Trailblazing in ENT: Dr. Ceisha Ukatu’s Journey

Breaking Barriers: Dr. Ceisha Ukatu’s Journey as a Black Female ENT Surgeon

Black ENT surgeons represent only 1% of all ENT specialists in the United States

Dr. Frances Mei Hardin: Welcome to this week’s episode of Promising Young Surgeon, where we delve into the challenging yet rewarding journey of becoming a surgeon. This week, Doctor Ceisha Ukatu joins us to discuss her experience as a successful black female ENT surgeon. Today, we shine a spotlight on a crucial but often overlooked aspect of surgical training, the representation and experiences of minorities, particularly black physicians. According to recent statistics, black ENT surgeons represent only 1% of all ENT specialists in the United States. This stark underrepresentation highlights broader systemic challenges and disparities within the medical community. As we explore the experiences of black ENT surgeons, we gain valuable insights into barriers that they face, unique perspectives that they bring, and the importance of diversity and inclusion in surgical practices. Minorities in surgical training often encounter multifaceted obstacles, ranging from limited access to mentorship and resources to implicit bias and cultural barriers. Black residents either leave or are, terminated from training programs at far higher rates than white residents, according to an unpublished analysis by the ACGME cited in the Stat news article from June 2022 on this topic, black residents account for about 5% of all residents, but accounted for nearly 20% of those who were dismissed from programs in 2015. A 2020 survey of 7000 residents found that nearly 25% experienced discrimination based on race, ethnicity, or religion, with the highest rates for black physicians. The study found that discrimination led to higher rates of burnout and not finishing residency. In today’s episode, we have the privilege of speaking with a trailblazing black female Ent surgeon who shares with us her journey through residency training and beyond. She is one of my favorite doctors of all time. Her story embodies resilience, determination, and a, commitment to excellence in the face of adversity. Join us today as we advocate for a more inclusive and equitable future in surgery.

Doctor Ceisha Ukatu is an otolaryngologist from Texas

Doctor Ceisha Ukatu is an otolaryngologist from Texas. Her second home is in the midwest, where she met her husband. She is an avid tennis player and started a book club. She and her husband have a two year old daughter and family time is cherished above all else. Thank you so much for joining me today, Doctor Ukatu. I do have to share that. Doctor Ukatu is one of my prior chief residents. She is one of my favorite doctors in the world. She self describes as a shy extrovert, and I would describe her as one of the gentlest souls that I’ve ever met in medicine, and I have certainly learned a lot firsthand from her over the years.

Dr. Ceisha Ukatu: Thank you. Frances Rae that’s really kind of you to say those things. I really appreciate it.

Dr. Frances Mei Hardin: Absolutely. No, it’s such a joy to chat with you, and we really appreciate you being on here today.

So I’d love to start at the beginning of your career in medicine

So I’d love to kind of start at the beginning of your career in medicine. Like, what led to your initial interest and then how did you end up deciding on Ent?

Dr. Ceisha Ukatu: So my initial interest, that started as a child, I had a chronic disease. I have sickle cell disease, and I spent a lot of time in the hospital. And even though I was sick a lot, I felt that it wasn’t so bad because of all the people around me, the nurses, the doctors who were so helpful and helped me get through really hard times. And that example is what propelled me to want to be a physician.

Dr. Frances Mei Hardin: Wow, that’s really incredible. I definitely feel like that totally makes sense. You know, hearing this from you, learning this about you, there is this, like, much greater perspective and depth that you have always had as a physician and as a surgeon that I’ve seen. But it makes sense if you come from this experience of having been a patient.

Dr. Ceisha Ukatu: Yeah.

Dr. Frances Mei Hardin: You know, for your, for your life, definitely.

Dr. Ceisha Ukatu: And, I think the other thing it brings, especially, like, being a sickle cell patient, is that typically when us in medicine think of sickle cell patients, we think of kind, of, you know, lower economic status, less educated kind of person. A lot of times we’re labeled as drug seekers. And, that’s just not the case. And I feel like I can be, a good example to people, showing that, you know, that’s not what a sickle cell patient is. there’s lots of us who are out here thriving and living beautiful lives. So it just goes back to, you know, what we hear over and over again. But representation matters. Whether it’s race, ethnicity, disability, illness, all kinds of representation matters.

