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Making an African American REI physician: a story of mentorship

2021; Elsevier BV; Volume: 116; Issue: 2 Linguagem: Inglês

10.1016/j.fertnstert.2021.06.043

1556-5653

Michael A. Thomas,

Mentoring and Academic Development

Few African American men graduating from medical school find a home as a provider in obstetrics and gynecology. This is a story of mentorship at every level of the medical pipeline and should serve as a primer on how to help future leaders from diverse backgrounds. Few African American men graduating from medical school find a home as a provider in obstetrics and gynecology. This is a story of mentorship at every level of the medical pipeline and should serve as a primer on how to help future leaders from diverse backgrounds. Discuss: You can discuss this article with its authors and other readers at https://www.fertstertdialog.com/posts/33354 Discuss: You can discuss this article with its authors and other readers at https://www.fertstertdialog.com/posts/33354 The latest MATCH for all residency programs was this past March 19. Anyone with a social media account who was following the results would have noticed that most programs, especially those in obstetrics and gynecology, are now becoming more diverse and inclusive. Many residency programs, in and outside of our field, were quickly posting the faces of their new residents. It was positively striking to me that this increase in residents of color would eventually result in having more fellows and faculty of color in the near future. This is a great sign that things have changed since my time as a medical student in the mid-1980s. However, placing more residents of color in your program because you finally want to prove that your program is “woke” and that diversity, equity, and inclusion is now the “right thing to do” is not enough without mentoring and support. Making the “right” moves but not doing the “right” thing means that you have to not only educate but also run interference when the grizzled, seasoned male obstetrician of any ethnicity tells one of your new Latina residents, who is Alpha Omega Alpha (AOA) and obtained Honors in every clinical rotation in medical school, that “Ob/Gyn residencies must be getting easier to match into these days.” Statements like this (an actual quote from a faculty member after the most recent MATCH) make me think that it’s never going to be easy for residents of color, those who are members of the LGBTQ+ community, or anyone with either a subtle or an overt disability. I was a medical student at the University of Illinois Medical Center (UIC) in Chicago from 1984 to 1988. My Step 1 score was at the median, so I knew that I had to work extra hard during every rotation in order to possibly get interviews at high-level residency programs if a fellowship was ever something that I wanted to entertain in the future. Therefore, I intentionally placed my third-year obstetrics and gynecology rotation at the end of the academic year. I hoped that gaining more knowledge about all aspects of medicine and the politics of being a clinical medical student would be helpful for me before starting the rotation in what I hoped to be my future career. I got Honors in General Surgery and Internal Medicine, but only a High Pass in pediatrics. When I finally reached my third-year rotation in obstetrics and gynecology, I was ready. I felt that I was well honed in how to make my residents’ lives easier… and how to showcase my talents. So I arrived before all the residents and medical students. I stayed late to prepare charts for the next day. I did my best to participate in every delivery and operation that I could over the eight short weeks of the rotation. By the end, I not only got the Honors that I truly deserved but I got to know many of the residents and the faculty much better. In many ways, I felt that I had found my tribe. In the next step to seal the deal, I campaigned to become the President of my medical school class. Not that I was political in any way, but the class President was the only medical student who sat on the Chair’s Forum, which included the Dean and every department chair. In this capacity, I would be able to meet and get to know Dr. William Spellacy, Chair of the Department of Obstetrics and Gynecology at the University of Illinois at Chicago. Bill Spellacy was tall, gray-haired, had a perpetual tan, and always spoke in a matter-of-fact fashion. He was a nationally renowned figure in maternal-fetal medicine. Spellacy had this icy stare that never betrayed what he was thinking at any given moment. I never knew if I was doing well or not when we had clinical encounters or during our time together at meetings. Because of his exacting nature, Spellacy’s residents were always focused and prepared when he conducted “Spell rounds.” Spell rounds were when he would have the resident’s present patients with difficult medical conditions, and the residents would answer questions in front of the medical students. As a student during the obstetrics and gynecology rotation, I found this amusing because we were off the hook and it helped me realize that I sometimes knew a few things (very few) that some of the more junior residents did not. If a question was ever thrown my way, I usually got it right. But I could never figure out if being correct and showing up your resident was good or bad because we never got feedback during these sessions since they weren’t aimed at us. Or at least that was my impression. The mid-1980s were a