A black woman with a PhD, dressed in professional attire at an industry conference, is mistaken during lunch by another attendee as a member of the waitstaff working the event. A health technology leader who is Chinese American, and who speaks with an accent some find hard to understand, is rarely asked to deliver company presentations. And a healthcare technology management (HTM) professional—in position for promotion after years of hard work—doesn't get the job for lack of talent, but simply because she happens to be Muslim.
It's right there at the bottom of every press release: The Association for the Advancement of Medical Instrumentation (AAMI), a nonprofit organization founded 53 years ago, “is a diverse community” of thousands of professionals devoted to “the development, management, and use of safe and effective health technology.” But what does this community actually look like from the perspective of those from racial or ethnic minority groups? Are prejudice and discrimination common in the industry? Can anything be done to encourage more diversity?
Hoping to shed light on these and other questions, BI&T reached out to six health technology professionals of diverse racial and ethnic backgrounds to share what it's like to be minorities in their fields, the challenges they've faced as they've pursued their careers, and their thoughts on everything from device maintenance to mentorships. How have they achieved their success? What struggles have they had to overcome related to prejudice in their lives? And what advice would they pass along to others on similar career paths if they're facing potentially discriminatory situations?
What they told us will sound familiar to some and will certainly come as a surprise to many others. Discrimination, they said, is real in health technology, just as it is in almost any field. But so is the passion they have for their careers—and their belief that it's possible to change things for the better.
Looking Back to Forge Ahead
Looking back, LaToya Mayfield said, her career probably owes its start to a course she took in sixth grade. “My middle school was the only one in the area offering Japanese,” she recalled.
That was in Richmond, VA, the same city where she works now as a technical specialist in the limulus amebocyte lysate (LAL) division of FUJIFILM Wako Chemicals, which is a wholly owned subsidiary of FUJIFILM Wako Pure Chemical Corporation of Japan.
Technical specialist, LAL Division, FUJIFILM Wako Chemicals, Richmond, VA. Founder and president, GiSTEM, Inc.
In her position within the limulus amebocyte lysate (LAL) division of the life sciences arm of FUJIFILM, Mayfield trains the company's customers on how to use its reagent and technology. She holds a bachelor's degree in forensic science from George Mason University, has a background in quality control and assurance, and is fully versed in Food and Drug Administration regulations and United States Pharmacopeia guidelines. Mayfield is also a member of the AAMI Next Generation Advisory Group and founder and president of GiSTEM, Inc. A nonprofit organization providing girls exposure to science, technology, engineering, and math (STEM) fields and careers traditionally dominated by men, GiSTEM recently launched a virtual series (GiSTEMChats) to help high school graduates transition to college during the coronavirus pandemic.
“When I went to my interview, I think they were impressed that I could read Japanese and that I already had an understanding of the culture,” said Mayfield.
When she was hired, it was through a temp agency as a quality control technician. The fact that she's a woman, and African American, probably had little to do with her placement, she said, but she does point to her background as a major driving factor in her ambition to be successful in her career.
“There are many different ethnicities and races here, and there really is the feeling that we're all in it together—that we're all using everyone's differences for good and for the common goal of moving the company forward,” said Mayfield.
She grew up in a family that valued science, technology, engineering, and math (STEM) education (her sister is an engineer and a cousin is a research scientist at NASA) and studied engineering at West Virginia University before transferring to George Mason University to get a degree in forensic science.
“My family always encouraged me to think outside the box,” said Mayfield. “My mom taught me that if there was something I needed or wanted to know, that I should go look it up, go research it.”
In her current position, Mayfield trains FUJIFILM Wako Chemicals customers in the use of her division's product, LAL, and on the microplate readers and other technology required to administer it. The reagent, she explained, is deployed to detect the presence of bacterial endotoxin in medications and on medical devices.
