Diversifying Medicine at the NIH

Dr. Marie A. Bernard has spent much of her professional life smoothing the pathway of success for scholars underrepresented in science, and the rest racking up distinguished positions and awards that cause her resume to run 19 pages, including research papers.

Since May 2021, Dr. Bernard has been the Chief Officer for Scientific Workforce Diversity at the National Institutes of Health (NIH) and co-leads NIH’s UNITE initiative to end structural racism. Prior to this position, she was deputy director of the National Institute on Aging (NIA), where as NIA’s senior geriatrician she served as principal advisor to the NIA director, and co-chaired two Department of Health and Human Services Healthy People 2020/2030 objectives—older adults; and dementias, including Alzheimer’s.

In early February Generations Now spoke with Dr. Bernard in a quick conversation on her thoughts about the importance of diversity in the scientific workforce, mentoring and legacy.

Generations Now (GN): Could you please tell us a bit about your background? Where did you begin your career?

Dr. Marie Bernard (MB): I studied medicine at University of Pennsylvania School of Medicine, did internal medicine residency training at Temple University Hospital, and had my first faculty appointment at the Temple University School of Medicine. Early in my faculty career I was approached to be assistant dean of minority affairs. However, I refused the offer as I was advised by my mentor that it was not something that was wise for me to do at this stage in my career. Nonetheless, supporting people who were not well represented in medicine and science has been a core value throughout my career.

After attaining associate professor status, University of Oklahoma College of Medicine made me an offer I could not refuse. I therefore moved to Oklahoma, where I grew up. It was a great professional opportunity and wonderful for my kids, as we lived next door to my sister.

While there (at the University of Oklahoma College of Medicine) I was given the opportunity to lead the competition for funds from the Donald W. Reynolds Foundation to establish a Department of Geriatric Medicine. Although unsuccessful on our first try, on the second application we got the largest grant ever received by the Health Sciences campus to that date (where Dr. Bernard ended up being endowed professor and founding chairman of what became the Donald W. Reynolds Department of Geriatric Medicine at the University of Oklahoma College of Medicine). I was proud that when I left, I left behind a $36 million endowment.

In 2008 I was recruited to come to the NIA (National Institute on Aging) as its deputy director. In addition to my role as principal advisor to the NIA director, I had a chance to lead the Women of Color Committee (WOCC) of the Working Group on Women in Biomedical Careers. The group has worked to enhance networking for women of color scientists and their supporters through the Women of Color Research Network, and systematically nominated outstanding women for the prestigious NIH Wednesday Afternoon Lecture series.

‘We have a lot of opportunity for enhancing the diversity of scientists supported by NIH.’

I also co-led the NIH-wide Inclusion Governance Committee that ensures the appropriate inclusion of individuals in clinical studies, including by sex/gender, race/ethnicity, and inclusion of children and older adults. In that role, I led the Inclusion Across the Lifespan (IAL) workshops that contributed to the NIH IAL policy and its implementation.

I was honored when Dr. Francis Collins, then NIH Director, asked me to be the acting Chief Officer for Scientific Workforce Diversity (COSWD) starting October 1, 2020. I was even more honored when I was selected as the permanent COSWD at the end of May 2021.

GN: Why is scientific workforce diversity so important and what has been the effect of a lack of scientific workforce diversity?

MB: As Chief Officer for Scientific Workforce Diversity, my role is to serve as the thought leader in the science of scientific workforce diversity, enabling NIH to take advantage of the full spectrum of talent that is available to foster creativity and innovation.

We have a lot of opportunity for enhancing the diversity of scientists supported by NIH. When we look at demographics in the United States, there is quite a bit of diversity among high school students and those entering college. However, from graduate school onward, diversity of the population progressively decreases. When you get to the level of department chairs, there is ample opportunity for broadening the diversity of those leaders.

Data shows that having diverse perspectives leads to better science. For instance, Freeman and Huang in 2015 did a study of 2.5 million published articles looking at diversity by ethnicity, geography and information—i.e., articles cited in the publication. Regardless of how they measured diversity, it was associated with higher impact factors and citation percentiles than when the article authors were more homogeneous.

A recent study reported in PNAS examined the patterns of fields that scientists study, and when you look at race, ethnicity and gender, it shows that women tend to do more studies on health and men tend to look at engineering, physics, etc. The study noted that women also tend not to have as many publications as men. So we are potentially missing out on productivity in those areas.

GT: Do you consider age to be a workforce diversity element, and if so, how difficult is it to get others to see this?

MB: In terms of workforce diversity writ large it is a consideration. In some fields you are considered old at age 40 and in others you’re expected to retire at 60. But at the NIH it’s not so much of an issue. There are no mandatory retirement ages, and many people work here well beyond the standard retirement age. There was a recent Nobel laureate who was in his 90s. But in other fields it’s an issue.

‘I really appreciate the fact that now there are a lot of women who look like me doing really incredible things in science, medicine and beyond.’

GN: Mentoring other Black women has played an important role in your career. What advice might you give others who would like to do more mentoring, especially with women of color?

MB: I would say that if you’re interested in mentoring, go forward, it’s an important way to give back. And be open to being there to support, advocate for and sponsor lots of individuals, not only those who look like you.

It is advantageous to seek out people who have had different life experiences. And it’s important not to rely upon just one mentor. Having several mentors on your team is really important, as you will gain something based on each of their experiences. The challenge is then synthesizing the input and determining what is best for you.

GN: How do you feel being a woman role model, especially for Black women scientists?

MB: The way I see it is I’m standing on the shoulders of prior generations. I look at what my mother and other women did breaking barriers in their own ways. And I really appreciate the fact that now there are a lot of women who look like me doing really incredible things in science, medicine and beyond.

GT: When you reflect on your career, what are some of the most impactful moments you’ve experienced?

MB: It’s a gestalt. When I got the opportunity to be founding Chairman (of the Donald W. Reynolds Department of Geriatric Medicine) at the University of Oklahoma College of Medicine, there was a wonderful group of faculty there, and it was a great opportunity to blaze a trail with medical students.

At NIH it has also been wonderful. I’m the ultimate nerd and being in the middle of all of this knowledge generation is unparalleled. I get to see an idea develop, the research done, the data analyzed, and then the findings implemented. A great example is the ASPREE study. I got to see it from conceptualization, to now, a modification of the United States Preventive Services Task Force recommendations regarding aspirin as a primary preventive therapy for older adults. That was really edifying.

GT: What will be your legacy in the field of aging?

MB: Two things: I hope that part of my legacy will be further enhancement of the diversity of scientists involved in research. There are programs in which I was involved at NIA that I hope will continue to thrive. And in my COSWD role we are working on programs that will hopefully have a wide-ranging impact, to the benefit of all researchers who want to produce impactful results to advance the health of the nation.

I am also looking forward to seeing the effect of the Inclusion Across the Lifespan policy that was put in place at NIH in 2019. If the policy works as hoped, we will see data showing that a broader range of older adults have been included in NIH-funded clinical trials, allowing the data from those trials to be applicable to the vast numbers of older adults with multiple chronic illnesses. The first opportunity to fully assess the impact of the policy will be in 2024. If the data are not in keeping with expectations, it is my hope that we will enhance the policy to assure that older adults are included in a meaningful fashion for studies that will generate findings applicable to them.