time when very few male doctors of color were being accepted into women’s health residency programs. Not that there wasn’t interest on the students’ side. But the programs just did didn’t appear to be interested in having a Black man. I was one of two Black men who applied from my medical school in that year. The majority gravitated to primary care (family medicine, pediatrics or internal medicine). The last Black male who matched into obstetrics and gynecology at our institution, with 250 total students per year was three years previously, when someone matched into the program at Rush Medical Center near our hospital. Rush had their own private medical school, and on rare occasions I would sneak into their medical library to find underutilized and more up-to-date textbooks that were difficult to find at UIC. On occasion, a Rush librarian would ask for my identification and I would leave. It is unclear why men of color, especially Black men, were not more prominent in the women’s health field at that time, especially since there were more men than women being trained. The number of women in obstetrics and gynecology programs appropriately increased in the 1990s, but the number of Black men in medical schools and residencies have generally declined. So as I was putting together my list of programs for fourth-year rotations in obstetrics and gynecology, I tried to be strategic and concentrated on Rush Medical Center and Michael Reese Hospital, which was on the near South side of Chicago that had a Black man in the second year of its residency program. Since these two programs demonstrated that a Black man could be a viable candidate, I thought it was worth a shot to apply to these programs. Because I didn’t have the funds to live in a short-term apartment in another city, I thought I’d concentrate on Chicago and just apply to programs in Los Angeles, which was my second-choice location. However, I didn’t get a fourth-year rotation at Rush because they were popular and treated their students well, therefore their open slots filled up quickly. In addition, Northwestern was a no for a women’s health rotation, but they did have an opening in the Emergency Department, which I accepted without hesitation. However, I was able to get a fourth-year rotation at Michael Reese Hospital. Because they were also a popular location for a fourth-year rotation, I could only get two weeks of obstetrics and two weeks of something called reproductive endocrinology and infertility (REI). I had no idea what REI was or even if we had it at UIC. But I accepted these terms and scheduled the rotation for some time in October. The two weeks of obstetrics at Michael Reese were two weeks of Hell, primarily because I didn’t get along with my assigned intern. At UIC, getting to work early and preparing charts for the next day was seen as a benefit, but my intern thought I made her look unprepared. Therefore, everything I did as a student was either “horrible” or “unprofessional.” During my third delivery with her on a 24-hour Saturday call, the intern became impatient after a very uncomplicated delivery with a shoulder dystocia. After the placenta didn’t come out as quickly as she wanted it to, the intern started pulling very vigorously on the umbilical cord. Without thinking, I blurted out, “Have you ever heard of a uterine inversion?” I have no idea where that came from. It surprised her and me. I was standing behind her, and she turned her head 180 degrees like an owl, gave me a glare, and then ran out of the delivery suite crying. As I watched the clamped cord swaying back and forth like a pendulum, I grabbed it, waited for a little bleeding, and then gently removed the placenta. After the placenta was out, I checked the mother for tears, massaged the uterus as it involuted, and then the nurse and I helped move the patient to her gurney to go to recovery. With the patient heading to the recovery room, I was checking the placenta to make sure it was intact when the chief resident meandered into the delivery suite to chastise me for not calling him to deliver the placenta. I pointed to the silver pan with the intact placenta, then pointed to the delivery table with an absent patient. He looked as I walked away to check the front desk for the next possible delivery. Because of this “incident,” the rest of my two weeks on the rotation consisted of “observing,” as the other fourth-year students were allowed to do deliveries or tie knots during cesarean sections. The final two weeks of the rotation were when I found what I hoped to be my life’s work. I got to rotate with the Chair of their program, Dr. Antonio Scommegna, and one of the fellows, Dr. Sandra Carson. I again got there early and read everything that I could on every patient and every reproductive disorder. Though there was no in vitro fertilization program at Michael Reese at the time, I got to actually do an insemination with Dr. Carson. It was thrilling and exciting. After that experience, my goal was now to get into a well-respected academic residency program with a track record in getting it’s trainees into REI fellowships. So I made a list: Northwestern—Well known but had not had a Black man. One of my former undergraduate classmates at Northwestern University, a Black woman, was a member of their six-year medical student program and currently a resident. I doubted that they would take two Blacks at the same time, though at different years of training. In addition, they had never had a Black fellow in REI. During my residency program interview, the