Our EDI Spotlight for April 2023 shines on fourth-year medical student (and 2022 Michelle P Winn Award recipient) Sonali Biswas, MPHS. Since coming to Duke, Biswas has helped create advocacy groups for students with disability and chronic illness, completed her master’s degree in population health sciences, and helped lead the school’s medical students’ anti-racism efforts after the murder of George Floyd.
In her Spotlight interview, Biswas reflects on how connecting with students sharing her identities helped her overcome her imposter syndrome and feelings of isolation. She also shares highlights from her research on how transgender teenagers feel about their own physical characteristics as well as her hopes to found a center providing gender-affirming care after completing her residency in plastic surgery in the University of Michigan.
What are your current responsibilities as a fourth-year medical student? What does a typical day look like for you?
The responsibilities during fourth year vary depending on the time of year. Earlier in the year, I was completing sub-internship rotations in plastic surgery, and later fulfilling requirements through electives such as dermatology and narrative medicine. Now that it's after Match Day and my requirements are complete, I get to spend my time with family and friends relaxing and traveling until graduation and the start of residency.
Last year you received the Michelle P. Winn Inclusive Excellence Award in recognition of your work to improve equity and inclusion within the School of Medicine, and your work to bring better medical care and social justice to our local communities. What’s one thing you’re most proud of from these efforts?
I was really honored to receive this award, and it would not have been possible without the efforts of so many other medical students who work toward improving DEI in medicine. What I am most proud of is the efforts toward advocacy for students with disability and chronic illness.
When I arrived at Duke, I felt isolated and had a strong sense of impostor syndrome about having a disability and chronic illness as an aspiring physician. I was grateful to connect with other students who shared this identity over the years to form Healthcare Students with Disability and Chronic Illness (HSDCI), which serves as a community for students with these experiences, advocates for policies on their behalf, and engages with research and education.
As one of the research directors on the national board now, I value the opportunity to improve representation of people with disability or chronic illness in academic medicine. The students in these organizations are extremely inspiring and have taught me so much about addressing my own internalized ableism.
What are some of the current issues relating to equity, diversity, and inclusion that most affect medical students? What steps can Duke (and other medical schools) take to address them?
There are many possible ways to answer this question, but what comes to mind is the following: how do we ensure medical education is equitably accessible to people of all backgrounds, and how do we ensure we support people from underrepresented backgrounds when they get in? It is wonderful that medical school classes look more diverse than ever, but there is still a long way to go before medical school and residency programs reflect the general population.
One of many tangible areas of improvement is addressing the thousands of dollars students spend in addition to tuition on medical school on required things such as exam registration and study materials, applications to medical school and residency, and travel and housing for fourth year away rotations, which may be prohibitive for some to access and/or succeed in medical school. Support within medical school for those from underrepresented backgrounds may look like increasing representation among faculty, ensuring faculty undergo implicit biases training, and improving access to well-planned and timely accommodations for those who need them.
You recently completed your master’s degree in population health sciences, where you studied how transgender teenagers feel about their physical features. What were the most surprising or important findings of that research?
My thesis was a qualitative project that assessed the attitudes of transgender teens toward their own physical features and the related medical interventions. While unsurprising, the study most importantly highlighted in the teens' own words how essential gender-affirming care is to their mental health and survival. Some interesting findings included how many teens (aged 13 - 20) were most interested in care that impacted their upper body and face because that influenced how well they could pass in their world, and less interested in surgeries for their lower body which may not be visible and would be costly with limited resources.
How do the rest of your population health science studies inform your studies as a medical student?
The population health sciences program was extremely valuable in contextualizing my education as a medical student. In medical school, we learn most deeply about the cells, organs, and systems of an individual, but health is greatly impacted by the economic, social, and political policies that happen on a population level. The program made me much more comfortable with understanding the health system in these realms, which has in turn informed my academic interests in patient-reported outcome measures and implementation science.
What plans do you have for after you graduate? If you could have any job in the world, what would it be?
I will be a plastic surgery resident at the University of Michigan starting this summer! While it's tough to say where residency and beyond will take me, at this time it would be amazing to one day be back in the south as a part of starting a center for gender-affirming surgery to improve access to care for our transgender populations here.
2023 has been an especially difficult year for transgender communities and for the people who support them, with dozens of state laws being proposed and passed in state legislatures. What’s one strategy that you’ve developed for staying focused and engaged during difficult times?
The transgender communities and gender-affirming care providers on the front lines face an enormous burden of restrictive policies daily that I as a cisgender student do not have to confront in the same way. Intentionally connecting with physician and patient gender affirming care advocates through their events makes me feel motivated to pursue this line of work.
The tenacity and bravery with which they defend gender equity and access to care is extremely inspiring, and gives me a sense of purpose to aspire to while in the early stages of training.
What passions or hobbies do you have outside of Duke?
I am a big fan of exploring Durham's food scene, hiking, painting, and scuba diving. As an NC native, I'll be sad to leave all of our beautiful nature.