From Medical Students to Highest-Ranking Administrators

Every August, scores of first-year students spill out onto the

plaza of Rutgers New Jersey Medical School to take part in the institution’s annual White Coat Ceremony, a rite of passage welcoming new medical students to the healthcare field. There, trainees from different walks of life —African Americans, Caucasians, Latinos, Asians, and the many other dimensions of diversity— gather, knitted together by their aspirations to become physicians. Surveying the panoply of smiling, multi-complexioned faces, New Jersey Medical School Dean Robert L. Johnson, MD,’72, and Vice Dean Maria Soto-Greene, MD,’80, smile back, reveling in the scene that decades ago would have looked very different.

In some ways it is a scene that speaks to NJMS’s standing as a school at the forefront of diversity and inclusion in medical education. It also hints at the story of the pair’s own journey from medical students who learned to practice at NJMS to their ascension as the academy’s two highest-ranking administrators, the first underrepresented minorities in the institution’s history to hold these prestigious positions.

With their combined 92 years of service at NJMS, Johnson and Soto-Greene can remember a time when such gatherings at the school would have been predominantly male with very few underrepresented minorities to speak of.

In fact, Johnson spent much of his educational experiences throughout the 1960s as an “only.” He was the only African-American in most of his classes at White Plains High School, a detail noted during a recent ceremony where he was inducted into the school’s Hall of Fame. He was the only African-American in his undergraduate class at Alfred University. And, long before becoming the first African- American dean at NJMS, he was the only African-American among his peers in the NJMS Class of 1972, and for a time, the only one in the entire school, Johnson adds.

“When I first came here, I was the only minority in the school. I think the next year, the number of minority students doubled,” with the addition of one more underrepresented minority student, the professor of pediatrics and psychiatry says with a laugh. He points to

his own graduation as an example of how far the school has come in terms of diversity and inclusion.

“My wife, Maxine, talks about this. When she went to the graduation, she and I and my parents were the only black people in the whole place,” Johnson says.

Underrepresented minorities made up 23 percent of the medical school’s enrollment in the 2017– 2018 school year. What’s more, NJMS ranks in the 80th percentile for underrepresented minority graduates and 85th percentile for minority faculty, according to the 2014 Association of American Medical Colleges’ Missions Management Tool.

“She is so amazed at how much has changed,” Johnson says of his wife. “And it really does make me feel gratified that this is something that I had some part in achieving.”

Johnson and Soto-Greene assumed the roles of dean and vice dean, respectively, in 2005. Since then, they have worked tirelessly to not only ensure that each student receives a top-notch education, but to foster a nurturing environment where students, residents, and faculty— regardless of race, ethnicity, gender, or sexual orientation— can thrive.

NJMS’s commitment to diversity and inclusion can be traced back some 50 years ago to 1968 with the signing of the Newark Agreements, a document created in response to a plan to relocate the school from Jersey City to Newark’s Central Ward. It provided for, among other things, public-sector healthcare services and employment opportunities for city residents and emphasized the recruitment of minority students.

That same year Johnson, a first-year medical student at NJMS, joined other trainees to help establish a program that would do some good in the city of Newark. Their collective efforts resulted in the founding of the Student Family Health Care Center (SFHCC).

“At the time, we knew we were going to Newark the next year and so we…opened the clinic in the basement of the old Newark City Hospital, which became Martland, and eventually University

Hospital,” Johnson says. Renowned as the oldest free student clinic in the nation offering medical care to the underserved, the SFHCC remains an enduring symbol of the school’s dedication to the residents of Newark and its commitment to fighting health disparities.

This devotion to the community is attributable to the school’s very location, Johnson says. “We certainly could not be in the Central Ward of Newark and just ignore the importance of responding to the needs of underrepresented minorities.”

Now medical schools throughout the nation are working hard to implement diversity and inclusion initiatives to respond to standards established by the Liaison Committee on Medical Education. But, Johnson states, this is an area where NJMS has an advantage. “We have so much depth already,” Johnson says of the school’s programs geared toward the recruitment, development, and retention of underrepresented minority students and faculty. From the school’s robust health equity and social justice curriculum to its efforts to promote cultural humility, NJMS is a place where students, residents, and faculty are given the tools to care for diverse communities of people. “I guess we’ve been doing it so long, and we find that it is so critical to the education of our students, that it’s like breathing.”

After becoming interim dean of NJMS in 2005 (a role that became permanent in 2011), Johnson tapped Soto- Greene as his vice dean. Not only was she someone who he knew well, Johnson says, “She was the best person for the job.”

By the time she matriculated at NJMS in 1976, the number of minority students had grown at the institution and so did the number of underrepresented minority faculty members.

“Once I got here, it was a no-brainer. You did see others like you,” Soto-Greene says, adding, “In our class there happened to be five Puerto Ricans and we formed a close bond.” Additionally, she says, “There was a cadre of minority role models who were in senior level positions who instilled a level of confidence that ‘I could do whatever I set out to do.’”

Soto-Greene strives to do for the NJMS student body what those role models did for her and her classmates. “What they did was instilled in us a level of social responsibility,” not just to the surrounding community but to each other, she says. “Whether by serving as a notetaker or arranging peer tutorials, we were taught the importance of uplifting each other to ensure our combined success.”

But even as the makeup of NJMS classes became more diverse with the increased enrollment of underrepresented minority students, attitudes about what your typical medical student looks like did not shift immediately. Recounting an incident at a conference that she attended with three others in Chicago during her senior year at NJMS, Soto-Greene says, “We were two women and two men. Of the four of us, two were minorities.” But when they registered, she and the other woman were sent to separate locations. “We quickly realized they were triaging us as spouses rather than as medical students.” This was just one of the many challenges Soto-Greene faced, both as a woman and as a minority. However, with the help of others, she felt well-equipped to overcome those challenges, she says.

As a resident at NJMS, where she met her now-husband of 33 years, Bruce Greene, MD, she became the first Latina chief resident at University Hospital. It wasn’t a role she sought, she says. Nonetheless, it was a decision

that propelled her onto a leadership track that eventually led to her joining the NJMS faculty. “I didn’t plan to be a faculty member, but I was invited to the academy and since I was very comfortable here, it became natural to join.”

A former associate dean for Special Programs at NJMS, the mother of three is a champion of health equity and social justice and has proven herself adept at building successful pipelines to medicine, dentistry,

and other health-related professions. She is the co-principal investigator of the Health Careers Opportunity Program, which implements pipeline education programs—from sixth grade on through to medical school—that are centered on increasing the number of minority and disadvantaged students entering health professions, including medicine. She is also the principal investigator of one of the nation’s longest-running Hispanic Centers of Excellence. Initially funded in 1991, the HCOE aims to increase the number of Latino physicians and faculty members at the local, regional, and national levels.

“We work really hard at having diversity represented along every stage of the continuum,” Soto-Greene says, noting that if trainees see people who look like themselves at every aspirational level—including her and Johnson—perhaps they too can see themselves in those roles. “This is an institution that is committed to inclusion and, thus, having everyone reach their full potential. And so, having the two of us (in charge), I think, embodies that ‘if we can do it, why can’t others?’” ●