• EnergEYES Awardee Mildred M.G. Olivier, MD, on Diversity, Inclusion in Ophthalmology

    As assistant dean for diversity and professor of ophthalmology at Rosalind Franklin University, Mildred M.G. Olivier, MD, has dedicated her career as a physician and mentor to championing inclusion in medicine. In particular, Dr. Olivier has played a key role in establishing and sustaining the Academy’s Minority Ophthalmology Mentoring program.

    These efforts have earned her the Academy’s EnergEYES Award honoring an ophthalmologist who demonstrates the best in energizing young ophthalmologists, serving as a strong role model and motivating others to get involved.

    During AAO 2020 Virtual, Dr. Olivier spoke with YO Info about what diversity means to ophthalmology and how mentoring can help overcome racial achievement gaps in medicine.

    Why should diversity matter to ophthalmology?

    Dr. Olivier: Underrepresented minorities make up 30% of the U.S. population yet only 9% of physicians. Like other specialties, this underrepresentation in ophthalmology takes root early on in a student’s life. We know that the number of minority candidates who match in ophthalmology residency programs has been historically poor. And we know that’s the effect of something more systemic. I have a colleague who goes to his local schools to talk about ophthalmology, and he asks, “How many of you want to become a doctor and make a lot of money?” Invariably, almost none of the minority students ever raise their hand. They can’t even envision being a physician. 

    This lack of diversity ultimately impacts communities in need. When people of color graduate from medical training, they most frequently return to their own communities to practice. But if a young person of color is never exposed to the possibilities of becoming a glaucoma specialist, for example, we are shortchanging not only that individual, but also those communities that already have limited access to the specialized care they might need.

    Have you experienced a lot of obstacles in your efforts for a more inclusive ophthalmology?

    Dr. Olivier: Simply put, yes. I know that these are difficult conversations to have. Many people feel that we are lowering academic standards, for example, when we advocate for more inclusive training programs. But we must ask difficult questions. 

    For example, there are a number of standardized tests that candidates must jump through in order to become a physician, but are these tests unfairly separating out people of color? Why are we using these standardized tests in the first place? We practice evidence-based medicine but there isn’t substantial evidence that great STEP scores, for example, are predictive of great physicians. And so, a more holistic approach is necessary. Can we find standardized assessments for other important qualities of being a physician? Can we better value clinical reasoning, patient care, leadership and professionalism?

    Realizing a truly inclusive ophthalmology is going to take time though. We have to go to grade schools. We have to get young African Americans, Latinx and Native Americans interested in STEM. We have to show them why medicine is cool and help them dream bigger than they’ve ever allowed themselves. And by “dream big” I mean DREAM BIG — refusing to be placed in a box. 

    And this applies all the way to the top of the educational spectrum. If you’re a young black person in medical school, for example, your institution might funnel you into family medicine or internal medicine — because historically that has been the “place” for physicians of color. But you — and your future patients — shouldn’t have to settle for that. It seems obvious, but patients deserve to have the choice of the specialist they want to see. A black person, for example, should have the choice of seeing a black ENT or a black neurosurgeon if that’s their preference.

    Are you seeing progress? 

    Dr. Olivier: Yes, but it’s going to take time. Mentoring is, of course, a powerful tool for impacting young people, but we also need to change the minds of majority people in general. 

    I really do believe the realities of social injustice that we are witnessing this year will play a role. For example, people who have been friends of mine for years are now asking me for the first time, “What has it been like to be black in America?” We can use these moments to share our stories and realities, to teach people about the other side. 

    So, I can take it upon myself to bring a white student or a white colleague to an underserved community and help open their eyes. They can talk to the patients and start to see firsthand the particular issues and problems that many people of color face in terms of medical access and care. That’s just one way that we can train people to be more culturally competent.

    What’s the best approach for students interested in finding a mentor? 

    Dr. Olivier: First off, finding a mentor is important for all people of all ages. But for young students and young ophthalmologists, you’ll need a lot of different mentors — black, white, brown, male, female — to curate a diversity of opinions and help you through the different stages of your professional life. 

    So, don’t limit yourself to just one. One of the most significant influences in my life, Dr. Eve Higginbotham, a black female ophthalmologist, molded me into a glaucoma specialist. But I’ve also needed the advice of a whole crew of men and women to help me consider how to enter academic medicine, how to establish a work-life balance and how to approach retirement.

    Another key piece of advice for both the mentor and the mentored is to stay proactive. As a student, I wanted to find the people who would best help my career. I shadowed people. I made as many connections as I could find. But many young people don’t even know that they need a mentor. So now as established professionals, we might need to take the first and tap young people to ask, “Hey, what are you interested in? Oh, ophthalmology? Okay, I can do that. Or general practice? I have a friend who is in family medicine. Let me call her and see if she can help.” 

    This is especially poignant for the year 2020, but now is not the time to be silent. A mentor can open your eyes to unforeseen opportunities and can see something in you that you can’t necessarily envision, especially if you’re underrepresented. So as a young ophthalmologist, speak up for your career. The more people you engage with for a job or a fellowship or a residency, the more people will start championing your cause because they know you are committed.

    I challenge each of us to reach back and mentor someone today!