When Oke Anakwenze, MD, was a medical student, it was hard for him to find mentors who looked like him. It was even harder once he began training in orthopaedic surgery, a field of medicine that is lacking in racial and ethnic diversity. In this month’s EDI Spotlight, Anakwenze shares how he’s trying to make the experience of finding mentors a bit easier for today’s underrepresented in medicine students, both in his role as shoulder section head in the Duke Department of Orthopaedic Surgery and as diversity committee chair for the American Shoulder and Elbow Surgeons. He also tells us about his passions outside of Duke, which include discovering Italian recipes and relearning to cook dishes from Nigeria, where he spent many years growing up.
What does a typical day look like for you as professor of orthopaedic surgery and shoulder section head?
I am a shoulder and elbow-trained surgeon and a clinical scientist, meaning I spend my time going between clinical responsibilities and research, and also teaching. The pillars of academic medicine are generally clinical practice, education, and research. And the two things that I have added are leadership and business.
My week consists of managing these five tenets, but for the most part, I spend 80% to 90% of my time doing clinical activities. In between that, I'm usually working with mentees. A lot of them are doing the research with me, so it's a good opportunity for me to help them, and myself, get research done. But more importantly, it's a way for me to guide some younger folks.
Tell me about your experience serving as a mentor to Duke medical students. Why is mentorship important, particularly for students underrepresented in medicine?
Mentorship is important because that's one thing I didn't really have when I was coming up as an orthopaedic surgeon. There weren't many people, maybe one or two at most, that looked like me. I didn't spend enough time looking to find people that looked like me because I probably just accepted that it was what it was. It was only until I got older that I started looking back. And I started thinking about how I could have progressed a lot better, avoided a lot of mistakes, and probably evened the playing field out to my benefit if I had a certain type of guidance.
As a result of these past experiences, when I came to Duke, my plan was to engage in mentorship activities; however, there were a lot more people looking to me for mentorship than I anticipated. At that time, I believe I was the first and only Black male orthopaedic surgeon within the PDC (Private Diagnostic Clinic), so there was a long list of young minority students who wanted to meet with me and talk with me.
We had a shoulder research group, which quickly became very successful. We were publishing 20, 30 or so papers a year. I included almost all the students who I spoke to, who were interested in orthopaedics. Proudly, each and every one of them has gotten at least one publication as a result. I am also proud to see a diverse group of medical students all working together towards shared goals.
In general, I'm trying to provide mentorship for all, but also know that some people/groups have fewer mentorship opportunities. For those, I'm trying to even up the playing field. I'm proud of the fact that my first mentee matched at Duke. He's now an orthopedic surgery resident at Duke.
You are actively involved with the American Shoulder and Elbow Surgeons (ASES), serving as chair of the society’s Diversity Committee and Young Scholars Memorial Committee. Tell us a little more about your work on those committees and what inspired you to get involved.
The American Shoulder and Elbow Surgery society is fairly competitive to get in. However, the group has historically suffered from a significant lack of diversity amongst the ranks. Over the last five years, in part due to some of the civil unrest that happened and the George Floyd killing, there has been an increased emphasis in trying to grow and stimulate efforts to increase the diversity on all fronts. So, they founded the diversity committee within the ASES. I was the inaugural chair of the committee along with another surgeon named Sara Edwards in San Francisco.
The ASES Scholarship Program invites 10 underrepresented minority students to attend our annual conference on a full sponsorship. They take part in the conference, and get to meet leaders, not just in the field of shoulder surgery, but also the field of orthopaedics. A lot of these students are looking to get into an orthopaedic surgery program. It's also a way for them to build their own network.
ASES partnered with [pipeline program] Nth Dimensions this year. We had over 30 students from Nth Dimensions come to our annual meeting at Scottsdale. Shoulder surgeons volunteered to come and help with Sawbones demonstrations, discussions, a symposium, and a luncheon. We are also sponsoring underrepresented minorities and women who are interested in the ASES resident annual course, where residents learn about shoulder and elbow surgery. It's a very great course, but it is expensive. So, we’re creating scholarship opportunities for them. We also created a summer internship program where students get to pick from volunteer surgeons around the country who are willing to host a student for the summer.
I'm not specifically and only looking to increase the number of underrepresented minorities in the field of shoulder surgery. That would be nice. However, I’m more interested in increasing the representation in medicine in general.
Why is your focus broader than shoulder surgery?
I believe about 2% to 4% of people going into orthopaedics are Black, so the representation is still low in general. And this is also true in general in medicine, but certainly more so in surgeon orthopaedics. That is such a small sample size. To me, it means that the problem is significant, and we have to progress in phases. If we had a situation where there was a lot more representation of underrepresented minorities and women in orthopaedics then we could say, "Let's start trying to see who wants to go into shoulder, sports, spine surgery and etc."
Basically, before we start thinking about what they're going to do their fellowship in, I'm interested in whether we get them into residency in the first place. And if they get into residency, can we provide an environment where they feel supported and they don't decline, and they make it through safely and successfully?
What drives your passion for equity, diversity, and inclusion, particularly in increasing diversity in orthopaedic medicine and academic medicine?
It's a very personal thing for me. I feel that with the platform I have, it would be shameful if I just completely ignored it and turned my head. Many people before me did a lot to help me get to where I am today, even if I never met them.
In some ways, even amongst good people, the system can be very unfair. A lot of people have blind spots. And someone has to be willing and bold enough to have tough conversations to allow people to self-evaluate their blind spots and implicit biases. I think having diversity at the leadership level is also important. Part of the reason why I try to advance professionally is to have an ability to provide a positive influence.
There is a minority tax where minority professionals in and out of medicine spend a lot of their personal time mentoring for free. I would love to get to a point where it's not as necessary. But until then, I think we have to do what we have to do. Again, as is usually the case, my prior experiences have led to the actions I put forth today.
It was around my years in medical school that I started to note the challenges that one may face in the field of medicine if you are one of the, quote, unquote, “others.” I noticed that the playing field between myself and my good friends who were medical students were a little bit different in terms of how we were judged and how people would look at us. It was a truly great hospital, and I learned a lot but began to feel isolated.
During my residency, I had some challenging experiences with finding mentors and finding understanding. Or feeling more harshly judged for similar errors than peers. Despite having some clinical mentors, there were others who were not as welcoming; telling me that I could not do it and not being proud to support me. It's hard when you go through all those things and then come out on the other side and act like nothing happened. It left scars that I want this generation to avoid.
Right now, I try to make sure the medical students are well-prepared. I let them know everyone's experience is going to be different. I certainly made a lot of mistakes, and there were things I probably could have done better. And that's where my job is now: to say, "Hey, this may be a blind spot. How can you improve? Are you asking yourself what can you do to be better?"
What passions or hobbies do you have outside of work?
I travel a lot. I love working out, and I read a lot of books. I don't drink a lot, but I am a sommelier, so I like wine. I like to cook. I am relearning how to make a lot of Nigerian dishes because that's what I ate growing up. I also love Italian food and spend a lot of time learning how to make it. I'm always learning and adding new things to the kitchen. I also love podcasts, especially about tech or leadership.