Chair, Dr. John J. Sciarra, asked me what books I had read during my third-year of obstetrics and gynecology rotation and which articles in the field had formed my interest. I stuttered and stammered and finally said “that Parkland book.” He smiled and made a note in his binder that seemed to take a few minutes, smiling as he wrote. I assumed I had not done well. I later found out that he edited an excellent series of chapters on obstetrics and gynecology disorders that were written by many leaders in the field and updated annually. Rush—Their Black male chief resident was about to graduate, and they had a well-respected REI program. The interview went well. This was probably going to be the best place for me as a future resident if I stayed in Chicago. So I laughed at all the bad jokes and had a permanent smile etched on my face for every interview. Was Rush an academic powerhouse at that time? Probably not, but they had an REI fellowship. UIC—Unknown to me, UIC had an REI division. Dr. Spellacy had never had a Black resident (male or female), and he didn’t seem to take much interest in me in the Chair Forum meetings either. Darn it. In my few interactions with the REI Division Director, it wasn’t clear that he had any interest in having a Black male fellow. However, there was a Black female fellow at the time. University of California Los Angeles (UCLA)—Great programs in obstetrics and gynecology and REI. I wanted to go to UCLA as an undergraduate because of their strong program in television production. Because I was a Radio-TV-Film major as an undergraduate, I applied to medical school and to a number of masters in fine arts programs in television production. On the day that I got accepted to medical school at UIC, I was also accepted to the UCLA Master’s program in television production. So, in my mind, I somehow figured they were still waiting for me to come back in some capacity. However, on the day of the interviews at UCLA, I consumed three cans of Diet Coke and two Snickers bars for my caffeine buzz within one hour before the start of the interviews. Because of this move, I had to leave at the end of every interview to go to the bathroom and would come back with a look of relief. After I was halfway through the interviews, I realized that the faculty and other interviewees probably thought I was either just odd or had a bladder issue. However, EVERYONE who interviewed me said they really liked me and I felt welcomed. One of the residents did state to all of the interviewees that day, “It would be great to one day have more residents from outside of California.” That didn’t really register as a potential obstacle at the time. University of Southern California (USC)—USC had a diverse residency program. I was unsure of the status of their REI fellowship at that time. Their obstetrics program did 15,000 deliveries per year. I remember walking through their Labor and Delivery unit thinking that there was no way in Hell that I needed to do 15,000 deliveries if I was never going to deliver a baby after residency. The intern gave us a tour and talked about crying the first night on call. While he was giving his disguised plea for us to leave and not look back, I observed that he had four beepers on the waist of his scrubs and looked as if he was forcing himself to stay awake. One eye was unusually wide open and the other at half-mast. At the end of the tour, one of the interviewees asked him, “Weren’t you on Wheel of Fortune?” The intern affirmed the question with a head nod and eye roll, then took us to a less hectic location. Michael Reese—I did get a chance to meet a Black male faculty member and a Black private practitioner who was also friendly and helpful. I thought that he could be a great mentor if I came to Reese as a resident. But when I interviewed with Sandy Carson, who I was excited to see because she was one of the reasons that I was committed to REI as a future career. However, after the initial cordial conversation, she told me that she was surprised that I was interviewing at their program because the residents HATED me. I was taken aback by her honesty and held off saying that I didn’t like them either, but keep my cool and stated how important the program was in cementing my focus on women’s health and future career in REI. She let me talk and at the end said that she liked me, but “Do you really want to be somewhere where the other residents just don’t …?” She never finished the sentence and just stared at me for a few seconds before the next question. The other two programs of note during my interview season were: Beaumont—Michael Cane (my roommate) and I decided to visit Beaumont Medical Center and extended our trip to include Wayne State. Dr. John Musich, who had been at UIC, was now the Chair at Beaumont. At the time, Beaumont was a high-level community program that was situated on a lush, green campus with a diverse resident contingent. They had campus townhouses on the property for their residents. From what I could tell, the residents were happy, but I the program seemed too perfect and I wanted something grittier, but not USC gritty. Mike and I agreed that Musich, who had only been there a year, was heading in the right direction to turn the program into a much sought-after residency. Wayne State—If USC was gritty with 15,000 deliveries, Wayne State was downright dirty and gritty in the best of ways. They did 12,000 deliveries and checked all the boxes of diversity and inclusion with Black, Hispanic, and Asian residents and faculty. They had a strong teaching