Dr. Makeda Dawkins, a Board-Certified Internal Medicine Physician and Gastroenterology Fellow at Westchester Medical Center, recently shared her experiences navigating the challenging path of medical residency. Coming from a family with deep roots in healthcare, Dawkins offers a candid perspective on the unique challenges faced by Black physicians and the importance of cultural representation in medicine. In this interview, Dawkins discusses everything from imposter syndrome to the daily routines of residency, providing valuable insights for aspiring medical professionals.
What inspired you to pursue medicine?
I come from a very long line of individuals in healthcare, my mother was a nurse, and my family members are also in nursing, and some of them were also doctors as well, but at a young age I always had an interest in science, pharmaceuticals, physiology things of that nature. I found that when certain people fell ill, the most useful thing I could do was interpret the medical literature, interpret what they’re going through when they’re seeing their physicians, try to help understand what’s happening and understand what they can do to improve their current clinical status. So it transformed from something I did out of love for my family, to an intellectual interest, to a career pursuit. I think that anyone interested in healthcare knows that if your heart is not in it, it’ll be very difficult for you to stick with the course, because there are challenges along the way.
How did being a Black woman impact your residency experience?
Imposter syndrome is real, and I think it’s something that is well documented and discussed throughout the literature, but it was difficult for me at first to work in hospitals where I didn’t see people who looked like me as physicians, to navigate spaces in rooms where there was no one that I could assimilate with, or connect with on a racial level. It’s a comfortability factor to be in a space where people look like you, you feel like you’re understood, and you can express yourself, because of that, I felt like, if I’m going to be the only African American Black person in this room, I need to know my information to a T, I need to be on my P’s and Q’s, I need to be sharp. I think it pushed me to study harder and be better at every turn, because I knew that I was a representative of my culture and people who looked like me, and I was also an example for people who were looking up to me and saying, they want to be a physician.
Did you have any mentors or role models that helped you along the way?
I think my most influential mentor is Dr. Alyson Myers, she is currently an endocrinologist at Montefiore, but she was very influential in me pursuing the next steps. Even when I finished Internal Medicine Residency, and I was trying to decide on doing another fellowship, I spoke to her about it, she really pushed me to be better and want better for myself. Having mentors and having sponsors is so important, not only as a female, but as a Black female in these spaces, because you need mentorship, you need guidance, you need to know how to navigate these rooms and how to present yourself as someone who’s interested in academic medicine. It’s not something that you’d be taught how to do necessarily right out of medical school, it really does take coaching.
What was the biggest challenge and most rewarding experience during your residency?
The biggest challenge was seeing patients who were colored and not seeing other physicians or medical staff that were colored. A lot of the times patients would say things or do things that I would interpret in our cultural context as something to be “of the norm”, or very common, and when you’re behind the scenes and you’re having conversations, there’s some people who don’t understand it, and they’re mistaking it for something different.
A prime example is psychiatry, psychiatrists have a lot of influence and a lot of power, if you’re not understanding the cultural context that your patient is coming from, you’re not going to be able to treat them to the best of your ability. If you have a patient of Caribbean descent, Caribbean people can be very proud people, and they’re telling you what they’ve accomplished and what their children accomplished, that’s a sense of pride for them, but if you don’t understand that, you may interpret it as someone being boastful or someone telling fallacies, and that can influence your diagnosis.
The most rewarding part is always seeing the effect that I have on patients, when they tell me, “Oh, you look so young, and you’re so knowledgeable. Thank you so much, and this journey would have been so difficult without you.” That really means something. Medicine is always going to be difficult, I trained during Covid and I started my residency during Covid in the ICU. During those times you really sit with yourself and think, am I doing this for the right reason? It’s getting very difficult. You have emotional demands, physical demands, academic demands, but you can overcome all of those things if you’re doing it for the right reasons, if your heart is in it.
How did you maintain your mental and physical health during residency?
In training during Covid, I really emphasized my mental health and my physical health, not only having an academic schedule for studying, but what am I doing for my body to keep up? Because when you’re working 6 to 6 or 6 to 8, you have to be able to physically meet those requirements. So making sure you’re eating properly, making sure you’re getting some type of exercise, making sure you’re leaning into your support system when you need it, and learning how to not take your hospital issues home with you.
During my residency and during my intern year was very hard for me to not bring the hospital home with me. In the beginning, I thought, can I do this? Is this natural? Is it right? Is it acceptable? But I’ve found a way to say that certain things happen in certain spheres of your life, and if you carry it with you it gets very, very heavy. I do my best when I’m at work, and I try to end every conversation with my patients to let them know that tomorrow’s another day, and I’ll be here tomorrow. We can pick it up tomorrow, and as they have family they want to talk to, I have family that I want to go home to and lean into and help me along the way.
Could you walk us through a typical day as a resident?
Typically depending on which hospital you’re at and depending on what program you’re in, your day can start anywhere from 6:30 to 7 o’clock. You’ll come in, you’ll receive handoff from your overnight resident or overnight intern, and it’ll be a list of all your patients and things that have happened overnight, any critical events, any rapid responses or any changes in clinical status. You’ll also get a list of new admissions depending on which hospital you work in, you’ll get a brief story, brief assessment, and a plan.
