UC Press Blog

Little has been written about Latina/o physicians as students, people, or workers in a high-skill occupation in the United States. The Weight of the White Coat traces the life stages that Latina/o physicians follow and the social mechanisms that shape their careers, from the role of the family to different educational trajectories and even the practice of medicine.

Glenda M. Flores turns a careful eye to this diverse pan-ethnic group in an elite profession, observing how demographic characteristics such as gender and ethnicity act like cumulative weights in their coat pockets, producing hindrances for some and elevating others as they provide care in poor and wealthy communities. Here, the high occupational status of Latina/o doctors offers a unique lens for examining the varied experiences of physicianhood and the still unsettled contours of Latinidad.

Glenda M. Flores is Associate Professor of Chicano/Latino Studies at the University of California, Irvine. She is the author of Latina Teachers: Creating Careers and Guarding Culture.

When and why did you develop such an interest in the lives of Latina/o physicians?

The seed was planted early on in my academic trajectory. I’ve always been interested in gender and work. At one point, I contemplated doing a comparative study of college-educated Latinas working in one masculinized and one feminized career. One group would have consisted of Latina doctors, an occupation that is mostly male. The other was going to be Latina elementary school teachers because that is the top feminized white-collar career that college-educated Latinas enter. I ended up writing a book that solely focused on the lives of Latina teachers, but the thought of investigating the lives of men and women in medicine was always in the back of my mind, especially as I interviewed the teachers. Many of the Latina teachers I spoke with had degrees in STEM fields such as biology, computer science, and mathematics. Some of them had aspired to become doctors, but financial constraints, among other factors, steered them in a different direction. What was the difference for those who made it into medicine? That’s what I wanted to investigate.

I also became more determined to write this book when I served as the Director of Undergraduate Studies for my department. In this role, I came across several first-generation college-going undergraduate students who were biology majors aspiring to become physicians. Time and time again, the message they received was that medical school was competitive, and they would never get in if they did not perform exceptionally well all of the time. Some of them were crestfallen when they received a grade they did not anticipate and had to switch out of the biology major. These students felt that their dreams of becoming doctors had ended. Through the interviews with current Latina/o physicians, I found that for some, this was only the beginning of the journey.

Your book, The Weight of the White Coat, follows various people at different points in their medical career trajectory. What were your methods in engaging them and getting them to trust you?

The very first question I asked the doctors who agreed to participate in the interview elicited a wave of emotions in them. Some of them cried. Telling the story of their medical journey made them reflect on their own immigrant parents’ experiences with health providers. Some of them had served as intermediaries between their parents and the doctor. This interpretation work was a heavy task to undertake as a child. Others were eager to share their stories. They wanted to provide a roadmap for students who wanted to follow in their footsteps. 

What helped me the most during the interview process was conveying to physicians that I was aware of the internal diversity within the Latina/o population, especially concerning ethnic background. They wanted to know that I wasn’t lumping all of their experiences together into one. This helped me build rapport and trust with their personal stories. It also made physicians more willing to share the personal experiences that they felt stood out to them with professors and mentors, medical school peers, and in their families of origin. 

In the current year we are in, what overarching challenges do Latina/o physicians face?

Today, about 6% of physicians in the U.S. are of Latina/o heritage, and the vast majority are concentrated in California, Texas, and Florida. In my book, I center the experiences of Latina/o doctors who were fully licensed and practiced in California, the state with the most active physicians. Most of the doctors I interviewed were trained in U.S. medical schools, and a far smaller number were trained in medical schools in Latin America and migrated as adults. The former accumulated astronomical student loans, and the latter arrived with visas that are usually reserved for the highly skilled. If I had interviewed doctors in places like Miami, Florida, I would have come across a larger number of Latina/o doctors who had attended medical school in Latin America. 

In the current year, I suspect that the cost of higher education will only mushroom, making debt accumulation a bigger hurdle. I also think that our changing immigration policies might reduce the possibilities for physicians trained in other countries to practice in the U.S. In the book, I also suggest that multilingual physicians are needed to provide care to patients whose primary language might not be English. The recent executive order designating English the official language of the United States makes me think about the implications for patients who speak other languages, and how their care will be impacted. 

In a time in the US when there is so much unfair upheaval and uncertainty surrounding the Latina/o population, is there something in the book or in the process of writing it that gives you greater hope for the community?

I enjoyed the process of writing Chapter 7 of the book because the focus is on patient-provider interactions. In the interviews, several bilingual physicians noted that predominantly Spanish-speaking patients would breathe a sigh of relief when they realized their provider was bilingual. Through the observations in the examination rooms, I was able to see this dynamic firsthand. I am extremely grateful to both doctors and patients who allowed me in these sensitive spaces because the result is a vibrant chapter that allowed me to center the patient, how they describe and talk about their health ailments, and how their providers respond to them and provide care. The chapter provides a window into what patients desire in their providers and how doctors are answering that call in culturally sensitive ways daily. 

As a FirstGen scholar yourself, did any of the subjects you portray in your book also identify as FirstGen? Broadly speaking, what can any FirstGen student wanting to be a physician take away from this book?

Yes. Over half of the Latina/o doctors in my sample were the first in their families to go to college, and several were the first doctor in their immediate family. Any first-generation college student interested in pursuing medicine must read the “Circuitous Pathways” chapter. Most first-generation college-going doctors described feeling incredibly “lost” about the pathway to medicine. The chapter demonstrates the hurdles they faced in their undergraduate careers, and as they made their way to medical school, but also shows how they overcame those obstacles.

The U.S. needs more doctors in all areas of medicine, from family medicine to surgery. I hope that any FirstGen student who reads this book walks away feeling reassured in their experiences, skillset, and what they bring to the table. And, if they are aspiring to become surgeons, what they bring to the operating table.