program. I actually liked them, but an incident after the interview tainted my view of Detroit. At the suggestion of the residency coordinator, Mike and I made an excursion to Windsor, Canada, for barbeque ribs. We got stopped on the Canadian side of the tunnel, and our car was searched for drugs. I guess a Black and a White guy going for ribs in Canada (and not in Detroit) with Chicago tags sparked some questions. We were placed in separate rooms and questioned. Then they allowed us to watch the car being given the once-over by border patrol officers, then dogs, then a second crew of officers. After this very embarrassing experience, we fumed as we ate the most awful ribs that I had ever had in my life. After the interviews, I figured that UCLA was where I would end up. They loved me, and they even sent me a great letter about their level of interest. I concluded that I would only put down my most desired programs. My advisor was a Black Ph.D. in cardiovascular pharmacology, so he was of little help when I discussed my match list. After much internal struggle, I placed my programs in the following order, primarily based on matching in Los Angeles because of the academic potential and the fact that I had friends in the entertainment field. Also, I thought this was a great chance to get relief from the snow for at least 4 years:1.UCLA2.USC3.UCLA Torrance4.UIC5.Rush6.Michael Reese7.Northwestern. That was it. I was confident that I wouldn’t go below four. As President of the class, I was tasked with making sure that the residents who didn’t match were meeting with the individual chairs of their desired specialty to discuss their options. I showed up at the Dean’s office to talk to him and get the low-down on the poor souls who didn’t make it. His assistant looked a little distressed. She said, “The Dean needs to see you! Like now!” The last time the Dean needed to see me was to discuss our expenses for a student bowling party. So I was not alarmed. “Mr. Thomas how are you doing?” Dean Richards said. “Mr. Thomas,” instead of “Michael” was a bad sign. “I’m doing fine, Dean Richards. How are you?” “This is the worst day of the year for me. I have the displeasure of telling 15 students out of 250 that they didn’t match.” I casually said, “That’s lower than I would have expected, and I’m sure your job isn’t easy. As President of the senior class, I want to make sure that my people are taken care of.” “You didn’t match,” he blurted. I wanted to look around to see if someone was behind me. He continued, “It is unclear what happened, but none of us expected you to…” “Not match.” I completed his sentence. “This is what is going to happen,” he continued. “You and the other two unmatched obstetrics and gynecology students will meet with Dr. Spellacy at noon. Spellacy will help you in any way he can. There are only two unmatched spots in the country. One is at Pontiac General near Detroit. Did you interview there?” In my daze I said, “Not there.” “Another spot is in New England, Vermont, or somewhere. Spellacy likes you. He always talks about you.” I was surprised. “He does?” “He wants you to actually come up to his office at 11:30 before the others. Good luck!” the Dean said. I just nodded and walked away in a fog. I was at Dr. Spellacy’s office at 11:10. His assistant was gone, but his office was open. As I walked into his office, I noticed that Dr. Spellacy was on the phone having an animated conversation, and he gestured for me to sit in the unpadded seat in front of his desk. I think the chair was intentionally uncomfortable to eliminate lingering. He ignored me as he spoke on the telephone. “Yes. He’s here now. I don’t know what happened. You ranked him in your top ten? I’m sorry. I’m sure there was a computer error. He told me that he really liked the program and was looking forward to coming to Detroit. We talk all the time. He’s one of those class President people.” All I could think was, “Detroit???? I’m not going to Detroit.” After I left the Dean’s office, I had arranged a preliminary year in internal medicine at Ravenswood Hospital in Chicago where I had done a rotation in Psychiatry. The medical student coordinator was an astrologist, and I let her do my star chart. I guess I was the only medical student who had ever consented. So I knew she would come through for me. And she did. They didn’t have an obstetrics program but I could always apply next year. Spellacy got off the phone. He looked directly at me and said in a direct fashion, “Please listen clearly. You have five minutes to make the most important decision in your life, Mr. Thomas. Dr. Bob Sokol at Wayne State really wanted you and was surprised that your name showed up on the unmatched list. He needs a favor from me to approve the merger of his program with the Grace Hospital residency program in order to increase their complement from 10 to 12. He has an unmatched student and I have an unmatched student. Are you willing to go to Detroit? You now have four minutes.” I was honored. This was the first time that Dr. Spellacy had ever spoken to me. And the Dean said that he liked me. “Three minutes and the clock is moving faster.” I didn’t like the treatment I experienced in Canada, but I truly didn’t have any trouble in Detroit per se. The burned-out buildings on Woodward Avenue were a little disturbing, but what were my options? Before he could give another countdown, I said, “It would be a pleasure to go to Detroit.” Dr. Spellacy immediately called Dr. Robert Sokol at Wayne State. “As I said, it must have been a computer