Making Music, not Muzak: Reflections on Affirmative Action

From left: Yeon Woo Lee, MD; Victoria Wang, MD; Kenneth H. Kim, MD, FACOG; and Michelle J. Wang, MD

Mitsuye Yamada, a Japanese American poet, essayist, and feminist activist, once poignantly described the experience of being an Asian American woman: to others, as Asian American women, we “remain in the background and we are heard but not really listened to. Like Muzak, they think we are piped into the airwaves by someone else.”

Three years ago, at the height of the COVID-19 pandemic, with the rising incidence of hate crimes and discrimination perpetrated against Asian and Asian American (AAPI) people and health care workers across the country, we indeed felt invisible and voiceless. As Asian American trainees in medicine, we felt furious, scared, and alone, reeling from the deafening silence from our friends, mentors, and institutions. But through the random serendipity of residency scheduling during this period, we found each other and also found a joint mentor, Kenneth H. Kim, MD, FACOG, who has embodied the spirit of “lift as you climb.” As a collective, we found in ourselves the strength to pipe our own voices into the “airwaves.” We even composed new original songs in the form of a coauthored personal perspectives piece for Obstetrics & Gynecology and a joint MedTalk on AAPI history, data equity, and cultural concordance at this year’s ACOG Annual Clinical & Scientific Meeting.

In the short amount of time that has passed since we first met, however, much has changed in our country and in the world. Notably, we were deeply disheartened to witness the repeal of critically important affirmative action policies last summer. We are Asian American obstetrician–gynecologists who have benefited greatly from affirmative action policies. We are calling upon our colleagues in the medical community to take action on the issue of diversity and inclusion.

We must remember that the practice of medicine operates within a larger societal context. The continual political weaponization of the model minority myth renders the experiences of less socioeconomically advantaged AAPI populations invisible, while also eliminating paths of advancement for other marginalized communities. Within our field, women of color are disproportionately affected by perinatal, gynecologic, and gynecologic cancer-related morbidity and mortality. The repeal of affirmative action will decrease the already small but instrumental pool of health care professionals who share cultural concordance with more medically vulnerable populations. Existing disparities in outcomes and quality of care will continue to widen, which will certainly have direct and deleterious effects on the patients we serve. 

Race is but one of many identities that shape a person’s lived experience. The use of holistic application review processes allows institutions of higher learning to account for the social context from which each individual comes. It is thus imperative now that without affirmative action, which served as a legal framework for the promotion and protection of racial diversity in higher education, we as health care professionals and leaders loudly advocate for more pathways and programs for underrepresented groups so that our students, patients, colleagues, and communities might also hear the chorus of our collective voices and push for change. 

So, what are you waiting for? Let’s get out there and make some music. 

Michelle Joy Wang, MD, is a first-year maternal–fetal medicine and genetics fellow at Beth Israel Deaconess Medical Center in Boston, Massachusetts. She is passionate about using research and advocacy to raise up the voices of the underserved and lift others with her as she climbs in all the work she does. 

Victoria Wang, MD, is a second-year gynecologic oncology fellow at Brigham and Women’s Hospital in Boston, Massachusetts. Her interests include studying barriers to health care access, patient education, and community advocacy. 

Yeon Woo Lee, MD, is a first-year gynecologic oncology fellow at UC San Francisco in San Francisco, California. Her interests include surgical and educational mentorship, health disparities in cancer care, and advocating for humanism and cultural humility in the provision of obstetric and gynecologic care. 

Kenneth H. Kim, MD, FACOG, is the director of gynecologic oncology at Cedars-Sinai Medical Center in West Hollywood, California. He has served as a mentor for many over the years, providing advice, moral support, unrelenting sponsorship, tennis and golf lessons, food and travel guides, various personalized swag, and innumerable lunches, dinners, and happy hours. 

Disclaimer: The thoughts and opinions in the Frontline Voices initiative reflect experiences of individual ACOG members and do not represent official organizational opinions of ACOG.