Talking about Racial Diversity in Neurosurgery with Jalen Alexander

Hey everyone,

Welcome to another episode of the Well Aware Podcast. In this episode, we’re going to be talking about awareness from a focus on racial diversity in the workforce in the field of neurosurgery with one of the first-ever authors on the subject, Jalen Alexander.

Jalen is a good friend of mine from my short time in New York City. When we last reconnected, he shared with me this work of his and others, and it became clear to me that this was something I wanted to help share and make you aware of.

One thing I want to invite you to keep in mind while listening to this episode:

Think about the broader implications of going from unaware to aware of something that speaks to your values and missions in life. In this episode, even Jalen admits surprise to his own assumptions about where he thought the data was going to be with respect to this research, and where the reality stood. To me, this is the first step in so many great calls to action. This is what takes us from aware to well aware, and subsequently well on our way.

With that, I hope you enjoy the episode.

For your awareness and access, here’s the article this conversation is referring to:

As well, here is Jalen’s LinkedIn profile:

His instagram: 

His Twitter: 

And finally, here’s the transcript of our conversation in case you want to follow along or would rather read than listen:

Jalen Alexander: [00:01:38] Hey there, how are you?

[00:01:39] Conrad Ruiz: [00:01:39] I’m good! How’s it going? 

[00:01:41] Jalen Alexander: [00:01:41] Good, good to see you. 

[00:01:43] Conrad Ruiz: [00:01:43] Good to see you! 

[00:01:45]Happy Thursday! 

[00:01:47] Jalen, let me formally get us into the scope of today’s podcast episode. I’m so excited for that!

[00:01:51]I wanted to get this discussion based on what you’d recently shared with me and kind of bring up a topic of awareness that I think I’m pretty sure so few people probably know about.

[00:02:00]Without further ado, let me introduce Jalen Alexander, everybody. Jalen is a report production analyst at MDRC. His main function, his role is pretty cross-functional. He provides training to staff members across policy areas on standards and report and proposal production.

[00:02:18] And he also happens to work in the K through 12 and post-secondary education policy areas. Jalen feel free to share a little bit more on that. I know I’m not an expert in your field, so would love to hear a little bit more about you and what you do from your perspective. But with that, Jalen Alexander.

[00:02:35] Jalen Alexander: [00:02:35] Yeah. Well, thanks for having me. I can share a little bit about myself for context. So I grew up in Missouri. In a really small town. I went to university in Connecticut. So I went to Wesleyan, both for undergrad and my master’s program. I studied psychology and I really leaned into data analysis while I was there at Wesleyan.

[00:02:55] So I published in the fields of public health and education. And now the reason why we’re talking today most recently, neurosurgery. But like I said, I was a psychology major and that’s what I focus on in my master’s program as well. So I’m not a neurosurgeon, I’m not working on people’s brains.

[00:03:11]But I am passionate about the topic of diversity across many fields of work. And we know there’s many benefits from diversifying our workplaces as America, as a country diversifies. So you know, a topic I’m very passionate about and excited to talk about with you. 

[00:03:26] And very timely to today. Because clearly, we’re in a world where, especially for diversity, amongst minorities, there is such a hotness around the different results that we seem to be getting, the different results that seem to be portrayed versus what’s real, what’s relative. I think what you brought up in this article that we’re going to talk about today and to everyone who’s listening in. The article that we’re specifically looking at is it’s published in world neurosurgery.

[00:03:53] We can give a link in the description of this podcast episode, but it’s Diversity in Neurosurgery: Trends in gender and racial/ethnic representation among applicants and residents from US neurological surgery residency programs. Jalen what should we really understand about this article? What is it about recognizing diversity in neurosurgery that you think people should really be taking away? 

[00:04:16] I want to hear from you. You’re the author here (among others). 

[00:04:19] So here’s the big picture: Our country is diversifying. The people who are seeking medical support from day to day is of course also diversifying. Don’t you think that the folks who are providing that care should also be diversifying, right? So we understand that the field of neurosurgery as a medical surgical specialty struggles with diversity.

[00:04:41]We know this from articles that have been written but we don’t really understand what’s happening on the opening end. And so when we think about, as folks come in and apply, the folks who get in and the folks who stick around long enough to become full-fledged doctors, as we might think about them, what’s happening in this pipeline?

