What it’s Like to Be a Black Female Doctor in Canada

From downplaying what she calls her “stereotypical disadvantaged upbringing” and perpetuating her own tokenism to fit in, to finally embracing her natural hair at the end of medical school, Dr. Teela Johnson’s impressive credentials come with a powerful backstory.

It’s one of incredible resilience and an unwavering work ethic.

As a Black female, Dr. Johnson – a Toronto-based hospitalist and emergency physician – is now helping to change the face of Canadian doctors in a historically white, male-dominated space.

We caught up with Dr. Johnson to hear more about her journey.

Have you always wanted to be a doctor?

Actually no. From a young age, I always gravitated towards science; one, because I liked it and two, because I understood that I needed a clear-cut and stable career in order to support myself. When it came time for university, I got a BSc in biology and then an MSc in pharmaceutical science, both from University of Toronto. It was during my masters that I decided to apply to medical school, but I had never thought seriously about medicine until then.  I arrived at my career in science and sort of felt that something was still missing – more of a human element – so I applied.  I applied to several schools in Canada, and got an interview at only one school, Queen’s University – but one is all it takes.  I am now a proud Queen’s grad!  At the time, the Queen’s admission criteria had a higher cutoff for the MCAT verbal reasoning and interview portion of the algorithm, which I think really worked in my favour.

What struggles did you face in your pursuit of a career in medicine?

My struggles were related to my family life. I grew up in Toronto with primarily my mom, and I was helping out financially. For this reason, we were still living together when I got into medical school, even though I was in my mid 20s and was in a serious relationship. The prospect of leaving her in the lurch (so to speak) to go off to medical school gave me pause. It was actually one of the reasons why I went to University of Toronto for my undergrad; I had wanted to go to McGill and see what life in Montreal would be like, but felt that my mom needed me, so I stayed in Toronto.  This time around however, my mom insisted that I go and reassured me that she would be fine. In the end, she actually ended up moving to a cheaper city after I left for Kingston. It was a real relief for me to know she was ok.  In her new city, she found a better job, and for the first time found a real sense of community – one of her new friends even taught her to drive a car!

The other struggle was financial. I am the only doctor in my family, and I grew up with minimal financial support from my parents, although I know my mom did the very best she could with minimal resources. In fact, I got a job at age 14 while in high school, to be able to help buy food and cover other expenses. I had a job all throughout high school, university, and grad school.  I often had multiple jobs and also had to get the grades to be able to get into grad school and medical school, and find time to pad my resume with things like volunteer work.  More financially fortunate students would have had a huge leg up on me in that department just from having sheer time to devote to volunteering and charity work.  

I knew when I applied that I couldn’t expect any financial help from my parents to defray the huge costs associated with medical school, and would need to get a bank loan to cover everything. After four years of medical school and four years of residency, I was over $200k in debt.  Needless to say, it’s a staggering amount of money to owe at the start of your career when you are already mid thirties and also need to save for retirement and try to start a family, etc.  

Several of our rotations were far flung rural, where for eight weeks we would be somewhere that couldn’t be readily accessed with public transportation, and I would need access to a car to get around. I didn’t have access to a car, or enough money to rent a car, and was feeling slightly panicky about the news of these rotations. I mentioned my concern to one of my classmates, and he glibly suggested I just “buy a car” to use. It was a very straightforward issue for him, but for me buying a car to use for a 60-day rotation just wasn’t an option. (In the end, I got around the car issue by choosing a rural location that was so remote that you had to fly in.)

Did you experience racism in medical school? 

My only recollection of overt racial discrimination in medical school was when a local Kingston man walked by me on the sidewalk and called me the n word –straight out of the blue.  I was taken by surprise, but not totally shocked, as several other POC at Queen’s had mentioned that, in their experience, Kingston has a low-key problem with racism. For a period while I was there the hastag #Queenssowhite was a central topic of discussion.

Overall, I felt accepted by the medical establishment at Queen’s. Throughout my life, I’ve always been a token, “exceptional” and “articulate” Black person among White people; I grew up in white spaces, and honestly took on that role without ever interrogating it until the end of medical school. I naturally would do things to ensure that I came across as palatable and “normal,” and I was often hyper aware of being different. I had a stereotypical disadvantaged upbringing that I tried to downplay, and threw myself into fitting in.  Of course, my hair was always styled pin-straight, and some of my friends would joke that my interest in yoga, environmentalism, and music festivals made me “whiter than them” (sidebar: I would always laugh when jokes like this were made).  So, I honestly was not aware of anything overt, and really participated in my own tokenism until close to the end of medical school when I stopped straightening my hair.

