WORCESTER MEDICINE
JEDI or Die A Young Attending’s Perspective on LGBTQIA+ Representation and Inclusivity in Medicine Interview with Ahmed Salama, MD (right) by Parul Sarwal, MD
please tell us a little about your background and what drew you toward this cause.
I
was privileged to work with minority groups
throughout my career – serving in remote areas of Egypt, I worked to help vulnerable migrants and victims of trafficking from several African countries who ended up being stranded in Egypt. When I came to the United States, I worked with the Black community in Harlem, New York . These experiences taught me to respect each patient’s individuality, appreciating their unique journey and the struggles that they faced. During my residency training, I noticed that pre-exposure prophylaxis, or PrEP, could only be provided through a consult placed to the infection disease team – this is something I believe should be accessible through any primary care provider. I was fortunate to have a wonderful preceptor during this time with whom I worked to develop a strategy for more comprehensive care for our small panel of LGBTQIA+ patients. Another time, during an emergency department rotation, I had a patient whom the staff were not sure how to address – this was very distressing for the patient. Entering the patient’s room, I realized that they were transgender – in fact, they were my first transgender patient. They were tearful and scared, so I approached them and gently inquired how they identified. This eased them up a bit and, as the conversation flowed, we talked about how far they were along in their hormone therapy and if they had any surgeries. Within the next few minutes, the patient became much more comfortable, allowing me to address their present medical concerns. I then passed this information over to the rest of the team. We were able to change the patient’s emergency department experience from one of uncertainty, vulnerability and fear to something much more like a safe zone where they could feel respected and cared for.
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are there any challenges you faced as a physician
during your training years, either back home in egypt or here in the u.s.?
We all face multiple challenges in our lives – that is what makes life interesting and worth living! I think the biggest challenge for any foreign medical graduate is getting an interview for residency. Unfortunately, many programs use automatic filters for interview selection, which may sometimes miss the unique stories of these applicants. I believe a significant challenge that minorities may face is microaggression– subtle, hidden and happen on a daily basis. Microaggressions can be more powerful and hurtful than visible aggression. Unfortunately, you might sometimes face patients and coworkers who question your knowledge and skills, based on your sex, orientation, age or skin color instead of your work or level of training. how can we empower physicians who identify as
lgbtqia+ so that there is better representation and
inclusivity in medicine? how do you think this would help?
Almost 18% of percent of Gen Z identifies as LGBTQIA+. That is nearly one in six people in that demographic. In light of this fact, I believe reinforcing workplace regulations that protect all minorities would be a major step toward establishing a safe work environment for all. Minority groups are not asking to be favored or receive special treatment – they just want to feel equal. Making sure that every staff member is treated with respect and professionalism, making sure they have access to the same opportunities and career progression, regardless of their individual gender, sexuality or color – these steps would go a long way in achieving these goals. It is not enough to just have this written on websites and pamphlets – it must be incorporated into the fabric and culture of any organization. Even today, we sometimes see leadership positions among many organizations lacking representation for most minority groups or have representation just for the sake of it without actual advocacy for the minorities in question. True representation is especially important and is needed to break the yokes that shackle our communities and divide us for artificial, nefarious reasons. do you think self-identification among lgbtqia+ physicians in leadership and faculty roles can help normalize workforce diversity among the newer
trainees? are there existing mentorship programs or support groups dedicated to this?
During residency, one of my favorite attending physicians used to be incredibly open about their life and personal experiences as an LGBTQIA+ physician. Seeing them so comfortable in their skin while being well-established made me feel confident myself – as a member of multiple minority groups, not just one. This is just one example of how representation for minorities in leadership positions can be impactful in medical training.
MAY / JUNE 2021