Dr. Frances Mei Hardin: That’s so true. Thank you for breaking the stigma. And, like, I can imagine if I was a young person or encountering sickle cell disease or anything like that. Like, yeah, it is life changing to then see a woman, like, in her thirties killing it extremely successfully, like, with a healthy family, with, you know, a thriving medical practice, surgical practice. That’s. That’s really incredible. And I guess so you knew that you wanted to be a doctor. You knew that you wanted to stay in medicine. Your own experience sounds like it was very impactful and also positive.

Dr. Frances Mei Hardin: And then what brought you to ent specifically?

Dr. Ceisha Ukatu: So when I started medical school, I didn’t even know what EMT was. I, just randomly we had these small group advisors, and my small group advisor was like, I’m an otorhinolaryngologist. And I was like, what the hell? Like, why can’t I have a pediatrician? All I want to do is be a pediatrician. So I knew I wanted to be a pediatrician. Went through third year of medical school and did peds. Love that. Did that pretty early on. But then I did surgery, and it was one of those things, like, surgery was not even on my radar, but I just knew when I stepped into that operating room, like, this is where I had to be. Like, I loved everything about operating and how it made me feel and, like, the work that we were doing. And from there, I knew I wanted to be a surgeon. And it was just like, what kind of surgeon do I want to be? And, you know, at the time, I was still a little bit interested in pediatrics, so, you know, as. Even as a general ent, we get to see lots of children. So that definitely drew me to it. I love that we take care of, usually, especially out, in general practice, more like quality of life issues. and so I felt like I could have a huge impact on quality, of life.

Dr. Frances Mei Hardin: That’s great. Very true that, you know, ent is one of those surgical subspecialties that gives us the opportunity, the option, to have a big pediatrics component of the practice.

How much of your practice is on the peds side of things

I would definitely love to hear, like, how much of your practice would you say is on the peds side of things?

Dr. Ceisha Ukatu: Well, the funny thing is, is after I started residency, I realized I didn’t really like peas as much as I thought. But even with that, I would say probably about 20%, is, which I’m fine with. Like, I don’t really want more than that. Like.

Dr. Frances Mei Hardin: that’s a lot. Yeah. I would also say I’m probably at 20%, and it’s wonderful. Like, we have a pediatric all done up with, like, giraffes on the walls and stuff, but, like, yeah, we still. We’ve got. We’ve got biters coming through.

Dr. Ceisha Ukatu: Yes. I mean, I love the kiddos, but it’s just easier for me to treat adults.

Dr. Frances Mei Hardin: Perfect. So, you know, then you. You do. Basically, it sounds like you just got called by the or. Like, some people call the call of the voice. French term, the call of the void, but the call of the or. And so you fell in love. You know, it sounds perfect because you already did have kind of, like, an ent mentor and so able.

Dr. Ceisha Ukatu: Yeah.

Dr. Frances Mei Hardin: Like, bring that all together.

Dr. Ceisha Ukatu: That’s true.

You and Cece both completed ent residencies

Dr. Frances Mei Hardin: And then, you know, I’d love to just kind of chat about, like, your formal training experience then, because, of course, you know, we both completed ent residencies. Those are five years after medical school, and then at the end of those five years, then you can practice general ent if you choose to, versus choose a fellowship, which is additional one or two years of training.

Dr. Ceisha Ukatu: Residency was okay. I I mean, it was. It was residency, so its residency is hard. A little background about the program. It is in the midwest. It’s in a kind of a smaller town in the midwest. It is a predominantly white, area. There’s not a ton of diversity. And so I. And, you know, there’s already, like you mentioned before, there’s already not that many black people within the field of ent. So I was the first black ent resident, at that institution. And so, you know, as you can imagine, residency is already isolating, but, just being the only one of someone can even make it more isolating. You know, it was hard, but I feel like I was trained well. I went, and I did what I was supposed to do, which was trained to become an, ear, nose, and throat surgeon. And I feel like I’m very comfortable and have been successful of doing that.