error. He’s just as surprised as we are. He will be there on July first with bells on. You have my word and your two spots.” Spellacy then looked up and hesitated before finally saying, “You can go now. Detroit is a good place. I don’t know how this happened, but I’m confident that you will do well there. I need to tell your other two classmates that every spot in the country is now filled. You’re a lucky man, Thomas.” I just stared and wanted to ask, “Why didn’t I match here?” But I didn’t. As I was turning to leave, Dr. Spellacy asked, “Did you send a letter to any of the programs that you were interested in? That came up during our department's discussion of you.” I looked at him with confusion. “No. I didn’t know to do that.” He nodded toward the door and I left feeling disoriented but happy that I “matched???” I first met Dr Robert W. Rebar, the man who would become my lifelong professional mentor, when I was an intern at Hutzel Hospital at Wayne State. As a first-year resident at Hutzel, you got two weeks of vacation. Though no one questioned it at that time, having only two weeks of vacation during a grueling residency is beyond sadistic. In my 12-member class, we eventually had five divorces, including mine. My new bride stated that she hated residency and wanted to move back to Chicago. I hated residency too!!! But I stayed. We went our separate ways and still remain friends to this day. However, to get more time off from the residency program, we were required to attend a conference that WE, as $20,000 salaried residents, had to pay for. I opted to go to a boards review conference back home in Chicago at Northwestern Prentice Hospital during the Thanksgiving break. Every Northwestern faculty member would be there. At that point, I knew two things: I had to get out of Detroit for a few days and I wanted to land an REI fellowship at Northwestern so I needed face time with the Division Director and anyone else there. I could not suffer another match snafu. Though a lowly intern, I knew that Dr. Robert W. Rebar was pretty famous in his circles. He had trained in the REI fellowship at the National Institutes of Health before he even finished his residency, then worked with Dr. Samuel Yen at the University of California San Diego. Rebar was considered an REI savant. He had come up with the 3:1 ratio of luteinizing hormone to follicle-stimulating hormone for the diagnosis of polycystic ovarian syndrome. So I drove to Chicago and staked out every REI lecture given at the conference. It wasn’t until the end of the day that Dr. Rebar spoke. He gave a fantastic lecture on neuroendocrinology. Most of it was over my head, but he made it understandable. After his lecture, I made a beeline to Dr. Rebar to ask a question, but he was surrounded by about nine people asking many of the same questions that I was going to ask. Most of the question askers were going to take their oral boards in a month, and they wanted to get insight into possible clinical scenarios. The fact that Dr. Rebar was a well-known scientist AND a board examiner gave me another reason to want to come to work with him. I waited patiently, and when he looked at me to possibly ask a question about some aspect of his talk, in front of everyone I erupted with, “Dr. Rebar, my name is Michael Thomas. I’m a resident at Wayne State. I’m going to be your fellow in 3 years.” He didn’t comment or laugh, just nodded and continued a conversation with someone who congratulated him on his talk. As I focused on the face, I realized it was Dr. John Sciarra, the Chair of the department. The same guy to whom I had mentioned the Parkland book. I slinked away but had done what I had come to do. I had marked my territory. I didn’t realize that when I matched to the Northwestern University/Prentice Hospital REI program in the fall of 1987, two things would happen. The first is that the Northwestern REI fellowship program would move to Cincinnati. A city’s whose exact location I didn’t know. I thought, as Bob Rebar discussed the move six months before the start of the fellowship, that Cincinnati was a suburb of Cleveland. When Dr. Rebar said it was across the river from Kentucky, I wanted to respectfully decline. As my silence became more prolonged, he waxed on about the wonderful opportunity that I was lucky enough to fall into compared with all the other fellows starting in July. The other matched fellows would not be lucky enough to be able to help start an REI division from scratch. The second was that I was making a decision to go to a brand-new program in a city that I did not know with a guy that I had only met a few times and didn’t really personally know. But the more Dr. Rebar talked about his vision for the department, the more I believed it could work out. Also, there were no other fellowship spots available. So I was enthusiastically on board. I didn’t fully realize that when I started as the sole fellow in July 1988 that I was being trained not only by Bob Rebar but by four other great powerhouse innovators in the field to build an REI, in vitro fertilization, and clinical trials program: Drs. James Liu, Marcelle Cedars, Andy LaBarbara, and Bruce Kessel. Because it was a new program, there was nothing in the department for me to do during the start of my two-year fellowship, so I started to write chapters on various topics for Bob and Jim. In addition, I wrote case reports on anything I saw that was interesting. I started a long-term project giving intravenous doses of corticotropin-releasing hormone to menopausal women to observe