Racism is pervasive in medicine and has existed for centuries without being entirely eliminated. In 1784, Thomas Jefferson wrote false and incredibly racist physiological theories in his Notes on the State of Virginia.⁵ In 1910, Abraham Flexner, an educator without any background in medicine, examined the state of medical education and produced a report that revolutionized the future of physician training. To this day, you can read that Mr. Flexner was “brilliant” and “creative.” However, what is not highlighted is that Mr. Flexner espoused multiple racist views about the inferiority of black physicians in his report. He wrote that Black medical schools are “wasting small sums annually and sending out undisciplined men, whose lack of real training is covered up by the imposing MD degree.”⁶ As a repercussion of that report, just two out of seven Black medical schools remained by 1920, Meharry and Howard. Those two schools were responsible for educating nearly all Black American physicians through the 1960s.

At this point, the civil rights movement stepped in, and the Association of American Medical Colleges (AAMC) outlined its plan to increase the number of Black physicians. These affirmative actions created more Black representation and thereby increased “diversity” to a paltry 5.4 percent of physicians being Black (as of 2018). However, few genuine efforts to effect change occurred on “inclusion” and “belonging” beyond empty discussions and unanswered calls to action.^7,8

There were others before Dr. Ray who experienced racism inside the house of medicine. In the 1990s, Dr. Damon Tweedy recounted in his book, “A Black Man in a White Coat,” several racist experiences he had during medical training.⁹ He shared an early experience at Duke Medical School when his professor mistook him for a maintenance technician there to fix a dim light in the back of the class. The professor frowned and asked Dr. Tweedy that if he did not come to fix the light, why was he there? Tweedy replied, “I’m a student … in your class.” The professor unapologetically turned around and resumed teaching. Afterward, Dr. Tweedy consciously decided not to pursue the teacher, human resources, or any other means of calling attention to the incident to avoid repercussions.

Surely, these events have been eliminated now in the 21st century? Nope. A study published in 2020 demonstrated that in a cohort of more than 27,500 graduating medical students, 23 percent of Black students reported at least one episode of racial discrimination.¹⁰ Dr. Ray and Dr. Tweedy’s experiences are far from unique if nearly one in four Black medical graduates have reported the same thing.