Dr. Frances Mei Hardin: I have the privilege of, like, knowing you from residency and from that aspect of work. And so I definitely do want to speak to a little bit, like, my experience is that, you know, you were fourth year when I came in as an intern, and then, of course, you were a chief during my pgy two year. And so, you know, we spent. We spent some good together. It was a wild ride. But, like, those are formative years for a young resident. They’re, like, often, like, kind of scary years for a young resident. That’s, like, a very steep learning curve, particularly during probably the second year, I would say. But some of my best memories of residency are even, like, at the VA, we did a rotation that was, like, a fifth year, a third year, and a second year. They made up a team over there, and when I was the second year on Cece’s team at the VA, it was like, those were truly some of, like, the best months. Like, it was lit.

Dr. Ceisha Ukatu: yes.

Dr. Frances Mei Hardin: And what I mean by that is just that I want to start with this quote. The quote is, intimidation is the lowest form of management, and I think that’s true. Like, and if you guys have ever heard me at all really, like, speak on any of these issues, I truly believe that that’s the case. And Cece just, like, really embodied kind of the opposite of that, because I’ve never seen her kind of, like, resort to some of this low hanging fruit, like, scaring someone or intimidating someone or using fear to try to, like, teach a point or reprimand or anything like that. That. And so it just. I’m being very serious when I just say, like, when I worked under you, like, and I worked for a team that you were the leader of, like, those were very positive memories. I wasn’t, like, dreading going to work, and I wasn’t terrified at work. And also, one of the reasons why I’ve learned a lot from you is just because I feel like I’ve asked you every version of maybe, like, a clever question, but also very dumb questions, and you’re always like, all right.

Dr. Ceisha Ukatu: Okay.

Dr. Frances Mei Hardin: You know, we’ll talk about it.

Dr. Ceisha Ukatu: Yeah. Yeah. I mean. I mean, those words are really nice to hear. I think that, you know, my main goal is just to be, like, a good person and be, like, the type of person I would want other people to treat me as. Yeah, I just try to be nice. I know that. And kind and, not, you know, be upset if people make mistakes or, you know, things don’t go the way, that we plan. It can be hard, obviously. Like, during residency, things happen. but I think, you know, we will all just do better and be better if we’re just kind people.

Black residents are more likely to be dismissed from residency programs based on professionalism

Dr. Frances Mei Hardin: Do you feel at all, like, because you are a woman, because you’re a black woman, that by having such a kind leadership style, that people ever, like, mistake that for just being a pushover or they mistake it for something else?

Dr. Ceisha Ukatu: Yeah, I think that was an issue pretty early on in my residency. So, during my first year, I did really well, especially on the off service rotations. Like, I felt like I excelled. and then when I became an ent as a second year, because back then, we didn’t have a full year of ent, but when I started, you know, being more involved in the daily runnings of Ent, I wasn’t super confident yet. And I think that’s normal as a second year resident. Like, if you’re too confident, that would be a bad thing. But I wasn’t good at, like, maybe as good as other people. At. As masking that.

Dr. Frances Mei Hardin: Yeah. Pretending to be confident. Yeah.

Dr. Ceisha Ukatu: Yeah, exactly. And so some people do a lot better than others at that, and I was not that person. Like, if I don’t know something, I’m not gonna pretend and put on this show. And so some of the feedback that I got was that, you know, I was soft spoken and I needed to speak up, and, you know, I wasn’t confident and things like that. And so, you know, that was definitely hard because, you know, I kind of felt like a lot of it was, like, attacking my personality. And so. And I think it’s really kind of interesting, too, because there’s this stereotype of, like, the angry black woman, and I’m like, not that, obviously. And it maybe it’s a little bit confusing to some people, but, yeah, it’s just rue m. And it’s not. That’s not me.