Whenever I had to go out to a small centre to do a rotation, I always felt a familiar frisson of trepidation – will there be any overt racists? Will I be profiled? Will I be accepted? Thankfully, I never experienced any of that, and I felt accepted in the small towns I worked in.

Were there many other POC in your program? 

My medical school class at Queen’s had 3 per cent Black students, there were three of us out of a class of 100. The year above us had one and I think the year below had one too.  I will say that our medical classes, while low on Black students, were otherwise fairly diverse.  My residency and fellowship programs in Toronto were very diverse with 50 per cent POC being typical.

Have you experienced racial discrimination or systemic racism during your career as a doctor?

The only time in medicine that I recall wondering if my race played a role was with a female preceptor in Toronto when I was an intern.  She immediately didn’t seem to like me and told my program director that I was hostile. It was a ludicrous claim! I was so shocked and embarrassed. Thankfully my program director was not impressed and in the end, this preceptor apologized to me.  I’ve always wondered if her perception of me as hostile was due to her own biases about Black people (we are often stereotyped as angry), but there’s no way to know.  

There was (and is) always sexism colouring my experience, where I sometimes get the feeling that patients and male colleagues don’t take me seriously because I am an approachable and young appearing woman. I’ve had patients I’ve been with in the ER for hours, tell me that I’m very nice but that they are upset they never saw a doctor during their visit, even though my badge says Doctor on it and I always introduce myself as the doctor. I find that patients also often ask me my age. Or if I’m married. Or where I live. Or where I went to school, etc. etc.  I feel that as a female physician, I am expected to field more personal questions than male physicians are.  I also feel that I need to justify my medical reasoning and repeat myself more than I saw my male receptors having to do when I was a trainee. I have attributed these observations to sexism, but it is possible that my intersection of race and gender are both at play.  Even among colleagues, even though I am a fellowship trained with an academic appointment, I often feel that my voice isn’t heard and that others speak over me.  And I’ll be honest, I don’t think of myself as a particularly quiet person. So it can be demoralizing at times for sure.  

When you meet people, are they surprised to learn that you’re a doctor? 

People are constantly surprised to learn I am a doctor.  Many people have told me that I don’t look like a doctor. In a way, this reminds me that I am an outsider and that I have to be twice as good to get half as far, and constantly prove myself. But in another way, I take it as a compliment and a reminder that I am helping to change the face of Canadian doctors.  

Sometimes people will even speak ill of doctors around me, never thinking I might be one. That’s always a tough one to navigate. Medicine has been complicit in perpetuating systemic racism, and many heinous acts have been done in the name of medicine historically. So I get why some people don’t trust the establishment. That being said, I have sacrificed so much personally to have the privilege of doing this job and serving my community, and it hurts to hear people think that doctors are just Big Pharma shills or out here scamming OHIP.  Every doctor I know, including myself, shoulders this responsibility with integrity and drive to do the absolute best for patients.

What do you wish you could say to those who have displayed racist behaviour toward you? 

I would like to see white allies speak to them, rather than me.  I think that is the most powerful way to eliminate racism.  Blacks have been speaking on racism for centuries, and it’s still here seemingly just as deadly as ever.  What we need are white people to speak to their family and friends and let them know that racist comments and actions are immoral and won’t be tolerated.

How would you like to see things changed/improved for Black Canadian doctors? 

The best thing would be to see more of us!  We need more Black students getting a chance to get into medical school. My socioeconomic status was a barrier to me getting in. I was lucky to be able to surmount it, thanks to my mom’s excellent parenting.  I was privileged to have a devoted and diligent parent who taught me to be resilient and resolute. But the fact is, I faced more barriers to entry that most, if not all, of my classmates. I can only imagine that there are many other Blacks like me out there, who start off with a disadvantage. If your family wealth enables you to live in a safer neighbourhood, that’s a leg up.  And if you can focus on school and not worry about paying bills, that’s another leg up.

Just because you come from humble beginnings, doesn’t mean you won’t be a great doctor, and in fact, I think my life experience has enabled me to understand and connect better with my patients. We need to see and acknowledge this and then make policies that address these gaps.  It all starts with the admission system. Maybe weigh work experience higher than volunteer experience on applications, etc.  Or allow an extra essay that describes social/financial/cultural/physical hardship if volunteer work or some other element of the application is missing.  This will level the playing field not only for Black medical students but also for any who start off with a disadvantage.

Do you have any advice to up-and-coming Black doctors? 

Seek out Black preceptors to help advocate for and support you. I didn’t know that when I was a medical student, but I think it would’ve helped.  Practical tips from someone who’s gone before you can be invaluable. Resist trying to shrink yourself to make others comfortable. Be proud of who you are and the experiences that made you who you are.  Be resolute and be resilient.  It’s a long, hard road.  But you will make it!