Clinical engineering intern, Baystate Medical Center, Springfield, MA
As an intern at Baystate Medical Center, a 700-plus bed facility that includes Western Massachusetts' only Level 1 trauma center, Viradia spends her time on a wide range of projects, such as management of recalls and alerts and replacement. With a bachelor's degree in biomedical engineering from the University of Connecticut, Viradia is now pursuing a master's in the same subject with a focus on clinical engineering. Her professional goals include obtaining her certification in clinical engineering and taking on a leadership role in a healthcare system. Last March, Viradia was awarded an AAMI-HSEA Health Systems Engineering Scholarship.
“If there's too much endotoxin in a drug, for example, that can be fatal for a patient,” she said.
Mayfield relies, in part, on ANSI/AAMI ST72:2019 (Bacterial endotoxins—Test methods, routine monitoring, and alternatives to batch testing)1 to guide her approach to her work. And she said that the most important skill she needs for her job is the ability to communicate clearly and effectively.
“I work with distributors all over the country and the world, and sometimes there are language barriers or cultural and ethnic differences” that must be negotiated to get critical points across, she noted.
Communication has also been critical in her work with her colleagues. “I'm at a predominantly Japanese company, and I'm a woman and African American in a predominantly male setting. For me, I've always been aware that I have to speak up if I want to get ahead.”
Her experience as a woman and minority in a health technology profession has opened a lot of doors in her life, Mayfield said, but it's also led her to give back to her community in the form of a nonprofit she created to help girls discover the value of careers in STEM fields. GiSTEM, Inc.'s mission, she explained, is to “instill, influence, and inspire girls to tap into their greatness in order to become a part of our STEM community.”
Mayfield founded the organization after reflecting on her own upbringing and the opportunities and challenges she faced as she pursued her dreams. “I don't want any girl to ever be in a situation where they feel like they aren't capable or they don't have a fair chance,” she said.
The group's logo includes a clenched fist in an array of different colors. “We want to represent all types of girls, no matter their background, and give them the tools and show them the fast track to get where they want to go,” said Mayfield.
Where She Wants to Be
When Rima Viradia was applying to colleges back in 2013, she originally thought she wanted to become a pediatrician. But then she had a long talk with her older brother, and he convinced her to consider biomedical engineering as well.
“He said he knew a few people who studied engineering at the same time they pursued medical school. So that's what I decided to do, and that's how I ended up where I am today,” she said.
Viradia opted out of the premed track and is currently a student in the biomedical engineering master's degree program at the University of Connecticut and a full-time clinical engineering intern at Baystate Health in Springfield, MA.
“I gravitated to the engineering side of things, and I really liked the math and the science. But I'm still in healthcare, which is where I've always wanted to be,” she said.
Viradia's parents came to the United States from India. She was born and raised in Connecticut, and she's the first engineer in her family. She went to UConn for her undergraduate degree as well and participated in a precollege summer program called “BRIDGE” for first-year engineering students who are minorities in the field.
“It was created to promote diversity in the School of Engineering,” she explained. “For me, it was nice to see people in the same boat as me—with different backgrounds, different cultures.”
In her current position at Baystate Medical Center, Viradia is one of the few women or people of color in the clinical engineering department. “I definitely think we need more programs like BRIDGE to help bring more diversity to the field,” she said.
On the other hand, she feels lucky to have a great supervisor in Kristopher Walsh, who she looks up to as the kind of professional she hopes to become. “He treats all of his employees the same, and if there's ever an issue that needs to be resolved, he'll take time off whatever he's doing just to help you out,” Viradia said. “He's a team player. He never lets you feel like you're alone or that you'd have to figure out something on your own.”
As she looks ahead to her future in clinical engineering, Viradia plans to continue working in the hospital environment. “I'm always thinking about the patients and their families—what would they want? And really what they want is to feel safe, and as a clinical engineer I can help with that.”
She prefers working in a hospital because no two shifts are ever alike. “You never know what your day is going to bring,” Viradia said.
Ready for Anything
Like Viradia, Maria Fernanda Zamudio, a BMET III for TRIMEDX at San Juan Regional Medical Center in Farmington, NM, had little idea what biomedical engineering was all about before someone suggested she give it a try.
