Who: Dr. Robert L. Johnson, dean of Rutgers University’s New Jersey Medical School in Newark and interim dean of its Robert Wood Johnson Medical School in New Brunswick. (He is not related to the school’s namesake.)
Hometown: Orange, NJ
What makes him unique: At age 72, Johnson is the only dean in the history of the United States to oversee two medical schools at once, according to the American Association of Medical Colleges. He is also one of only a handful of African American deans in a profession that is markedly lacking in diversity among its leaders.
Recent AAMC data shows an increase in the number of nonwhite medical students over recent years, following changes in the accreditation process designed to increase diversity at medical schools nationwide. Between 2002 and 2017 white students went from nearly 68% to barely 59% of the student body, while African American enrollment grew from 6.8% to 7.3%.
But it remains hard for medical students of color to find role models who look like them in college, according to a 2019 AAMC faculty survey. Of the more than 179,200 professors, associate and assistant professors and instructors at participating colleges, only 3.6% were black. Among full professors, African Americans comprise less than 2% of the workforce. In general, blacks make up 14% of the U.S. population, but only 4% of its doctors.
“I fully understand that, in my presence, I represent the two schools; but I also represent my race,” Johnson said. “In a lot of the places where I work, I am often the only black person in the room.”
Growing up in South Carolina: Being the sole African American is not unfamiliar to Johnson, who was born in South Carolina but moved to White Plains, New York when he was 9 years old.
“One of the things that was unique about that was that I was usually the only black student in those classes, in high school,” Johnson explained during an interview with NJ Spotlight last week. When he attended undergraduate college at Alfred University in rural western New York State, “I was the only black person in the whole county at the time,” he added.
Despite this lack of diversity, Johnson did well at Alfred, both academically and socially. “I don’t recall it being a major strain. I had a lot of friends, I was involved in a lot of organizations,” including the Latin Club and as president of his fraternity. “I was not isolated because of race.”
His experience as an undergraduate was also shaped by activist politics, at first as a Republican and later as a Democrat. (“The Republican party was really different then,” he said, laughing.) He helped organize migrant laborers on upstate farms and became involved in the peace movement.
Johnson traces his decision to become a doctor to an announcement he made at age 10, during a youth program at his family’s church. Other than an aunt who was a nurse, there were no medical professionals in his family, so he’s not sure how he got this idea. “I was always interested in science and it sort of took off from there,” he said.
Medical school in Garden State: Johnson graduated from Alfred in 1968. He applied to several medical schools, including the precursor to the New Jersey Medical School, the College of Medicine and Dentistry of New Jersey; the school was then in Jersey City before moving to Newark. “That was the school that gave me the most money, as far as scholarships. That’s how I got to New Jersey; that’s where I met my wife,” he said.
Among 72 medical students entering the college, Johnson found himself in a familiar situation. “I was the only black student in my class,” he recalled. “There had been some other black students in the school before me, not a lot, but some. But there were only four women too.”
Once again, Johnson was able to find his niche. Newark was still shaken from the 1967 riots, alternatively called a rebellion, which left 26 people dead and hundreds injured and had been prompted in large part by the government’s condemnation of housing to make way for new medical and education facilities. Johnson joined with fellow medical students to form a free student-run clinic for Newark residents who had no access to health care.
“Funny thing is, in looking back, I don’t think about it as something other than just being as natural as breathing,” Johnson recalled. “It’s something you just did. The New Jersey Medical School has always been that way. Students have always been dedicated to community, dedicated to recognizing issues and helping (patients) and that’s true today with all of our students as well. It’s an important thing.”
Finding focus: Graduating from medical school in 1972, Johnson got married and began the next step of his professional training as in intern, then later a resident, at Martland Hospital in Newark, which would later become University Hospital. He then spent two years as a research fellow at New York University’s Bellevue Medical Center, in Manhattan.
It was during these early years that Johnson discovered his love for treating children and focused on pediatrics, at first. But he also recognized a gap in adolescent care and began to zero in on that age group, a new specialty in those days.
His passion and professional choices led Johnson to collaborate with a group of doctors to launch a free health clinic for young people in New York City, a program that continues today as The Door. Johnson remains on the board and still sees patients there every week.
Through this work, Johnson became more aware of the social and environmental factors impacting the health of the adolescent and young adults he was treating, including poverty and substance abuse. He eventually became an expert in teen pregnancy, the challenges facing gay youth, and the emergence of a new disease that would come to be known as AIDS. His knowledge of these little-understood areas led him to be appointed to many state, regional and national panels seeking to improve outcomes for at-risk groups.
“It’s really amazing too that we’ve gone from something that is totally hopeless to something that’s just, you know, you shrug your shoulders,” Johnson said of the medical response to the AIDS epidemic. Once it was considered a death sentence; now patients can live full lives with the disease. “It’s amazing to see what science can really do.”
Johnson said he has long recognized the connection between social determinants — like poverty and race — and health outcomes, and is glad these factors are now gaining more widespread attention. “I think the thing that’s different now is we actually have a name for it,” he said of these social determinants of health.
“We also have very importantly discovered that there is a dollar value to social determinants; and so if you’re actually going to decrease expenditures in health care, you have to do more than just give out medications,” Johnson continued. “You have to address some of the social determinants. If you don’t, you’re not going to get outcomes that save money.”
The same calculations need to be made when it comes to racism, Johnson said, and the role discrimination plays in medical care. We need to understand “that society in general loses a great deal by having a segment of society that has poor health outcomes. It costs money for everyone,” he said.
Rising through the ranks: In 1976, the chair of the pediatric department at Martland Hospital in Newark lured Johnson back to launch its first adolescent health program; he remained there for nearly 30 years, as the hospital evolved and was eventually aligned with the former University of Medicine and Dentistry of New Jersey, which would replace the medical school he attended.
Johnson also continued on the academic track, as an associate and later full professor at UMDNJ — where he was named vice chair of the department in 1996, interim chair in 2001, and chairman three years later — and eventually at Rutgers University’s Robert Wood Johnson Medical School as well. In 2005, he became interim dean at UMDNJ and in 2011 he was named the school’s dean.
In 2013 the state reformed its medical education system, eliminating the UMDNJ system and combining both Newark’s New Jersey Medical School and Robert Wood Johnson Medical School in New Brunswick under a newly created Rutgers Biomedical and Health Sciences program, along with a half-dozen other health related professional programs. Johnson remained as dean of the Newark medical school and, in January 2019, he was also named interim dean of the New Brunswick program when the previous leader departed.
Need for more diversity: While the Rutgers medical schools are more diverse than the nationwide average — nearly one in four NJMS students were minorities, as of last year — Johnson is eager to increase minority participation. The university has created pipeline initiatives to lure local minority students into the undergraduate program, support services to help them stay on track once enrolled, and post-baccalaureate efforts to keep them involved and engaged in academic medicine after they graduate.
“One of the things to know is that medical students in general have better cultural competence, that ability to relate to all people, if they are trained in a diverse environment. So we need to make sure our classes are diverse to achieve that outcome,” he said.
But the need is great and there aren’t enough black students — especially males — pursuing science programs after high school, Johnson said. And too often, minority graduates from the Rutgers medical schools are lured to hospitals outside of New Jersey, he said. “So we’re increasing the pool, but a lot of people are competing for that same small pool,” Johnson said.
Hear more from Dean Robert L. Johnson on diversity in medicine and the role of Black History Month in this 2019 interview produced by Rutgers University.