You’ll go to your computer, you’ll chart check, make sure all the vitals are okay, check all the labs that are in. Make sure your patients are getting the right medications in the morning. Make sure you know what the tasks for the day are, so you can call any consult services or any surgery services early, and then you go see your patients. You figure out how they’re feeling, what’s going on on their behalf. Are they having chest pain? Are they having shortness of breath? Did they sleep well? These things really matter, they do make a difference during the hospital course.
You do your physical exam, you talk about the plan for the day and go back to your desk. If you have a senior, you’ll talk about the plan with your senior, if you are the senior, you’ll talk about the plan with the team, and then your attending. The attending will come in, who’s the board certified internist, and you’ll go through all the patients and see each one at the bedside. You round as a team, and then you’ll come up with a plan usually that ends around 10:30, 11.
At 11 you have interdisciplinary rounds where you go around with a social worker, case management, physical therapist and sometimes clinical utilization of the hospital to make sure that everyone’s on the same page. The nurse will mention something like, “Oh, the patient’s having trouble walking, or they couldn’t go to the bathroom, they’ll benefit from physical therapy.” Well, now, you have physical therapy right there, everything’s more streamlined.
Interdisciplinary rounds usually runs from maybe 11:30 to 12:30, you’ll go back to your desk, You’ll take care of any tasks you have, see your patients, call your consults, and then sometimes you have some time to eat lunch, depending on how you manage your time.
Education is also part of the Residency program, depending on what year you’re in will dictate when you have lectures. After that you’ll round again with your attending, going through everything that’s happened during the day. What did you accomplish today? What was changed? What were the outcomes? And then you’ll sign out to the next team.
So usually the day runs from, I would say, 6:30 to 5 if you’re good at managing your time, oftentimes you probably leave at 7.
What advice would you give to young Black students who want to pursue medicine?
Find the learning point in every opportunity, and find the opportunity experience. You’re going to be in spaces where you never know who’s there, you never know what you can learn. You never know who you can learn from, even if you’re uncomfortable in a certain situation, there’s always something to learn.
The way I approach things is, I work with a lot of physicians, and everyone has their own teaching style, and I pick certain things I like from each of their teaching modalities. I take bits and pieces from each person’s teaching style, and make it my own. Always put yourself in a position to learn, always put yourself in a position to be seen. There are always a lot of opportunities for undergraduates, and even people who are not in medical school who are interested in doing a post back.
Even if you don’t get into a program you apply for, still reach out, stay in communication, because you never know what can come of it. Find a good mentor or a good sponsor who’s willing to invest time in you and be professional and responsible when you have a mentor, because mentorship is two ways, you have to have a good mentee and a good mentor and believe in yourself, don’t ever let anyone tell you you can’t do it.
How did you prepare for medical school applications and residency interviews?
Medical school applications are pretty objective, your academic performance is a large part of it, and letters of recommendation are a large part of it. So I would say be very meticulous about who writes your letters, make sure that they know you very well, and kind of can speak to your character, and also phone calls make a difference. So you can have three people write your letters, but someone else can call who didn’t write a letter, and maybe that’ll help you.
In your personal statement, start the personal statement early, because sometimes the direction you’ll take will change. Make sure that you have people to review your personal statement very early and make sure you’re receptive to the feedback as well. Once a program gets to your personal statement, they know they’re interested in you, and they kind of want to figure out more about who you are. So take it seriously, take time, put in good thought, and start early.
Did you have any scholarships or resources that helped you succeed?
I actually went to what is now the CUNY School of Med, which is a BS/MD program, I finished college early and I started medical school thereafter. There are a lot of programs throughout the CUNY system, and there’s a circulating PDF of all the scholarships and externships that are available. I don’t know if it’s still around now that things have changed and funding has changed, but it was a document that used to circulate around everyone who was interested in medical school or pre-med in the city at the time, and you would just go down the list and apply for whatever you thought was applicable, and what you were interested in.
Lean on your parents, lean on your community members, a lot of churches, sponsored applications for some of their students, big brothers, big sisters links, Jack and Jill, some sororities and fraternities. All these organizations sponsor events, applications, and have people who will be willing to review your application and review your personal statement and give you honest feedback. You have to really put the work in to research those places, to find those resources. Sometimes there’s a feeling of wanting to do things on your own, you’re in medical school, it’s an independent journey, you’re going to get there, it’s not true, it’s not true at all. Sometimes it does take a village, and there is no shame in using your support system, that’s what they’re there for, they’re there to help you.
Where did you decide to focus your medical career?
After medical school, I was trying to decide if I wanted to pursue family medicine or internal medicine, and I decided to pursue internal medicine, so I completed my Internal Medicine Residency at Westchester Medical Center. Thereafter I completed my chief residency at Westchester Medical Center, and then, after that I decided to pursue a fellowship in gastroenterology and hepatology, that’s what I’m doing currently.
What is gastroenterology and hepatology in layman’s terms?
GI, as some people know it, is the study of the digestive tract, from your mouth to your esophagus, your stomach, your small bowel, your colon, your pancreas, your liver, your gallbladder, generally, are the systems that we study and we intervene upon. A lot of people say they have stomach aches, or they have problems with their digestive tract, or you go to the hospital and you find that your LFTs are elevated, those are all things that a gastroenterologist would help you with depending on the severity.