She was living in Texas at the time and decided to sit in on a few classes before enrolling in an associate's degree program at Texas State Technical College.
“Those classes were all full of men, but I stuck with them,” she recalled.
Now, looking back, she thinks the field should be better advertised, especially when it comes to outreach to women and minorities. “It's so often overlooked. Even people in the hospital, sometimes you tell them, ‘Oh, I'm with clinical engineering,' and they're clueless as to what you're talking about.”
Born in Jalisco, Mexico, Zamudio moved with her family to southern Texas when she was nine and overstayed her visa. Most of the people in her community, including in school, were Hispanic, she said.
“I never realized I was a minority, because in that area I wasn't.” It was only when she moved to Lubbock for her first job that her skin color and heritage registered as “different,” she said.
BMET III, TRIMEDX, San Juan Regional Medical Center, Farmington, NM
After earning an associate's degree in biomedical engineering technology from Texas State Technical College in 2014, Zamudio took a job as an entry-level technician position with Aramark, where she specialized in respiratory equipment. One year later, she joined the company's field service team, and before long—and at the age of 23—she was offered the site lead position at a hospital in Maryland. While there, Zamudio returned to college and went on to earn a bachelor's degree in business management. Currently working as a biomedical equipment technician with TRIMEDX, she hopes to eventually work for the company as a district manager. In addition, Zamudio has enrolled at Texas A&M, where she will begin working toward her MBA in healthcare management.
“That was a culture shock. Luckily, I had a great manager who embraced my background, and I had a really great experience.” If she did face a challenge during that time, it was because she is a woman, she said.
“It never fails—every single hospital I've been to—people just skip right over me. They're like, ‘Hey, are one of the guys in the shop?' And I'm like, ‘I can handle this. I can help you,'” Zamudio said.
Her legal status in the United States has been the biggest barrier to pursuing her career goals, but she's done everything in her power to get ahead whenever provided the opportunity. “In my internship and at every site I've worked at, I've always said ‘yes’ to everything,” Zamudio said. “It's never mattered if it's a small job or a big job or a get-your-hands-dirty job. I'm going to do it the best that I can.”
That attitude has paid off over the years. Now just 26, Zamudio's already worked as a site lead and acting manager for Aramark in Maryland, and she only left that to pursue a bachelor's degree in business management. In her position today with TRIMEDX, she's working under David Reed, site manager for St. Joseph's Regional Medical Center.
Danielle McGeary, AAMI's vice president of HTM, was Zamudio's district manager when she was hired in Maryland and continues to provide her with mentorship. “Danielle is such an advocate for HTM,” she said.
Supervisor of clinical engineering, Department of Veterans Affairs (VA) Boston Healthcare System, Jamaica Plain VA Medical Center, Boston, MA
Mankoo earned a bachelor's degree in biomedical engineering from UConn in 2011, then graduated from the university's clinical engineering master's program in 2014. He worked as a staff clinical engineer from 2014 to 2017 at the VA Boston Healthcare System, at which point he switched over to the operations side as a supervisory clinical engineer. He earned his CCE in 2018 and was later selected to be a member of the Board of Examiners for Certification in Clinical Engineering. He has presented, through AAMI, on the topic of alarms management and has published on the subject in Worldviews on Evidence Based Nursing.
Zamudio describes her relationship with McGeary as “amazing” and said that she never hesitates to ask her for guidance as she navigates challenges in her own career.
“If I were to offer any advice to someone just coming into this profession, it's to be like a sponge and absorb everything and anything that others are willing to share with you,” she said. “That's what I try to do, and I think it helps me every day.”
Encouraging Diversity at the VA
Having grown up as a practicing Sikh in the post-9/11 world, Jaspreet Mankoo is no stranger to stereotyping and racial profiling. In his professional life, however, he's enjoyed nothing but acceptance—a fact for which he's thankful to his colleagues in HTM.
“I think that every department I've been a part of has been relatively diverse. It may just reflect where I live geographically, but it's been a pleasant surprise,” he said.