changes in luteinizing hormone pulsatility over an eight-hour time period. This led to many more papers and presentations and opened an opportunity for me to stay on the faculty at the University of Cincinnati, becoming more involved with clinical trials and then applying for and receiving my first National Institutes of Health contract in contraception, an area of research that both Rebar and I had an interest in. As I was ramping up my research and clinical career, Bob prepared me as a lecturer. Whether it was at grand rounds at local or regional hospitals or giving talks on sexually transmitted diseases prevention at the Hamilton County sexually transmitted diseases center, it was Rebar’s thought that any time I could get in front of a medical audience to impart knowledge I instantly become known as an academic expert. This included “walking “ with him at every American Fertility Society, Endocrine Society, or Society for Gynecologic Investigation to meet and shake hands with all the heavyweights in our field. When I was hiding away practicing my next oral presentation, I would get a call when he was ready to “walk” and shake hands. This is how I met Drs. Yen, McDonough, Jaffe, Judd, Wallach, DeCherney, Santoro, Ryan, and, of course, the Parkland guys. From then on I became known as Bob Rebar’s guy. From the time that I was a fellow to the time I was a junior faculty member, Rebar would call me to join him for one of his Chair meetings. I’d sit in the background and just listen. Whether it was a meeting to discuss the build-out of an office space or how surgical block time would be divided, I was there. To the point that “Who is that guy?” just became “That’s Bob’s guy.” Opening doors and being in the rooms to witness the decision-making process (locally and nationally) helped to normalize a Black face in these proceedings that wasn’t an administrative assistant and therefore propel me to the close affiliation with the University of Cincinnati and ASRM that I have to this day. But most importantly, by the introductions to many other leaders around the country, I was invited to give talks or sit on panels. My time with American Board of Obstetrics and Gynecology started because Rebar introduced me to Dr. Nanette Santoro when I was a new junior faculty member. She then invited me to sit as an oral board examiner in 1999, well before my peers had reached the same level of recognition. At a Society for Family Planning meeting in 2014, Dr. John J. Sciarra, now former Chair at Northwestern, sat next to me on a bench as I was getting mentally prepared to give a talk. Dr. Sciarra was being honored for his contributions in the contraceptive field. I didn’t think he remembered who I was, so I nodded and said hello. Surprisingly, he whispered, “Michael, I have a story for you.” I was now intrigued and moved closer. Dr. Sciarra continued, “The Monday after you interviewed for the REI fellowship, Bob came into my office and told me that he thought that he had found his next fellow and that he was Black. He wanted me to make sure that no one was going to give you a hard time. He stood there steadfastly until I said that I would take care of it. I promised him that I would take care of it. Bob’s a good man. I just wanted you to know that.” Dr. Sciarra then just walked away. I am a Black male reproductive endocrinologist who has succeeded through the academic pipeline to become a tenured professor, department division director, REI Fellowship director, American Board of Obstetrics and Gynecology Division Director and Board member, Chair of a major university department, and soon-to-be President of ASRM. I’ve used that influence to increase the number of residents of color at our University well before this new national awakening. Over the last 7 years, I have been working with a hysteroscopic device company that allows me to use two of their three surgical simulators to take to my former middle school in Robbins, Illinois, to teach every sixth-, seventh-, and eighth-grader how to perform surgical procedures. These Black and Hispanic kids who are being educated in one of the poorest school districts in the state of Illinois have become predental, prenursing, and premedical students since I started the program. As you increase the number of residents, fellows, faculty members, and partners who are of a different color, ethnicity, or sexual orientation, you will discover the benefits of a diverse, equitable, and inclusive workforce. It also means being or assigning a mentor for trainees and junior faculty member. Someone who will be there to open the doors, run interference, and then step back to allow the spotlight to shine on the mentee. I have been very lucky. I may not have had such a notable career without Dr. Robert W. Rebar. He pushed me into a mindset of excellence and focus that I didn’t quite have prior to my fellowship. He also normalized the fact that a Black man could excel in our subspecialty, which is known to be more “cerebral” than its women’s health counterparts. So my parting words would be that everyone should follow the Rebar Rule. Find a mentee that is different from you. Train them in a way that will make them a better version of you. Then walk with them at a national meeting and make sure that everyone knows who they are, thus giving them the credibility to one day become a “member of the Club.” In the end, it’s not the number of peer-reviewed papers or book chapters alone that will sustain your legacy. It’s the people that you leave behind who will continue to tell your story.