Protect the Specialty From Whom?
In 2024, I presented early findings from Black Doc Village’s first research project to a room of residency program directors, the physicians who are the first line of authority deciding which new doctors finish training and which are dismissed. My last slide summarized what the research was telling us.
One bullet read: “Train, not weed.”
A White trauma surgeon, a man proud of his “diversity work” took offense and approached me after my talk.
“If you don’t want to lose the audience, I”d really encourage you to change that ‘train, not weed’ bullet, he said. “We work really hard to match residents and keep them in our programs. It is a lot of work to dismiss someone.”
“OK, but the data don’t bear that out,” I said.
“Well, we have to protect the specialty.”
What I wish I had said: “Protect the specialty from whom?” But I’ve always been slow on the draw, especially when someone says the quiet part out loud.
Here is what the data say. In our national study of 1,755 resident physicians, Black residents were three times more likely to report ever being placed on remediation and a 76% more likely to report any disciplinary action, even after accounting for gender, specialty, and sociodemographic factors. In the companion interview study, residents described remediation as a path to being pushed out and rarely about helping someone be a better doctor. These are people who already earned a medical degree, passed several standardized tests and matched into a residency program. Every one of them weeded out is a doctor some community never gets.
The same reflex guards the front door. Medical schools are being sued and investigated over holistic admissions, which means weighing more than MCAT scores and GPAs when deciding who gets in. Black and Brown applicants do score lower on average. But the question is why. Redlining gutted the property taxes that fund public schools. Generations of wealth were siphoned away, and with it the money for private schools, tutors, and test prep. Refuse to consider any of that, and only one explanation for the gap is left: that some people are born less capable and, therefore, don’t deserve admission.
This week we mark Indigenous Peoples’ Day, which exists because generations of us were taught that Columbus discovered America. You can only “discover” a place if the people already living there don’t count. You can only “protect” a specialty if you’ve already decided whom it belongs to. That is how Whiteness works—it calls itself superior while preventing those it believes beneath it from competing.
Can we please stop the lies?
If Whiteness really is the best—prove it. Provide non-White communities all the resources you’ve been hoarding for yourselves. Pay us the same as you pay yourselves. Release all the data, not just the data supporting your argument. Train the residents you match. Stop claiming a standard, but then only apply it selectively.
The truth: Whiteness doesn’t have a monopoly on excellence. Just power.
Vanessa Grubbs, MD, MPH
Founder & President, Black Doc Village