Asian Americans in Medicine: The Race That Nobody Sees

The son of a physician, I was born and raised in Greenville, Texas. My parents are immigrants from Thailand and ethnically Chinese. We were the first Asian family in town. I proudly call myself Texan-Thai-Chinese (in that order). While growing up, I was the target of racial slurs. I remember waiting in the lunch line in fifth grade when another student asked me, "Do you know kung fu? Do you know Bruce Lee?" When I was in high school, a new girl had moved into town. Immediately after we first met, she blurted out with a fake Japanese accent, "Ohhh, sexy girlfriend," quoting the character Long Duk Dong from the 1984 movie Sixteen Candles. Such ignorant remarks stung with a realization: I was a foreigner in my own hometown. Ignoring little comments becomes difficult because these racial slurs build up over time. I learned that I was different from everyone else and didn't fit in.

The purpose of telling my story is to begin a conversation about how Asian Americans are invisible in medicine. One may balk at such a charge—aren't Asian Americans disproportionately overrepresented in medicine already? Asians comprise 5.6% of the US population yet make up 20% of all US medical school graduates, according to the Association of American Medical Colleges (AAMC) data. Or, one may point out that Asian Americans have been in the cultural spotlight. In the US, since the beginning of the COVID-19 pandemic in March 2020, Asian Americans have persistently been targets of racial discrimination and racially motivated violence, most recently in the shooting deaths of multiple women in Atlanta. But the very fact that racially motivated killings are required to thrust Asian Americans into the spotlight about race issues shows their invisibility. Since this racial group is neither White nor Black, they are invisible and irrelevant to race issues in America. Despite the overrepresentation of Asian Americans in medicine, to my knowledge, there is nothing published about the Asian American physician experience in the medical literature. I hope to remedy this massive lacuna by sharing my experience as an Asian American physician.

Feeling like a foreigner was not confined to my hometown—I also felt like a foreigner in my own skin. As a second-generation Asian American, I feel my identity is split between two cultures to which I don't fully belong. The racial slurs affirmed that I was different than everyone else because I looked foreign. When I visit my extended family in Thailand, everyone looked like me, but I didn't feel like I fit in because I couldn't speak the Thai language. If my body was not American enough, and my culture was not Asian enough, then what was I?

I did well in school. I internalized my parents' expectations: with academic success you can live a good life. When I was growing up, my parents identified three viable career options: medicine, law, or engineering. No other possibilities entered my imagination. If you go to an elite school and get a good job, then you can provide for your family, so the cultural logic goes. Following my father's example, I wanted to become a physician. I dreamed of going to an Ivy League caliber school, having internalized the dream from my parents who equated success with the Ivy League. If I couldn't be a full Asian culturally or a full American bodily, then my identity would be rooted in academic success. Those dreams died when I was rejected by all of the Ivy League caliber schools. Since I didn't meet the internalized family expectations nor the standards of my own self-identification, I felt like a failure and was ashamed.

One might think that becoming a physician alleviates Asian American racial dynamics, but the culture of medicine is not immune to microaggressions. As a medical student, I enjoyed rotating at the VA hospital because of the veteran population. However, immediately after I walked into a patient's room, a veteran told me, "Go away. I don't want a Jap doctor...