Like Rima Viradia, Mankoo attended UConn and learned about HTM during an undergraduate seminar. He volunteered one summer with the Department of Veterans Affairs (VA) Connecticut Healthcare System and has been hooked on the field ever since.
“I loved that HTM involves so many multidisciplinary projects that require engagement of diverse stakeholders within healthcare,” he said.
Eventually, Mankoo enrolled in UConn's clinical engineering master's program and, through it, worked as an intern with VA Boston Healthcare System. “That turned into a job after I graduated when I was hired as a full-time engineer,” he recalled. Three years later, he was promoted to supervisor—the same position he holds today.
As part of his work, Mankoo serves as a mentor through the VA's Technical Career Field program. He also spends time on hiring and evaluations of clinical engineering department team members and interns. His own experience as an Indian American has helped shape his approach to this aspect of his job, he said, as he always considers the need for diversity in his recruiting efforts.
“Ensuring that we have a diverse interview panel is really important to me. People from different backgrounds bring different qualities to the table and can really help a department” be successful, he noted.
Along similar lines, Mankoo has helped drive efforts within his organization to offer “targeted internships” by fostering relationships with nearby schools that might have been overlooked in the past. VA Boston Healthcare recruits “pretty heavily” from local four-year institutions like Boston University and UCONN, he said, “but we also reach out to places with associate's programs because we know there are qualified people there as well.”
When he's not handling human resources responsibilities, Mankoo spends his time like most clinical engineers—focused on everything from procuring new equipment to maintaining the devices already on the hospital's floors.
“We've been especially busy lately with COVID-19 in terms of activity and responsibilities for our department, doing strategic planning, building and developing our intensive care units—those kinds of things,” he said.
The pandemic, and the need for additional resources—telehealth technologies, expanded testing, physical barriers in shared spaces—are probably the biggest challenges facing the field today. “For us, it's meant a lot of hard work, but it's also been rewarding to see tangible results from what we've done,” Mankoo said.
Malinda Elammari's mother was Polish, Dutch, German, Irish, and Italian. Her father was Puerto Rican and Spaniard. “So I guess, in short, I'm Puerto Rican–Polish,” she said. “In addition, I converted to Islam at the age of 16.”
Growing up in Lauderdale, FL, Elammari's nationality was “an issue,” she recalled. “The area I was from was predominantly African American, and I was basically the only Caucasian/Puerto Rican” in my neighborhood. Every year, Elammari had to endure what was known at her school as “cracker day.”
“On that day, the non–African American kids would get beat up. Fortunately for me, I was well known in the community for my involvement in martial arts,” she said.
“Mentoring has been very rewarding, but I've come to realize that it is a growth experience not only for the trainee, but myself as well. Being an effective mentor is in many ways an art and has its own nuisances.”
Elammari, who today is the sterile processing department educator and quality control manager at Duke Raleigh Hospital in Raleigh, NC, can chuckle about that time now. “I'm a firm believer that what doesn't kill you makes you stronger,” she said.
It also has helped her understand and to empathize with people facing similar situations. “It upsets me and is very hard to swallow when I see a whole group of people lumped into one category,” she said. “You cannot judge a group by one person—there will be good and bad people in every group.”
Elammari decided to become Muslim while in high school after years as a “holy roller,” when she went to church six days a week and was president of the Christian club. Her immediate family wasn't especially religious, but her conversion left them upset.
“It was a struggle to just express what I felt was real and what I believed in. My conversion resulted in members of my family not speaking to me for up to 20 years,” she said.
Central sterile reprocessing educator and quality control manager, Duke Raleigh Hospital, Raleigh, NC
Elammari began her career in the medical world as a surgical technologist specializing in open heart surgery. She later changed direction to focus on sterile processing and went on to earn six certifications in the field through the Certification Board for Sterile Processing and Distribution and the International Association of Healthcare Central Service Materiel Management (IAHCSMM). She spent six years as the lead instructor for the central sterile program at Durham Technical Community College. Currently, Elammari also serves as president-elect of the North Carolina Association for Hospital Central Service Professionals board.