Dr. Frances Mei Hardin: Yeah, I think that that’s a great point. And what it makes me think of when you talk about, like, those are just kind of complaints about your personality, which, like, obviously, many more of us love your personality. It is a very unique personality, and there isn’t, like, one right way to be a female surgeon. You know, everyone has their own preferences, because I think that maybe, like, the overly confident or aggressive or intimidating female surgeon, that’s not my favorite, you know, but what it really intersects with that a lot of people increasingly over these past few years have pointed out, like, in literature and conferences, is this nebulous, quote, unquote professionalism, end quote, piece of, like, the curriculum, and that’s a piece of graduate medical education. It’s not very well defined. It’s extremely easy to weaponize it against people because, like, somebody might say, well, this woman is pretty soft spoken. So I don’t find that, like, professionally very appealing to me. Whereas, like, on the other end of the spectrum, I am. Perhaps I am more direct. And then people will be like, this woman doesn’t have enough tact, like, some, but not the amount that I want. And so professionalism, especially against minorities in residency, that’s where a lot of this discussion comes, is like, how do we make that uniform for all? Because from a professionalism standpoint, it can be easy for, like, the old guard of medicine M or hospital administration to say, well, this specific black hairstyle is just not professional. I won’t have it.

Dr. Ceisha Ukatu: Yeah, definitely. So I think that is kind of, like, the key where some of this stuff becomes really difficult is because, you know, the stats that you mentioned that black residents are more likely to be dismissed from a residency program. The problem is that a lot of the time, reasons that they’re being dismissed are subjective. And professionalism is one of those AcGMe core competencies. And so if you’re lacking in any of those core competencies, then you can be reprimanded, you can be, placed on probation, you can be dismissed from a program. And so there’s six of these competencies. And professionalism is probably the most subjective of all of them, but some of the other ones have some subjective components as well. And so the issue I see is that we need a more standardized approach to, like, when talking or what, to bring disciplinary action on residents. we need more objective criteria. And so the ACGMe currently does not have any guidelines on, how this process should work. If you read their guidelines, they say it’s up to each institution. And so each institution is getting to decide, you know, what’s acceptable, what’s not acceptable. Let’s say you don’t get along with some of the administrators at one of the institutions. They can decide, you know, I don’t like this person, and they can use some of these subjective criteria to get rid of you. And I’m not saying that there’s not bad physicians. There’s not people that should not be completing residency. There definitely is that. But we should be able to find a way to get those bad apples out using objective criteria and not get people that could end up being good physicians and good surgeons out. And the thing that also. I know I’m talking a lot, but the thing that I also want to mention is that the more that we lose, you know, minority physicians, female physicians, that creates less diversity in our workplace. And really, what this comes down to is our patients. There’s been lots of studies that show that minority patients do better and they have better outcomes when they have a physician who looks like them. There’s been studies that show that female surgeons have better outcomes. And so if we’re losing black physicians, minority physicians, and female physicians to these random, vague, subjective criteria, we’re losing our workforce, and we’re preventing diversity in our workforce, and it’s hurting our patients.

Dr. Frances Mei Hardin: Totally agree. And, like, I truly agree that that’s the case now. And over the next 20 years, the patient population is only continuing to diversify, and so medicine also needs to diversify with it, you know, so not only are we, like, a little. A lot behind the eight ball now, but think about kind of, as we move forward, how this is only going to be more and more true.

Dr. Ceisha Ukatu: Exactly. And, you know, a lot of our efforts are focused on, like, getting people into med school and getting people into residency. But what happens after you get into residency? What happens as an attending? Mike? There’s also been lots of studies and research that says that even black attendings have issues, like, with coming up for peer review and not being able to make the same kind of mistakes as some of their counterparts. And so, all of these things are good things to talk about and think about in terms of how can we make this better for, you know, future trainees, future attendees, and our patients.

Dr. Frances Mei Hardin: I agree. Like, those are just such reasonable places to start. And, you know, it’s important that people, like, role models in the community, like yourself, you know, kind of just put names to some of the phenomenon that have been happening. Like, none of this is new. It is new that people talk about it in any way or look it in the eye.

