25 Years of Progress and Momentum Continues

Feb. 1, 2024

By Tochi Iroku-Malize, M.D., M.P.H., M.B.A., FAAFP
AAFP Board Chair

When did I know I wanted to be a doctor? When a teacher told me I couldn’t.

I was in grade school. We had just moved from Brooklyn to the New Jersey suburbs and I was the only Black child in my class.

One day, we were asked to fill out a form asking what we wanted to be as adults. My classmates and teacher didn’t know that my parents were a surgeon and nurse-midwife. Besides, I was a self-starter, a go-getter. Becoming a doctor seemed second nature. So, naturally, I wrote “doctor” for my career and turned the form in.

A week later, when we received our forms back, mine said “secretary.” I raised my hand and told the teacher (white, male) that there must have been a mistake. The teacher gave me a patronizing little smile and said that no, it wasn’t a mistake; I couldn’t be a doctor, but maybe, one day, if I studied and worked really hard, I could be a secretary in a doctor’s office.

When I went home that day, I told my mom what happened. Obscenity laws prevent me from repeating everything she said here, but I will say that it included the wise advice, “You can be anything you want to be. Don’t you ever let anyone tell you what you can or cannot be.”

So I became a doctor. We moved to Nigeria when I was 15, where I attended and graduated from the University of Nigeria College of Medicine and Dentistry. Upon my return to the U.S., I completed my family medicine residency in New York and have since added board certifications in hospice and palliative medicine, as well as obesity medicine. I have also tacked on a few initials (M.P.H., M.B.A., FAAFP, S.F.H.M., FAAHPM) for good measure.

A few decades after my grade-school teacher told me I’d make a great secretary, I had a conversation with my daughter, then 17 and getting ready to start college. In high school, her adviser recommended that she only apply to a few colleges that matched her “skill set.” I told her to apply to other schools — top-rated schools — because I knew what she was capable of. And I told her basically the same thing my mother told me all those years ago.

“Don’t let anyone define you,” I said. “You can be anything you want to be.”

And now here we are. My daughter is a few months from graduating from the NYU Stern School of Business, one of the highest-ranked business schools in the country, as a double major in business and marketing. She’s learned new skills through various internships and is looking to spread her wings.

I wouldn’t let that teacher define me, and I wouldn’t let that adviser define my daughter.

Much has changed since I was a little girl in the 1970s. And yet I know from my daughter’s experience that our work is not finished.

I sometimes think about that when I look back on my time with the Academy. I have been a proud member of the AAFP since 1999. That’s right: 25 years! Where has the time gone?

I am grateful to Richard Bonanno, M.D., my residency program director at Southside Hospital (now South Shore University Hospital), for introducing me to the Academy when I was starting out. Without him, I don’t know that I would have joined the New York State AFP, much less take on leadership roles within the AAFP. I don’t know that I’d be the family physician leader I am today.

I mention him every time I speak of my journey with the AAFP, even though I know he likes to stay under the radar. And I smile when I think of the progress we have made as a professional organization.

When I joined in 1999, the AAFP had exactly one woman on its Board of Directors. Today, we have one of the most diverse boards in the Academy’s history.

When I joined, no Black person had ever served as the AAFP’s president. Then came Warren Jones — and a few years later, Gary LeRoy and Ada Stewart.

When I joined, the Academy held an annual National Conference of Special Constituencies, which was comprised primarily of women, minorities and new physicians. Today, NCSC is known as the National Conference of Constituency Leaders, and it’s one of the largest and fastest-growing events the AAFP offers.

When I joined, National Minority Health Month as we know it didn’t exist. Now, the Academy officially recognizes the month as “an opportunity to promote improved health in minority populations and to promote interest in family medicine.” We have recognized Minority Health Month every year since 2018 and we make concentrated efforts to celebrate other patient populations each year.

And the work continues.

Today, 23 AAFP member interest groups give family physicians opportunities to connect and share common interests. With MIGs on topics like global health, lifestyle medicine and reproductive health care, every member can find a place to make themselves heard and appreciated.

Each month, the Academy produces new educational activities, journal articles, practice management resources and patient-facing materials to ensure our members have the latest information and clinical updates.

Our ongoing advocacy efforts have delivered several wins for the specialty. We work with members of Congress regularly, explaining the benefits of family medicine and the role of family physicians in serving on the front lines of care in the United States.

The AAFP’s Center for Diversity and Health Equity (and its signature program, The EveryONE Project) are going strong, providing members with toolkits, guidance documents and other resources to help them address health inequities and provide optimal care.

And our Commission on Diversity, Equity and Inclusion in Family Medicine, established in 2022, makes sure the Academy considers disparities in care, health and the family physician workforce in all its work.

This year, the theme for Black History Month is African Americans and the Arts. Make no mistake: medicine, though a science, is also an art. The art of family medicine requires fine-tuning our communication skills with patients, educating students and residents, and taking on complex topics and making them easily understandable. Let’s continue to practice this art to the best of our ability!

As we move forward, let us also remember to be true to ourselves, respect and appreciate others who may differ from us in experiences, and create opportunities that are safe spaces for open dialogue and discussion.

The last 25 years have been quite a ride for me and for the AAFP. I can’t wait to see what happens next.