An active member of AAMI, Elammari sits on seven national standards-writing committees and the BI&T Editorial Board. She serves as one of the project managers for the Kilmer Packaging group, has presented at her local Association for Professionals in Infection Control and Epidemiology conference, and was recently featured as a guest on the “Beyond Clean” podcast. Her abstract posters have been displayed at the Duke Quality and Safety Conference, Cone Symposium, National IAHCSMM Conference, and American Hospital Association TeamSTEPPS Conference. In April 2019, she was awarded the Diane Fink Outstanding Leadership in Central Services Award.
Today, as a professional in healthcare technology, Elammari wears a hijab when she's not donning a surgical cap. Although she doesn't think her religion or her heritage have caused her to be overtly discriminated against at her current facility, she has been subjected to prejudice at other stages in her career.
“One of my top priorities is to make sure that sterile processing gets the recognition that it deserves. I think it's an area that is underemphasized—people don't understand what the sterile processing department does, and therefore, its true importance is overlooked.”
“In surgical tech school, I had to deal with discrimination on several occasions,” she said. “There were times when I didn't get hired or wasn't promoted because I am a Muslim.”
Overall, Elammari believes that people today are more open to “different” cultures than they were even a few years ago. “I think there's been a shift for the better, and I think it has a lot to do with our younger generations.”
In her life and in her work, Elammari said she follows a few simple principles. No matter the situation, she always tries to remember what it was like to “be the new person or to be the person who was somehow different.”
She also makes a point to always “strive for more—to reach beyond whatever's in the way and ask, ‘How can we make it better together?'” When something doesn't go her way, she doesn't dwell on it, she said. And she tries to keep in mind that everyone she meets can teach her something.
“I look at every person I encounter as an opportunity to learn,” said Elammari. “Whether it is something positive that you want to adopt or something negative that you commit to transform. Having this mindset throughout my career has made me into the professional that I am today.”
Driving Toward Solutions through a Focus on Inclusivity
Aftin Ross, PhD, describes herself as a “solutions-oriented person.” As a senior project manager with the Food and Drug Administration (FDA) Center for Devices and Radiological Health, where she works to ensure continuous medical device availability, Ross loves finding solutions using “out-of-the-box thinking” and collaboration with other members of her team.
“Our focus is on ‘all-hazards readiness,'” Ross explained. “Those hazards might be natural disasters, or they could be related to a cybersecurity attack,” for example. “It's very interesting, very dynamic work. There are a lot of complex challenges that do not have prescriptive answers.”
One challenge not related to potential medical device vulnerabilities: As an African American woman in a health technology career, Ross often finds that her gender and the color of her skin affect the interactions she has with the people around her.
Senior project manager and senior science health advisor, All-Hazards Readiness Response and Cybersecurity Team, All-Hazards Response, Science and Strategic Partnerships Division, Office of Strategic Partnerships and Technology Innovation, Center for Devices and Radiological Health (CDRH), Food and Drug Administration (FDA), Silver Spring, MD
In her role with the FDA, Ross leads cross-disciplinary projects related to preparedness, including medical device cybersecurity, respiratory protective devices, personal protective equipment, and incident response. She's had leadership roles in CDRH incident response to COVID-19, device-related infections, and natural disasters (e.g., 2017 Atlantic hurricanes), as well as served as the agency's lead in a wide range of national and international medical device cybersecurity efforts.
Ross earned a bachelor's degree in mechanical engineering from the University of Maryland Baltimore County and completed her graduate work at the University of Michigan, earning a master's degree and PhD in biomedical engineering. Following her graduate work, she completed a postdoctoral fellowship as a Whitaker International Fellow at the Karlsruhe Institute of Technology in Karlsruhe, Germany.
In 2016, she completed the National Preparedness Leadership Initiative and an executive education program in the Harvard School of Public Health and Kennedy School of Government. In 2019, she became a certified Six Sigma Green Belt. She has been the recipient of numerous awards, including the FDA Outstanding Service Award, FDA Commissioner's Special Citations, FDA Commissioner Fellowship Award, U-Michigan Distinguished Leadership Award, Rackham Pre-doctoral Fellowship, and the Richard and Eleanor Towner Prize for Distinguished Academic Achievement in Biomedical Engineering.