One question I have about support for black medical trainees is residency

One question I have, and this is just, you know, it’s interesting to think about, because you mentioned how there can be, like, hopefully in many parts of the country, there’s support for people to, like, get into medical school, to kind of make it through. You know, then the med school will support you through your education there. But then sometimes in residency, like, you know, sometimes we don’t control where we match, and we end up transplanted somewhere where we don’t have an existing support system. And that can make it really difficult, especially difficult, if any problems arise. But I wonder what could be done in terms of, like, better regional and national support for trainees who. Yeah, maybe, like, marooned somewhere. And what if they are, like, the first black resident in their program or, like, one of the very few at their institution? What do you think would be good next steps in terms of like.

Dr. Ceisha Ukatu: Well, there are. So it’s kind of like how people probably find, you know, your website and things. They’re like, I’m having a hard time in residency. Let me google something. And so there are kind of some resources out there for black trainees. There is the black otolaryngologist network, who are very active, and they give, you know, advice on medical school interviews, attending interviews. if you’re having difficulty within a program, they can help support you through that. There are a number of organizations that specifically are geared towards helping black physicians who feel they are unfairly being, remediated or dismissed from a program. and I can, you know, compile some of those resources.

Dr. Frances Mei Hardin: We can link that. Like, what is that one called? Well, we’ll link it at the bottom.

Dr. Ceisha Ukatu: I don’t know all the names by heart, but I can definitely. There’s a few, but I can definitely share, those with you. We do have a black women in otolaryngology group as well. So all of these are out there. But, yeah, ah, I’ll definitely send you some of those links later.

Dr. Frances Mei Hardin: Yeah, I mean, I do think that the Internet has helped a lot. I mean, I just can’t even imagine, you know, like, 1520 years ago, before some of these widespread networks. It’s like, okay, you might be really ruined. Like, 300 miles from the nearest person who could give you expert advice on what you’re experiencing or things like that.

Dr. Ceisha Ukatu: And the other thing I will say is, like, you don’t have to get someone who looks like you. Like an advocate can be anyone. Like, one of my biggest advocates was the chief the year ahead of me, and so she was always there to give advice to, you know, help me when I was having difficult times, when I was getting negative feedback about, you know, my personality and things like that. She was great. I had maybe one or two attendees that definitely really advocated for me during residency, and, you know, none of them were black. There are people that may be consciously or unconsciously, like, causing problems for black residents, but they’re on the other end of the spectrum. There are a lot of people who see that there’s been problems and want to make sure that doesn’t continue to happen, that want to give people opportunities to thrive and be successful. So it’s not just all bleak. Like, the opportunities we have are so much greater than they’ve ever been. You know, people are realizing what has happened, and it’s really changing our landscape right now.

Dr. Frances Mei Hardin: Totally. And, of course, I do agree with you. It’s not all bleak.

Dr. Ceisha Ukatu: Yes, you do agree with me. That’s. I was just kidding.

Dr. Frances Mei Hardin: No, I do. I. And I’m just kind of a bleak person, so you gotta ignore me if I’m being bleak. But, But again, like, this goes back to, like, I really admire you. I think you’re a better woman than I am because you do. Even in the face of adversity, in. Even in the face of, like, some of. Even these systemic issues that we’re talking about, you show up to work with an incredible attitude, you know, like, a positive disposition, and, you know, and you just really never put that on other people, never take things out on other people. And I just really love that. And I kind of, you know, I wish that there were more people like you out there, because then I’d be a little less bleak, I guess. Yeah, I do think. Yeah. But I think in the next generation, too, like, yeah, it’s. It’s increasingly moving towards maybe, like, not taking stuff out on people at work and also just.

Dr. Ceisha Ukatu: Yeah.

Dr. Frances Mei Hardin: Being able to see the positive, just be effective about problems, because, like, you’re saying there absolutely are people out there who want to mentor, support things like that, and it’s just about finding them and totally agree. Like, similarly, my mentors didn’t look like me, but interestingly, I do think that oftentimes women do understand some of the issues, that female doctors face a little bit better. But not to say that I don’t have incredible, you know, male mentors as well.

Early in my third year of residency, I received a letter of counseling

Do you have any pivotal moments that you can think of during your training that did significantly shape your career as a surgeon?