[00:04:59] And so we really wanted to understand looking at: Are people applying? Are people getting in? What is it our residency consistency look like? And so that’s why we decided to focus in on this aspect. 

[00:05:11]There’ve been many studies highlighting the fact that a diverse workforce, especially within the medical field impacts the type of people that will come into an office, the type of folks who are seeking care and getting care and also how people feel when they come into an office. And so it’s really important for us to think about how to do diversity better and inclusion work in our medical fields and especially in neurosurgery. 

[00:05:39] Conrad Ruiz: [00:05:39] Okay. So there’s a lot to unpack here. I think one of the things that we’re trying to understand is:

[00:05:45] what are the results trying to tell us? What don’t we understand about this workflow that is ultimately revealing to us this sort of disconnect from the goals of meeting diversity and the reality? 

[00:05:58] So we clearly have an expectation. Diversity is making its way across the workforce, but what exactly is preventing us from meeting diversity goals inside of neurosurgery? 

[00:06:10] Jalen Alexander: [00:06:10] So that’s a really big question. And it’s one that we wanted to really open the conversation up to. And so one it’s about: let’s identify a problem and understand really the scope of it. And so what we were able to do is look at 10 years of data to understand over time, as we know the country’s diversifying, are the applications in our residency spots, really changing and shifting?

[00:06:34] And so we know that from what we looked up we are expanding the number of residency programs within neurosurgery and also, therefore, expanding the number of positions available. But as we looked across the decade, we found that not a lot is changing in terms of diversity for women, for black and Hispanic people, all of whom are historically underrepresented within the medical field and especially within neurosurgery.

[00:07:01] Conrad Ruiz: [00:07:01] Okay. And so without really getting a true understanding of the cause, we are at the very least able to say, “Hey, this is a problem.” and it was really interesting to notice that there was, so I’m highlighting this here from the abstract itself.

[00:07:15] So the percentage of black and Hispanic applicants decreased across the observed period, as you said, a decade, specifically 4% and 1% respectively. And so while black people represented 5.2% of the resident pool in 2009, this decreased at 4.95% by 2018. Whereas with Hispanic residents, they saw a less than 2% net increase in resident representation, but still fell behind when compared with census statistics.

[00:07:46] Jalen Alexander: [00:07:46] Yeah, so I can speak to that a little more. What we’re talking about here as a decade we’re obviously, as you think about the country at large the dynamics racially and also gender-wise in terms of diversifying of the workplaces is really changing. Why are we not seeing that reflected?

[00:08:02] And so to see a decrease of people… we have more spots available within neurosurgery programs. And we’re seeing a decrease in applicant representation for black and Hispanic folks who have been historically underrepresented. That’s a big question. How are we reaching out to these folks? How are we making sure that they feel welcomed into these programs? Who do they see when they look at our brochure as they think about their surgical specialties? 

[00:08:29]In my head, when I went into this work, I expected to see at least light increases in diversity across all of these areas and it was really disappointing to see that in some areas there was a decrease.

[00:08:40]And so people are being for whatever reason. discouraged* to pursue neurosurgery. And that’s really a shame because we need, as I mentioned before, more people who look like the people being served.

[00:08:53]Conrad Ruiz: [00:08:53] Is it a useful assumption to say that although the pool has increased, the respective statistic Minority and ethnic representation, it’s diminished –  does that somehow say more about the, in whatever context the pool increased, those increases seem to not proportionally affect those populations? Is that sort of a correct assumption? 

[00:09:20] That’s number one, number two: are we recognizing that existing efforts that were established for those statistics to exist as they were back in 2009 – are those somehow, have they somehow lost ground in the last decade? Is that another correctness of it is the combined efforts of these two assumptions. What we’re seeing in some context? 

[00:09:42] Jalen Alexander: [00:09:42] I think so. And as I talked with my writing partner Dr. Phabinly James Gabriel who is pursuing the world of neurosurgery as a resident at Rutgers sees this within his program.

[00:09:55]And saw this as he was going through med school that he didn’t see as a black man, many people who looked like him. He couldn’t name your top three programs that are there to support men of color or to support black men or black people in general within neurosurgery. So if you have someone who is doing well within that space and is unable to identify resources to support his existence with his intersections of identity, what does that say for other people who were younger in the journey? What does that say for people who are considering pursuing it and you can’t look around and see the supports that would be available? 