“I've seen people dumb down responses to my questions, assuming that I don't know as much as I do. I've met people in person after communicating via email, and I've seen the surprised look on their faces because I wasn't the person they were expecting.”
On one occasion, someone she worked with mistook her for another black woman in the industry. And in professional meetings, her colleagues often introduce her as “Dr. Ross,” even when everyone in the room has an advanced degree.
“I get why they do it. They do it because they're trying to level set at the very beginning. They want everyone to know that I belong here, that I'm going to be contributing, that I'm not just the note taker in the room,” Ross said.
Although Ross is still relatively early on in her career—she joined the FDA in 2014—she's received many awards and accolades for her work. She attributes her success to her “can do” attitude and to her longstanding commitment to being as inclusive as possible.
“I always try to be positive. It's never ‘We can't,' it's ‘How might we?' If you have an objective in mind, there are always different ways to get to that objective, so everything should be on the table at the start,” Ross said.
On every team that she has been a part of, Ross tries to identify each team member's strengths and then works to put them in position to be successful. “It's so important to get people with diverse perspectives to work together toward a common purpose. And the way you do that is by giving everyone an opportunity to contribute by showing them that their opinions are valued.”
With Black Lives Matter and other racial- and gender-equity movements gaining ground in the United States, many organizations have come forward to announce their commitments to improving diversity. But what does it actually take to bolster diversity within an organization?
One person who has given this question thought is Aftin Ross, a senior project manager and senior science health advisor at the Food and Drug Administration Center for Devices and Radiological Health.
“If diversity is a core value for an organization, it is imperative that they demonstrate it through their actions,” said Ross.
Words alone are not sufficient, she added. Time and resources must be devoted to the cause, and the effort must include everyone at every level of the organization.
Other recommendations from Ross, who is African American:
1. Reward employees for their pro-diversity work and activities. Pay employees for the time they spend focused on diversity-related initiatives. Include this work in their performance evaluations and make it a factor when it comes to promotion. “It's human nature to work toward what the system is rewarding,” Ross said. “If you don't provide a reward, you have deincentivized work in this space.”
2. Consider the positions in your organization and the opportunities employees have for advancement. Think about whether you have positions in your organization that are focused on increasing and maintaining diversity. Although you can improve diversity through recruiting efforts, you must provide the space for people to grow their careers if you want them to stay long term.
3. Ensure diversity all the way to the top. Many organizations that pride themselves on being diverse are really only diverse at the staff level. “Don't forget about middle management or executive leadership,” Ross said. “Focus your efforts on those positions as well.” Success in this area, she suggested, is much easier if you have an “executive champion,” or someone already within the higher ranks who is willing to use their position and influence to advocate for you in a way that actively facilitates new opportunities and your career progression.
4. Create cohorts for minority employees to help support them in their career journeys. Ross said she's experienced what it's like to be “the only,” and often it is a lonely and awkward journey. The cohort model promotes inclusivity, which is a natural benefit. Specifically, she benefited as an undergraduate by rooming with two other black women engineering majors and by participating in a scholarship program devoted to helping underrepresented students earn advanced STEM degrees. Organizations, she said, should create similar programs for their employees. “I cannot emphasize enough how valuable it is to have that community,” she said.
5. Invest in staff training. Train staff to be allies for underrepresented groups, Ross recommended. “Teach them to recognize when a comment is inappropriate, for example, and then give them the tools they need to stand up and do something about it.”
Ross predicted that her career will involve technology and public health until the end. She's motivated by public health's mission and by the fact that her field in particular “hits the sweet spot” between science and technology.
“I'm working to help improve people's lives, and that's very valuable to me,” she said. “I think as long as I can continue doing that—and I can continue to be collaborative, to innovate, and to push the envelope to do better together—I'm going to be happy anywhere I go.”