In the early 1800s, James McCune Smith wasn't allowed to attend medical school in the US, so he went to Scotland. When he returned with a degree, he became the first professionally trained African American physician in the nation. 

Although times have changed greatly since then, African American medical professionals still face unique barriers in their pursuit of education and career opportunities.

We sat down with 4 African American physicians to learn about obstacles they've faced, how things have changed for doctors of color, and where there's still room for improvement.

Dr. Adam Milam, chief anesthesiology resident: I was encouraged to take a leave of absence during college because I had to work and was discouraged from applying to medical school. Thankfully, I had a great mentor and supportive family. Even after navigating this process and becoming a physician, there are additional obstacles. I'm often not seen as a physician although I have both a doctorate and medical degree.

Dr. Keith Black, chair of neurosurgery: As a physician of color, you face both conscious and unconscious bias. It's more obvious in training situations, more than when you're in practice. I recall scenarios as a medical student where I really sensed it. When I decided I wanted to be a neurosurgeon, I met with the chair of neurosurgery at my school for advice. The feedback from him was, "Why are you asking about this? You have to be smart to be a neurosurgeon." The only thing he knew about me was the color of my skin—he didn't know my academic background. 

Dr. Milton Little, orthopaedic trauma surgeon: Less than 3% of orthopaedists in the US are black. It's very rare to even meet another African American orthopaedist. In some situations, you might be the only person of color in the residency program or on staff at the hospital. I was lucky enough to go to Stanford, where I was exposed to successful people of color from a lot of backgrounds and they set an example for me of what could be accomplished. I was also lucky enough to train at institutions with numerous African American faculty and residents.

Depsite these factors, I can't count how many times I walked into a patient's room and they asked if I was the person who would be transporting them. I've had patients refuse my care because I was black. I've treated patients with Confederate flags and Nazi tattoos. You just have to focus on the job and maybe it will change their opinion, maybe not. In the end, you can't let that change the way you treat them. 

Read: Faces of Cedars-Sinai: Neurosurgeon Keith Black

Dr. Black: If you enjoy science and helping people, it's one of the most rewarding careers you can have. You will encounter situations where you'll face bias and you'll have to come up with a strategy to deal with that. You'll have to be better and more prepared. 

Dr. Kyle Monk, pediatrician: I would encourage any youth, especially of color, to pursue a career in medicine. Each day I am reminded how important it is to have a physician that looks like you caring for you. The patients thank me for being a positive role model for their children.

Dr. Little: You might not have the same advantages of people from different backgrounds. You have a very small margin of error, so being as successful as possible on standardized tests and objective measurements removes questions about your qualifications. Find a mentor, someone you can trust and talk to, someone who will give you advice on how to make good decisions. Understand there will be setbacks, but that shouldn't discourage you. 

Dr. Monk: I am still very early in my career so I haven't noticed many changes, but over the past year I have noticed Cedars-Sinai making a bigger effort to support minority staff with mentorship and having our providers better represent the patients we serve.

Dr. Black: Society at large is more aware of bias than it was before, and we're collectively trying to address those issues. Unfortunately, as a whole we haven't made a lot of progress increasing the number of physicians of color, trainees, scientists, or the pipeline for future doctors. There's still a lot to be done.  

Dr. Milam: Unfortunately, I don't think there have been major improvements for African American physicians in medicine over the last decade. The number of African American and other underrepresented minority physicians has not improved despite research showing improvements in morbidity with more diverse medical staff. 

Dr. Black: In almost every situation, whether it's medicine or business, having a diverse talent pool just creates a better product. It brings different perspectives that are broader and more creative. In dealing with health challenges we're going to face globally and as a nation, if we don't address healthcare disparities, we're not going to deliver the type of healthcare we're going to need in society. It's not going to just affect the people who are disadvantaged, it's going to affect all of us.

Dr. Little: Black and African American patients have a tenuous history with the medical profession due to things like the Tuskegee experiements. Numerous studies have also shown the impact of implicit bias in relation to patient care, especially in areas like maternal mortality rates, cardiovascular interventions, and arthritis care for patients of color.

Having someone who might look like you or might have similar experiences as you could bring a sense of comfort and limit the bias that exists so patients can be treated with the same level of care. 

Dr. Milam: African Americans make up only 6% of the physician workforce, and the disparity is more apparent in certain specialties such as orthopaedic surgery and dermatology. There is evidence that increased diversity among the medical workforce not only improves patient care and patient satisfaction and helps to reduce health disparities, it also improves learning outcomes, cultural sensitivity, and interpersonal skills for all students.