physician, who advances, and who is excluded. For too long, the solution has been to get more Black students into medical school. That work matters. But if the system continues removing people during residency, the pipeline problem was never upstream. It was always here.
Black Doc Village is no longer waiting.
This relaunch marks a shift — not in our mission, but in our strategy.
We are moving from awareness to action. From publishing to pressure. From describing the problem to forcing change. We have released a national policy brief grounded in our research. It is not a summary. It is a set of demands, rooted in the civil rights issue this is. We call for:
Greater transparency in residency disciplinary processes
Standardization of how performance concerns are evaluated and addressed
Protections for residents navigating remediation, probation, and dismissal
Accountability structures tied to federal and institutional funding
These are not requests. They are the minimum conditions for a training system that claims to value equity while producing outcomes that contradict it.
We are not a research organization that occasionally publishes. We are not a storytelling platform that documents harm and waits for someone else to act.
We are an accountability engine.
That means producing data that cannot be ignored. Translating that data into policy demands. Engaging directly with the institutions — and the federal funding structures that support them — that govern how physicians are trained and who survives that training.
It also required a personal decision. At the beginning of this year, I left my leadership role at a community health center I care deeply about. Not because that work wasn’t meaningful — it was. I left because Black Doc Village had major foundation funding and completed research that needed full-time attention to become real in the world. Leaving wasn’t a sacrifice. Rather, it was the only decision that made sense. Black Doc Village is no longer a project alongside my career. It is the work.
This is not a call for sympathy. This is not an invitation to consume stories of harm. We are not interested in trauma as proof.
We are interested in evidence. In patterns. In comparisons that reveal how the same behavior is interpreted differently depending on who you are.
If you have experienced or witnessed differences in how residents are evaluated, supported, or disciplined — differences that reveal unequal application of standards — we want to hear from you. Not just what happened. But how it happened differently.
And if you are reading this as a colleague, a leader, or someone positioned within this system: this is your opportunity to decide where you stand. The next phase of this work is not about whether disparities exist. We have answered that. It is about what happens in response.
Here is what you can do:
Subscribe. Stay informed as this work develops. Share. Put this in front of people who need to see it. Engage. Bring us into rooms where decisions are being made. Invest. This work is funded by people who understand what’s at stake.