[00:10:31] Conrad Ruiz: [00:10:31] I think from that Jalen I want to segue into something: it sounds like we are from this article alone, we went from an unaware stage of what is the problem to we’re now aware of the problem. What’s the Well Aware takeaway?

[00:10:44]In that recognition alone, it sounds like we know that the vast majority of statistically underrepresented youth. Are unaware of these opportunities, and even those at the very top of this particular career path  – they are also unaware of the avenues that can take these youth into the same career path. 

[00:11:07] How do we become aware? How do we apply incentive or opportunity, or just more awareness to get to that next stage of actually moving the statistics back in the direction that we’re looking for? 

[00:11:21] Jalen Alexander: [00:11:21] That’s a really great question. I think it’s multifaceted. One is I think we have to start younger. We have to start talking to people about these opportunities earlier on. It comes from the images that we see on television, what we read in a book or a newspaper. We have to really show people that there are opportunities and there are black neurosurgeons out there.

[00:11:40] There are women out there who are really excelling as CEOs, as business leaders, those folks are out there. But they’re often not highlighted. They’re often not given the right credit until much later in life. And so how do we highlight those examples? And not just the exceptions, but people who are doing sort of the everyday things that keep our country running our world running.

[00:12:01] How do we highlight that for people much younger than when they’re trying to make this decision of what college to go to or what medical subspecialty to focus on? We really need to get people believing in the reality that you can get here one day and that these opportunities are open to you.

[00:12:19]Conrad Ruiz: [00:12:19] It feels like a very important game of marketing. 

[00:12:24] Oh, for sure. 

[00:12:26] Okay. Okay. Forgive me I’m just trying to take my time to think like what’s the route, what’s the path. So Jalen, if you had to make a pitch or say, “Hey folks, you should be more aware about this.” 

[00:12:38] What would it be in the context of this information?

[00:12:41]What should help push this agenda forward? 

[00:12:46] Jalen Alexander: [00:12:46] That’s a good question as well. All of your questions have been great. I think that one big thing that we’re pushing for is that we need more data collection around this stuff, and we need that to be more visible. We did some scouring to just find the information that we did.

[00:13:00]It should be easy to understand what at a country-wide scale – what does diversity looks like for our doctors, for our medical practitioners at all levels, right? 

[00:13:09] So how are we fairing? What my mind thought I would be seeing when I entered this study versus the reality of what we found.

[00:13:16] And so I think we really have to do that work of pushing people who are in charge to share the data. If we’re not doing the job that we should be doing around creating more inclusive workspaces, then that needs to be displaying and shown, and discussed. So we can think about how to move forward. So I think that’s a big push for me. 

[00:13:34] It shouldn’t be hard. And this shouldn’t be one of the first works on diversity in neurosurgery. This should have been maybe the 50th or something. Like we should not be in 2021, starting to lead this conversation around diversity within this field, we need to have these conversations much more often.

[00:13:51] And of course, connected to that is we need to see action. So what are people now that we become aware? What are we going to do about it? 

[00:14:01] Conrad Ruiz: [00:14:01] Let’s put that to the test. How should we support more data collection around this particular initiative? And in general, how are we supposed to – it’s a time-intensive task, right?

[00:14:10] You experienced it yourself – you scoured through data just to get to the awareness level that you are at now. How are we going to ease ourselves the time and task burden of data collection? So that more opportunities like this can be researched with less scouring. 

[00:14:27] Jalen Alexander: [00:14:27] So my data brain goes to thinking about what databases exist.

[00:14:31]And so rather than us having to put together a data set, what databases exists that easily display this information? We have this around census data, right? So you can look nationally and across states for information on race and other demographics. How do we make it easier and more accessible for people, so how can we push the American medical association?

[00:14:53] How can we make the data available? They have it. Make it available to the people so we can go in and draw our own conclusions about the trends that exist within these spaces. 

[00:15:05] So I think that we’ve seen a lot of great things happen in terms of data in the past year or so, especially in the past couple years.

[00:15:12] And so I definitely don’t want to harp on the fact that I, I think that within the world of medicine we’ve been doing, I think the CDC, for example, has been doing a really great job of trying to help us learn over time from data. And I think, you know, one thing you –

[00:15:25] Conrad Ruiz: [00:15:25] have quite the incentive this year! 

[00:15:29] Jalen Alexander: [00:15:29] For sure. But I think one thing that we can learn from the CDC is that the story may shift over time. And so as we do more studies as the years progress, the story is going to change. 