Dr. Ceisha Ukatu: So, yeah, I kind of, ah, alluded to, some of the issues that I had in residency, but the most significant and why I’m so passionate about this is because early in my third year of, residency, I received, what they termed a letter of counseling. And it was a formal letter, and it noted all of these deficiencies that were very vague and subjective, like we were discussing before. It said that I needed to take more initiatives. I needed to work, on handling my fatigue. I needed to be better at multitasking. But there was no concrete examples of when I had made a mistake. There was no anecdotes of me doing something wrong. There was no comment on my medical knowledge. There was no comment on my surgical skills. And this goes back to me feeling like it was an attack of my personality. The other thing is, if I had been struggling so bad that I needed a formal letter, then why hadn’t this ever brought. Been brought up before? So we’re now, you know, I’ve been first year through second year, and we’re now, you know, partway through third year, and I, out of the blue, I’m shocked. Like, I didn’t know we had an issue. So if there was an issue, then there could have been meetings before that, like, saying, this is what we see. And I did say, they did say that I was soft spoken, but no one ever said, like, we’re worried about you because you’re soft spoken. Like, we’re worried that you’re not going to be a good surgeon. And so that was very hard, and it was the hardest thing that I went through residency, because when that happens, you feel an, enormous sense of shame, feel like you’re not good enough. Even for me, it was even worse because, like, I felt like they just didn’t like who I was, you know, like, okay, you just don’t like me, and now you’re trying to get me out of the program, which I don’t know if that was really the goal, but I did have some attending say, like, maybe you should look into a different specialty based on, like, these subjective things. And so that was just really hurtful. I became depressed. I went on an antidepressant for the first time in my life. Yeah, I was just probably at one of the lowest points that I had been throughout residency and throughout my life. And, you know, I haven’t had that hard of heard that, like, easy of a life. So to say that is really not that I’ve had a hard life, but I’m just saying, like, I’ve been through really hard things, and that was really up there in terms of, like, how it impacted my mental health and, things like that.

Dr. Frances Mei Hardin: I’m so sorry. I just honestly, you know, I listen to you, and I have to, like, try to not cry, and also I sweat through my clothes because, you know, like, I can. I can imagine, you know, and many of us in, medicine can, like, relate to at least even feeling, like, maybe blindsided by something like that or feedback or anything to have gone through what you’ve gone through. And then again, like, in my experience, for the listeners and everything, when I was a first and second year and you were a fourth and fifth year, I never knew that no one would ever know that people were like, this is a very chill, competent chief. You know, you were very well liked. So it is. and that’s a good thing, I think, because that’s a testament to you. And it also help show that even when there is, like, that personal pain and journey that accompanies something like that, outwardly, you were living your life in a way and then practicing ent in a way that garnered a lot of respect. And so it’s kind of nice to think that the truth wins out in the end and you just keep doing what you’re doing.

Black surgical residents make 5% of trainees but 20% of dismissals

Dr. Ceisha Ukatu: Ah.

Dr. Frances Mei Hardin: Do you feel like you did anything differently, or did you just kind of, like, keep, you know, keep doing a good job, keep showing up?

Dr. Ceisha Ukatu: So I think what I did differently is I tried really hard to change the perception. And so, like, I. Which maybe, you know, you could argue that maybe it made me a strong insurgent in the end, but I tried really hard to, like, find a stronger voice to build that confidence. I think once I did that, people were like, okay, we’re good. You know? And I’m not saying, like, it was right. I think maybe in a different program, it would have been handled differently. And I think the culture of a program can really change how something like that is, managed. Like, some programs I wasn’t attending at a recent program where I feel like, that may have been a positive thing, having a personality like that. They would have valued that. And at my program, it wasn’t really valued. And so, that goes back to what we were talking about.

Dr. Frances Mei Hardin: It’s all so subjective and location dependent, like you’re saying. I agree with that.

