An Interview with Malika Siker, MD

Our physician advocacy chair, Dr. Mary McGunigal, interviewed Dr. Malika Siker, radiation oncologist and Associate Dean for Student Inclusion and Diversity at the Medical College of Wisconsin. Her background in advocating for workforce diversity and efforts to improve health equity serves as an inspiration to all of us, and I was honored to speak with her more about this work.

Tell me about your path to radiation oncology.

I was inspired to become an oncologist when my dad was diagnosed with cancer during my second year of medical school. Thanks to strong peer and faculty mentorship, I was able to find my way to the field of radiation oncology.

SWRO was established to "fill the gap" for female trainees who may lack strong female role models either in their training or in their work environment—where do you think radiation oncology stands in relation to other specialties and medicine in regards to diversity?

Dr. Curt Deville has published extensively on workforce diversity. Through his work, we know that radiation oncology ranks near the bottom for gender, racial and ethnic diversity. We have a lot of work as a field to improve that record.

Do you have any advice for our members, which include many trainees and newer attendings, on academic advancement?

One of the main keys to professional satisfaction is to really stay focused on the journey, ensuring that the work that we are doing resonates with who we each are as a person and how we want to impact the world. I would encourage women to invest their time in work that fulfills them. For women in medicine especially, it is important for us to speak up when we see inequities, and that could be for ourselves as women or other groups that have less privilege. Ideally, our workplaces should be safe spaces where this dialogue can ensue with supportive allies. Academic medicine right now is undergoing a reckoning with realizing how the structure of promotion and advancement has not been built as an equal playing field. We can all work together to change the structure of medicine so women have the same opportunities for advancement. Part of that is holding leaders accountable and calling things out when we see them with our allies.

What suggestions do you have for identifying mentors and cultivating relationships?

Mentorship is typically an organic process. I think you get to a certain point in your career where there’s not one mentor who can “do everything” so it’s important to find diverse mentorship. Maybe you have one mentor that helps you with clinical knowledge, another that helps you with leadership, another that helps you with work-life balance. As a mentee it is important to put yourself out there and connect with those you hope to learn from, but also in turn to be a mentor to other people as well. It’s also a two-way street of investing time and shared experiences.

You’ve published on achieving gender equity in the radiation oncology workforce and identified several barriers to this- what do you see as the next steps?

Being an advocate for equity is really important to me. It’s critical to be an advocate for equity for all groups facing disparities in addition to being aware of the compounding effect of intersectionality. For example, as women, there are groups among us who face even greater challenges. As we work towards equity, we need to make sure that we are not leaving behind or excluding other groups of women.

In many ways, the COVID-19 pandemic has highlighted health disparities in America- what are your thoughts on this?

There’s been a lot of research to show that health inequities are mainly not due to biologic factors but due to social or environmental factors. The COVID-19 pandemic has laid bare racial health inequities and highlighted the impact of structural racism on our communities. As women and advocates for equity, we have a responsibility to call out structural racism when we see it and do what we can to dismantle the infrastructure that allows it to thrive. Specifically, within the women’s movement, we have to recognize intersectionality: if we want to represent all women, then we have to ensure that we are a voice for women of color as well. The racial justice movement should not be viewed as a threat to the gender equity movement; in fact, they’re inextricably intertwined.

What are some actions on a local level you think people can do as far as putting this into practice?

For those looking to deepening their engagement in equity, the first place to start is themselves. We all have personal biases and can all reflect on times when either through action or inaction, we could have done better. We need to really reflect on our blind spots. If someone is not able to find any blind spots, then they are not trying hard enough. If they haven’t gotten uncomfortable, they haven’t gone deep enough yet. There are a lot of tools available online like the Harvard implicit bias test.

After personal reflection, I think the next step is to actually do the work and deepen their knowledge on the subject. There’s an abundance of resources, including some great documentaries, podcasts, and books. In doing the work to learn more about health equity, it’s important to understand more about related topics like the social determinants of health, redlining, and criminal justice system and how they intersect with health. In learning about the past and present, we can be mindful about how we want our actions to impact the future. An important part of this process is to do something positive with your power and privilege that is not just performative—it can’t just stop there. Dr. Chapman and Dr. Winkfield’s article has some great suggestions.

You have spoken before about being active on social media in medicine- do you have any advice specific to navigating and getting the most out of social media platforms?

First and foremost, you have to ask yourself if being on social medial is in line with your values. I know many people who aren’t on social media for reasons of privacy and those individuals shouldn’t feel pressured to be on social media. I try to be intentional with my voice on social media and post about things that are in line with my professional mission but I keep strict boundaries on what I don’t want to share, including my personal life. Each person needs to define their voice and boundaries themselves. I actually wasn’t on social media for a very long time but I began to see social media as a tool where I could learn, advocate and find community. I also keep in mind that my Twitter is public, so my posts can be seen by anyone, including my patients and family members.

How do you balance everything you do?

Between family, clinical responsibilities, administrative duties and advocacy, life is very busy. Because I am doing work that I love, it doesn’t feel like work. I think that’s been the secret to my work-life balance. I’ve been focused on work that aligns with my passions. I don’t know if balance is the right word. It’s more of just making the most of all opportunities that present themselves and being thoughtful. Some of these opportunities are related to my professional life and some are related to my personal life, and it’s hard to just focus solely on one or the other. I think the COVID-19 pandemic has really forced us to integrate them and be ruthless about cutting what no longer serves us.

How were you initially drawn to the sort of work that you do, specifically advancing diversity, equity, and inclusion?

This is a hard question to fully answer because I cannot remember a time where I was not involved with advancing diversity, equity, and inclusion. Being raised in a multiracial, multicultural, and multiethnic family in a small town in Wisconsin, I was always aware of how my family was different and experienced prejudice and exclusion firsthand during my formative years. It was not until college and afterward that I fully realized all the privileges I had been afforded and how best to share what I know and have with others who do not have the same access. I have been fortunate enough to have leadership that has allowed me to deepen my engagement with diversity, equity, and inclusion in the professional sphere, aligning with my passion.

Any final pieces of advice for our members?

I think the take-home message is to be intentional about recognizing your own privilege and power and to advocate for equity. Sometimes that means having the courage to call out the injustices that are happening to ourselves and sometimes that means calling out the injustices happening to other people. And this work is a journey- you’re not always going to get it right and sometimes you will get less affirming feedback. I have been and continue to be the recipient of less affirming feedback. It’s important to see this feedback as a gift, and an opportunity to grow, do, and be better.

Malika Siker, MD is Associate Dean for Student Inclusion and Diversity and an Associate Professor in the Department of Radiation Oncology at Medical College of Wisconsin. In her administrative role, she directs initiatives focusing on cultivating a culture of inclusion for learners and increasing student diversity through pathway programs for learners interested in health science careers. Her patient care emphases are blood, brain, pediatric, and prostate cancers. She has published multiple peer-reviewed manuscripts, essays, and book chapters and is a passionate advocate for health equity. As faculty of the Kern Institute, she works to transform medical education around character and empathy. She is active on Twitter (@drmalikasiker). She enjoys yoga and traveling.