50 Years: Diversity in the Department of Medicine

Thursday, March 14, 2013

[caption id="attachment_10507" align="alignright" width="240"]Tiffany Randolph, MD Tiffany Randolph, MD[/caption]

Tiffany Randolph, MD, is a first-year cardiology fellow in the cardiovascular diseases training program. Dr. Randolph graduated from Harvard Medical School and completed her internal medicine residency at Duke University. She recently shared some thoughts on diversity in medicine:

Q. How does Duke compare to other residency programs you looked at in terms of diversity?

A few things really struck me about this program when I came to visit. I felt welcomed by everyone in the Duke community. One thing that kind of bothered me in medical school was that I felt that when I had my white coat on everyone was friendly toward me and welcoming, but when I walked around the hospital without my white coat on I sometimes felt invisible. Some of the people who were open and welcoming previously, sort of ignored my presence. When I came to Duke I specifically remember feeling that no matter what I was wearing people always spoke to me and were friendly. Another thing that really stood out to me was the diversity that I saw at every level from the attendings, house staff, and medical students to the custodial and nursing staff – that also really attracted me to this program. But I have to say, one of the biggest factors was knowing that if I came here I had faculty members like Camille Frazier-Mills, MD, assistant professor of medicine (Cardiology); Kevin Thomas, MD, assistant professor of medicine (Cardiology); Kimberley Evans, MD, assistant professor of medicine (Nephrology), Gus Grant, MD, PhD, professor of medicine (Cardiology), and Joe Rogers, MD, associate professor of medicine (Cardiology), going to bat for me and helping to make sure that I would be successful at every step along the way.

Q. What helped you decide to stay at Duke for your fellowship?

I’ve known that I wanted to do cardiac electrophysiology since medical school, and one thing that I think is very unique to Duke is our electrophysiology department. I’m not aware of any other place in the country where there are so many African Americans or females in the department. There are typically pretty small numbers in EP.  There are three African Americans and more women in electrophysiology than pretty much anywhere else in the country. Those two things combined with the fact that Duke’s internal medicine, cardiology and EP departments are phenomenal, both clinically and in research, made the decision to stay easy. The diversity in the department was the icing on the cake that made me want to come here even more and made me feel as though I would be welcomed and supported when I got here.

final-01Q. What are some of the resources and support you have had at Duke?

The Minority Recruitment and Retention Committee really serves an important role here in helping residents and faculty members know what resources are available. The MRRC also helps with preparation for applying and obtaining these resources. The evening seminars through the MRRC have been helpful in learning more about grant writing and how to be successful at the next level. One thing I think Duke and programs around the country have been successful in is starting to improve the number of minority medical students, and therefore young faculty members.  However, one thing I think we’re all still struggling with across the country is retaining and promoting those faculty members through the ranks to higher-level professorships. I think that the MRRC is going to play an integral role in highlighting the accomplishments of minority physicians as well as helping to make us successful and ready to be promoted to the next level.

I also can’t underscore the importance of having a mentor, specifically, someone who has been or currently is where you are trying to go. Camille Frazier-Mills has been an excellent resource for me at every level. As a former Duke chief resident, Camille was a great mentor as I navigated through the internal medicine program; now, as a first-year cardiology fellow, she continues to be someone who I look to for guidance on obtaining grant funding, research projects as well as how to improve my clinical training on a day-to-day basis - and sometimes even more importantly than that is how to balance it all with having a family and a young child at home.

Q. What opportunities have you had to get to know Duke colleagues?

The MRRC is also important for social aspects of being a young minority physician. It’s nice to have an organized group to help people come together across areas of medicine that maybe wouldn’t otherwise meet.  For instance, medicine, surgery and pediatric hospital staff don’t necessarily have a lot of interaction other than recognizing each other in the hallways and saying hello. The MRRC provides a venue for us to get together on a more social level and also to integrate with faculty members of different departments, whether it’s dinner at a faculty member’s house or a holiday gathering. Those events can be really fun and an important way to establish a support group and new friendships.

Q. How has diversity played a role in your interactions with patients?

One thing that also drew me to Duke was the fact that there is such a diverse patient population; specifically there are a lot of African Americans and a growing Hispanic population here. There’s nothing like the feeling you get when you walk into an elderly or middle-aged African American patient’s room and they tell you how proud they are of you and how happy they are to have you as their doctor. This is especially true knowing the history of African Americans in Durham, where we previously were only allowed to be treated in what is now Duke Regional Hospital, or speaking to different attendings on our faculty who remember when there were days when there were separate entrances for black and white patients or separate wards. To know that we’ve come so far from that to now when minority physicians are doctors to all patients and patients can receive care from any physician in this hospital is a pretty amazing thing. Sometimes I think we take that for granted and it seems like it was in the remote past, but when a patient says something like that to you, it brings it all back into perspective and makes you realize it wasn’t that long ago when things were different.

Q. How did you end up becoming a doctor?

Part of what inspired me to be a doctor was seeing other doctors who were like me. I had a black pediatrician and my mother had a black gynecologist. My interactions with them really helped me to see that I could be a doctor if I wanted to. There is a special relationship that I’ve now developed with some of my patients whose children are with them in the hospital or in clinic. You can see the children’s eyes light up when they realize that you look like them or when you ask them what they want to be when they grow up. Even if they don’t say that they want to be a doctor, sometimes I’ll ask them, “what about being a doctor?”  As they smile you see that they are really thinking about the fact that they could become doctors if they wanted to.

Q. What are your hopes for diversity in medicine over the next 25 years?

My hope is that in 25 years hospital staff will look exactly like the patient populations they serve. I also hope that is true for clinical researchers and trial participants.

Q. Is there anything else you’d like to add?

I really appreciate the emphasis and dedication that the Department of Medicine and the program directors both past and present have placed on recruiting a diverse class of residents each year. It enriches the program, our experiences as residents and also the patients’ experiences.

This interview is part of a series in Duke University’s year-long commemoration: Celebrating the Past, Charting the Future: Commemorating 50 Years of Black Students at Duke. The Department of Medicine has begun collecting essays and interviews on diversity in medicine, and we encourage you to participate in this conversation. Please contact Anton Zuiker or Elizabeth McCamic for more information.

Here are links to the first and second installments in this series, plus a link to Duke Magazine's coverage.