Dr. Ceisha Ukatu: Ah, it’s regional institutions, different institutions. Yeah. And so it was hard. but, yeah, that’s what I did to kind of, like, change that perception. And, you know, I think I had to meet with my program director once a month for about six months. And then after that, you know, everything was fine. And, you know, I feel like I’m, degree in residency, and. And that’s another thing. Like, you can overcome these things. I feel like my story is, like, very benign to what some people have experienced. because from what I remember, there was five black surgical residencies that, like, I remember at the total residency program at where we went to residency. And so I know that I received formal letter. I know that two of them were dismissed. I know that one of them was held back a year, and I know that one that graduated had been dismissed from another program. So out of, like, all the black surgical residents that were at, that program while I was a resident, all of them had issues. And obviously, the sample size is only five, but I mean, like, how can every single one of them have issues? Like, maybe they did, maybe they didn’t. I don’t know. But it’s just fishy.

Dr. Frances Mei Hardin: Yeah. I mean, issues to the point of, like, formal disciplinary.

Dr. Ceisha Ukatu: Because, well, exactly. Exactly. Everyone has issues in residency or, like, mistakes, whatever. But to have formal disciplinary action or a, remediation year or being completely dismissed from a residency program. And I know one of these people was dismissed as an intern. And, like, I don’t know what kind of mistake you can make as an intern where you have to go find another, residency program. And so I know that he’s, like, a successful er physician, and there is, like, life after something like this. But from, you know, the statistics you shared, black people make 5% of, trainees, but 20% of dismissals. Like, from my experience, that I have. No, I’m not shocked about that statistic. Like, it makes completely. A lot of sense.

Dr. Frances Mei Hardin: Yeah. And, I mean, it’s. It’s upsetting to kind of even, like, think too much about and certainly to talk about. I agree with you. I think that part of, like, what we talk about here is just that I obviously, I think all residents have issues. I’ve never met, like, an extremely well adjusted resident. Like, no offense to residents, I’ve never met someone and I was like, man, you are, like, 100% killing it. Like, typically, even if there’s somebody who is truly, like, handling the job very well and that they seem even in, like, pretty good spirits about it, like, they seem to have some good perspective. Those people are still drinking themselves to sleep every night at home. So, like, I have never. I’ve never truly. Or they’re, you know, I mean, they’re doing something else pretty insane, ah, to cope, you know, like, very, ah, difficult experience. So, yes, kind of this line between who receives formal disciplinary notice or action or anything like that and who doesn’t. It’s just kind of, It’s obviously, it’s not been fair. The more that we can, like, look at this. I mean, I think that if people also feel, like, eyes are on this issue, or maybe if institutions are like, man, you know, like, some of our numbers are crazy, like, I’d hate to be in for this. Like, yeah, you would hate to be on CNN for this. Like, you know, like, quit doing it.

Dr. Ceisha Ukatu: Yeah.

Dr. Frances Mei Hardin: So I think that that’s all wonderful.

Stephanie Simmons was the first black ent resident to graduate from Stanford

I mean, I do want to share the story real quick of, like, your final grand rounds, which I still totally remember. Like, I remember it like it was yesterday. I thought it was really beautiful because, you know, you gave. You gave a good grand rounds. I’m sure it was on, like, the inner ear or something, not the content part, but then the end and the clothes, you were just like, this is my last grand rounds. Thank you, guys. Like, what a ride. You know, I’m paraphrasing because obviously, like, you know, between the lines, you were like, yeah, what a ride. Like, all right, well, I’m almost. I’m almost gone. And thank you guys for, you know, the love. But you put up this slide of a unicorn, and you said, look, 1% of ENTs are black, and to be a black female ent is like a true unicorn. And it was just very powerful, and it was very impactful.

Dr. Ceisha Ukatu: Yes, I think, when the data that I used was from 2016, and I was able to get a rough estimate of the number of black female ENTs, and in 2016, from my rough estimate, Ent residents, there were eleven black female ent residents in the entire country, and that’s obviously a really small number. And so I just wanted people to realize, like, yes, it had been a wild ride, and it had. It also, like, means so much to me to be a part of that small cohort of people. it meant so much to me to be the first black resident to graduate from that ent residency program. I feel like, you know, hopefully there’s only many more to come. It was a hard ride, but it got there in the end for sure.