[00:15:42] And so how do we keep people updated and informed? I think that you know, this model of producing sort of peer review is a bit archaic. Not a lot of people have access to the information. 

[00:15:52] I’m happy to have this sort of form where I can talk to you about it and we can share it with the world. But I think it’s uncommon – most people who are publishing in journals like this are not then going on a press tour and talking about it in smaller groups of people.

[00:16:07] And so how do even doctors who were individually involved, how do you push people to get into the community to share these results, like actually connect with people rather than these folks who are at the top, just talking to each other. 

[00:16:20]My sort of hope as I do this research and other research is that it’s always connecting back to people and making it make sense for the reader. And so that’s really important to me. 

[00:16:31] And I think that’s a charge that the American Medical Association can do the work of connecting with the people and make that a part of their duty. 

[00:16:40]Conrad Ruiz: [00:16:40] I love that.

[00:16:40] I feel like you’re sort of getting the first part of the bridge built and you’re saying, “Hey, recognize that so that you can start to build the second half.” And that way we can form this, this connection of going from being unaware to aware, and then from aware to taking action and performing on what needs to be done because when we look at the data, yeah, the truth is inconvenient. 

[00:17:04] So let’s make it better. 

[00:17:07]Jalen Alexander: [00:17:07] To be transparent, the benefit for me being someone who comes in to analyze data and help tell a story is that I’m not in the neurosurgical field. So I don’t have to then be the person to recommend the shakeup of “Oh wow, we haven’t made much progress over the past decade.”, but I think it’s important for me again, to help people tell that story so that people who are coming into the field are able to understand what the landscape is. 

[00:17:32] And they’re able to say, “look, there’s data backing this up.”

[00:17:35] “There are stories being told that it’s not just me feeling unsupported. We’re largely unsupported. So I hope that for folks who are entering the field of neurosurgery or whatever medical specialty, that they can have another support story in their head of “It’s not just me, this is tough for us to go through cause we don’t have these built-in supports.” 

[00:17:58]Conrad Ruiz: [00:17:58] I think to your point, if it’s not, so isolatory, if you can kind of rally the underrepresented groups and show them from a statistics standpoint there’s a lot to be done…

[00:18:08]Maybe that’s a cool battle flag to rally everyone around? Almost like when you get to whatever stage you’re in, here’s the percentages of where you stand amongst peers from your background, from your perspectives, from your history. And, here’s where you’re standing ground and treading and creating a new path. Here’s where we need your help to blaze the trail further. As that would allow more folks to recognize where your footsteps can lead to more promising ones for theirs… 

[00:18:33] Jalen what are you working on right now? What’s sort of the next thing on your plate? What are we going to hear from you a couple months from this time? What’s going on in your world today?

[00:18:43] Jalen Alexander: [00:18:43] Yeah. What did Drake say? What’s next, right?

[00:18:46] You know, I’m thinking about what’s next. Dr. Phabinly James Gabriel wants to do more papers on this topic. He’s going to be in the neurosurgical field for quite a while. And so I think we want to keep digging into this and keep having conversations about it.

[00:18:59]We’re trying to unionize my workplace in my professional world. And I think about what’s the next story that needs to be told? And so, as I think about sort of my data path, which is sort of just on the side of my full-time job, I think about what stories are waiting to be told.

[00:19:15] And is there a way in which data can help us do that? And so wherever life takes me on, on telling that next story, I’m definitely open to that and thinking about it.

[00:19:26] Conrad Ruiz: [00:19:26] All right. Everyone, Jalen Alexander. Thank you so much for the time. 

[00:19:31] Jalen Alexander: [00:19:31] And may I say that you can find the full article on Science Direct. Diversity in Neurosurgery. You can also find me on LinkedIn, Jalen. Jalen Alexander. And you can find the links to my links directly to the full article on my IG and Twitter.

[00:19:49] Both places there I’m Jalen2kool. That’s Jalen2kool. 

[00:19:56] Do you mind if I, I take all those resources and put them someplace wherever I can find them? 

[00:20:00] Oh, of course, absolutely. 

[00:20:02] Conrad Ruiz: [00:20:02] Okay.


Time is your ultimate currency. Make more of it.

Book a one hour free consult on how you can improve on your time.

Other Recent Posts

Pin It on Pinterest

Share This