Mane Interest

The hair clinic that Dr. McMichael started when she arrived at Wake Forest now sees more than 45 patients a week. Her early clinical interest in hair evolved into a research agenda: “I’m really proud of the fact that I’ve been able to answer questions related to African American women and hair loss, because that was a really big black box when I started in dermatology.” Her passion has culminated in the recent publication in New England Journal of Medicine of a seminal piece on the genetics of CCCA. “I never in my life thought that this little black girl from North Philadelphia would work with colleagues in S. Africa (Dr. Ncoza Dlova) and Israel (Drs. Sprecher and Sarig) to publish a paper n the NEJM,” Dr. McMichael says.

Chair of the Dept. of Dermatology at Wake Forest School of Medicine, Amy McMichael, MD is an international lecturer and researcher with a focus on hair disorders, specifically in women with skin of color. She was recently elected to the Board of Directors for the American Academy of Dermatology, an organization that, along with the Skin of Color Society, Dr. McMichael credits with having the greatest impact on her career.

Dr. McMichael says her greatest personal accomplishment has been balancing family and career. “I never would have planned the life that I’ve had, and it’s been a lot of fun, and I think my kids are all the better for it,” she says. “There are times where I had to say no to work in order to spend time with my family. I’m glad that I did that; I think that doing it all together was probably my greatest accomplishment.”

What is your advice to mentees?

Dr. McMichael: You need to treat people ethically and well. I think that that’s something that a lot of people don’t do. They speak down to people who they presume are not as educated as they are, or don’t account for their interest in something. I think that no matter what level we’re at, we need to be able to work with all levels...to get people healthier, to move our department forward, to educate the next generation, and do all the things that we need to do.

How can we encourage students of color to pursue dermatology?

Dr. McMichael: We need to start a lot earlier than medical school. We are admitting fewer African American males to medical school than we did 20 years ago. We have a lot of work to do to encourage people who are members of under-represented minority groups in this country to get involved in STEM and start to think about medical and scientific careers early on.

A lot must be done to prepare them for the rigor that’s going to be required certainly for the more competitive specialties of which one is derm. I think that we have to get that experience and exposure to excellence into their frame of reference early on—in middle school, in high school, in college—so that they can aspire to do more.

Could women be better represented in academia leadership?

Dr. McMichael: My experience has been a really good one, because I have an absolutely amazing faculty. They are so supportive, so willing to help. My former, founding Chair, Dr. Joe Jorizzo, is still on the faculty, and he is really invaluable as a mentor, sounding board, faculty member, and overall teacher. He has been very foundational in my career. Part of the reason that I was able to do this job was because he was always in my corner telling me I could do it. There were a lot of people telling me I couldn’t do it, or didn’t need to do it. I’ve also had support through the years in the academic leadership at the medical center.

We have a number of women who are now dermatology chairs across the country—certainly not the majority—and we actually have a supportive group for dermatology women chairs. We communicate over the internet. We have conference calls. We meet at the Association of Professors of Dermatology meeting. None of us has had the same experience at our institutions. We all have different woes as far as what’s going on in our states, but it’s still very helpful to have people who are in similar position.

I have women chairs here at the medical center in different disciplines who are very supportive and who field questions. I think it is worthwhile to have those mentorships, those sponsorships, that communication with others who are in similar roles. Now that we have this core group, it is a good time to start working on medical students and residents to get them interested in academics. We can act as role models, allowing them to see what we do in academics as rewarding, challenging, and fun. With increasing numbers of women in academics, we can increase the numbers of women deans and CEOs eventually.

Even with all that support, it’s still a little lonely. At the end of the day, if something is not working right, it falls on me…You have to balance the good with the bad and recognize that you’re not going to win every day, and you’re going to probably need to sit back and take stock of things and do what you can...We’re living in an imperfect medical system in an imperfect world.

I try to communicate this to medical students and residents, so they are not turned off by the challenges in academic practice.

Why did you choose academia?

Dr. McMichael: I did my three years of residency at the University of Michigan School of Medicine where we did a lot of basic science research, and I was lucky enough that one of my faculty mentors, Dr. Chris Griffith [now in Manchester, England] was kind enough to let me work on a project with him looking at how retinoids could aggregate the thinning of skin that is caused by topical steroids. That was the first exposure that I got to really do a research project.

That was coupled with the experience of giving a lecture during my residency to medical students in place of a faculty member who was unable to present. Afterward, many, many, many students came running up to me and said, “I actually never thought about dermatology as an option for residency. Tell us more about this specialty”; I guess I was approachable because I was closer in age to them than many of the people that usually lecture. Many of those people were actually women and skin of color people. Those experiences, coupled with probably more unsavory experiences that I had in medical school, probably in many cases related to me being a person of color, made me want to represent our specialty in academics.