Dr. Frances Mei Hardin: Oh, my gosh. One day. I mean, I gotta tell you, I have, like, a graduation speech that I wrote. Unpublished, really. Not given. Yeah, no, it’s great. We’ll have to. It’ll be, like, in the archives, or it’ll be, like, published posthumously for me, playing no, that’s all. And, you know, of course, like, I’m still thinking about what you said with the five. The stories of, like, the five black surgery residents at our program from when we were there. And I do think, like, of course, the fact that that one guy who was dismissed somewhere else, he came to the program and then, you know, probably, like, then graduated, like, that kind of helps validate that there wasn’t something dangerous or, you know, untenable as a physician.

Dr. Ceisha Ukatu: And I, think all of these people are practicing physicians and thriving. So I will say, I know that’s not always the case that, you know, you get a new residency program or whatever, but a lot of times it can be the case. Especially, you know, if you advocate for yourself, if you find other people to advocate for you. The only other thing is, like, even if you do end up being successful, something like that takes a huge toll on you. It really messes with your mental health. So I don’t want people to take lightly giving people formal reprimands or remediation or dismissal, and it follows you the rest of your career. And so there’s a lot of shame with that. There’s a lot of stress and anxiety about, is this going to make an impact on where I match for fellowship, where I can get an attending job? And so it’s not. It’s more than just, like, what happens in the end. Yes, we’re all successful physicians, but what did you have to go through or give up to get to that place? You know, that’s something to think about and consider as well.

Dr. Frances Mei Hardin: I love that. That’s a great point, and I appreciate you making it, because that is, like, one of the major takeaway points. I totally agree. It reminds me of Doctor Stephanie Simmons, the chief medical officer of the Doctor Lorna Breen Heroes foundation, came on the podcast, and I loved her message directly to, you know, like, trainees. And the message was, we don’t want to lose you, and we don’t want to lose part of you. And, you know, you and I both survived, like, technically alive, you know, extreme. I mean, yeah, like a shell of a person. But, like, in all seriousness, I just thought it was really. I loved how she also shouted out, like, well, what about the cost? What about the things that we give up because of things we experienced during training? I, wouldn’t have necessarily, like, agreed to give those up. Sometimes you just. But then you blink, and then, like, you’re at the end of training, and you gave up more than you would have ever consciously agreed to.

Dr. Ceisha Ukatu: Yeah. Yeah, I heard that. I love that when she said that.

Dr. Frances Mei Hardin: I really, really appreciate you. Obviously, I could talk to you about this for a hundred hours. and I really, really appreciate your time. I mean, like I said, if you ever want to come back. And we hit other important topics, which include, like, work life balance.

Dr. Ceisha Ukatu: Yeah.

Dr. Frances Mei Hardin: Avery, your cat, who is, like, kind of an Internet sensation, you know. Yeah. Very beloved. Talk about ways that you are able to prioritize quality, family time, things like that. Like, we would always love to chat with you and learn from you.

Dr. Ceisha Ukatu: Thank you so much. This was really fun. Thank you.

Dr. Frances Mei Hardin: Yeah. Wish you the best. I mean, you’re just a good role model because, like, people, I mean, I know my family is going to have something to say to me. They’re going to be like, look at what? Like, handling it with Grace looks like. And they’re gonna be like. They’ll be like, do you feel like you want to handle it with Grace? And I’ll be like, negative. Yeah, I’m just kidding. I’m getting there. And so I definitely appreciate every role model, people like you who are out there, like, I and all women, you know, in the next generation for us, like, hopefully we just, like, are picking it up and. And learning as well.

Dr. Ceisha Ukatu: Definitely.

Dr. Frances Mei Hardin: Doctor Ukatu is a Promising Young Surgeon

Dr. Frances Mei Hardin: Well, thank you so much for joining me today, Doctor Ukatu. It is such a sincere joy to chat with you, and thank you again for all the personal mentorship that you’ve provided me over the years as well. Follow me on Instagram at Francesmay, MD and ethinkingresidency. Visit my website, rethinkingresidency.com, to learn more about resident physician stories and ways that residents can most effectively navigate the game of residency. I cannot wait to connect with you on the next episode of Promising Young Surgeon.