Q & A with Dr. Kathie-Ann Joseph

Dr. Kathie-Anne Joseph
In our first installment of profiles on African-American living legends, we spoke with Dr. Kathie-Ann Joseph. A 34-year-old oncological surgeon and assistant professor of surgery at New York-Presbyterian Medical Center. Dr. Joseph is the first African-American woman appointed a faculty member in the Department of Surgery at Columbia. She was recently selected by Crain’s New York Business weekly as one of the top 40 under 40 rising stars in New York City. FOX Fan sat with Dr. Joseph to learn about her journey and current research on breast cancer in African-American women.

Where are you from originally?

My parents moved to Brooklyn, New York from Jamaica. My mother had five children, and she wanted each one of us to be born in Jamaica, so I was born there, but I grew up in Brooklyn, New York.

What or who influenced you to become a doctor?

I always loved reading about how the body worked and the ability doctors had to make people feel better. Also, my mother was a nurse, so I guess she was also a major influence. There was nothing else I ever wanted to do or be. When I was in junior high school I volunteered at a hospital and got to see first-hand the work doctors do. In high school I did a weekend program called PREP at Columbia University, which was designed as a pre-med orientation for high school students.

What was it like to leave your family and friends in Brooklyn, New York to go to a place like Harvard for your undergraduate education?

It was a great experience for me. Obviously I was very nervous leaving home for the first time. My mother had been sick when I first started college, so I had apprehensions about leaving. The best aspect of college was meeting people from all over the country and the world. I found the work challenging, but I made life-long friends, with whom I still keep in touch. Being pre-med was really hard; it’s one of the most difficult roads you could take in college. But the support I had from my friends in school and from my family really got me through it. I didn’t do the typical academic route. I was pre-med, but I didn’t major in biology or one of the sciences. I majored in sociology, which I think served me well. Someone gave me really great advice: “You will have the rest of your life to do medicine and science. Take the opportunity to use your four years at Harvard to learn something else, because college is really the place to get a broad education.” I had taken some sociology courses my first semester and loved it. It impacts how I approach medicine today. I became interested in medical sociology, and spent the summers between my junior and senior years working with a researcher at Harlem Hospital, which was affiliated with Columbia University. The researcher was working on a breast and cervical screening program for elderly African-American women. It was the first time I had the chance to see that not everyone is exposed to the same healthcare. Also, meeting women in their 80s who never had a pap smear, cervical exam, breast exam or mammogram was really an eye-opening experience. I had a chance to interview these women, and that formed the basis of my senior thesis at Harvard, which won the Hoopes Award.

Since writing that thesis at Harvard, has addressing healthcare disparities for African-American women been your life’s goal?

It has played a role in everything I do, and all the projects I am involved in. One issue I have been troubled by is breast cancer, which is more prevalent in white women, but has the worst prognosis and mortality rate stage-by-stage in African-American women. Various reasons for this include lack of screening and education among African-American women and the reluctance of these women to come in and get screened. Also, black women also tend to get breast cancer at a younger age, but most women don’t start getting screened until the age of 40. These are considerations that we need to really address in the community about getting women in with their doctors, and educating doctors about encouraging women of color to get mammograms. Also, if you don’t have any insurance, it’s very difficult to pay for a mammogram, which needs to be done every year when you are over the age of 40. The screening program here at Columbia provides free screening for women who are uninsured, so we are able to treat a lot of them that way. They can get all of their surgery, chemotherapy, and even reconstructive surgery for those who have had a mastectomy, paid for through partial funding by the state and private donors.

What research are you currently working on?

We are looking at biological factors that play a role in why women of color do worse with cancer. We are starting to see in African-American women that perhaps the biology of the tumors may be slightly different and more aggressive than those suffered by women of other ethnic groups. This may explain why an African-American woman with stage one breast cancer, which in the general population of women usually has a positive prognosis — 90% survival rate — has a higher mortality rate for blacks. I am particularly looking at the hormone receptors for these cancers among African-American and white women.

You seemed to be deeply vested in public health. What influenced your decision to specialize in surgery at med school?

When you’re a student, your teachers are a huge influence. I always thought based on my interests that primary care would have been the best way to go, but I was very fortunate to have as my surgery instructor Dr. Ken Ford, who was the first African-American to do a residency at Columbia. What impressed me about him was not just that he was an amazing surgeon, but the level of humanity that he brought to his practice, and the way he cared for his patients. I was just blown away. Up until meeting him I thought all surgeons were white, old men. There was one other black surgeon on the faculty, Dr. Spencer Amory, who was also a really great person and doctor. After having these two doctors as my mentors, plus observing how a patient could come in with a problem and get their ailment fixed by a surgeon, I just got the ‘surgery’ bug. I don’t regret that decision, and it was nice when I came back to Columbia to teach in the faculty — both Dr. Ford and Dr. Amory are still here. Also learning that I am the first African-American female to teach in the department of surgery at Columbia, which is pretty amazing.

What advice would you give to a young person just starting out at the age of 17 or 18?

If you are truly interested in something, don’t give up. There will always be roadblocks. Nothing that is worthwhile ever really comes easy. I can’t tell you all the roadblocks I have gone through, and how many times I almost gave up. My mother passed away when I was a freshman at Harvard; during my medical school residency I had two children. Life can be hard, but when you persevere, it just makes the rewards that much sweeter. Look at your long-term goals. Plus, you can’t do everything yourself, so don’t be afraid to make the first step and ask for help and mentorship. Mentorship is key because when you are trying to move up the ranks, not just in medicine, but in any field, you need someone who is going to give you good advice and keep you on the right track.

Has spirituality played a role in your journey?

I am a Christian, and I pray. Believe me, I prayed my entire journey through medical school. You have to have some type of spirituality. It plays a role in how I care for my patients. When you’re in a field where you have to tell people that they have cancer, facing a life threatening disease, a strong faith helps. My childhood rearing in church carried me through all these years. I even observe that my patients who have some sort of spirituality are the ones who do better.

Dr. Kathie-Ann Joseph was born in Jamaica, West Indies and raised in Brooklyn, New York. She attended public schools in Brooklyn and then went on to attend Stuyvesant High School in Manhattan. She was educated at Harvard University and earned an A.B. degree in sociology. While at Harvard, she won the prestigious Hoopes Prize for Excellence in Undergraduate Research at Harvard for her senior thesis entitled, “Triple Jeopardy: Elderly, Poor, African-American Women and Their Barriers to Health Care and Screening for Breast and Cervical Cancer.” After graduating from Harvard, she entered Columbia College of Physicians and Surgeons and completed a joint MD/MPH degree from the medical school and Columbia School of Public Health. Afterwards, she spent seven years at NYU Medical Center, where she completed her general surgery residency training and a two-year research fellowship in surgical oncology. She then returned to Columbia to do a one-year breast surgical oncology fellowship. Dr. Joseph is the first African-American woman appointed a faculty member in the Department of Surgery at Columbia University Medical Center, where she serves as an assistant professor of surgery. She is a member of several professional societies including the American Association for Cancer Research, American Society of Clinical Oncology, and the Association for Academic Surgery. She plans to focus her career on both the management and treatment of breast cancer. She is dedicated to improving access to screening in underserved populations and communities. She is the recipient of the Joanne Masin Breast Cancer Alliance Young Investigator Award, a National Institute of Health (NIH) supplement grant, and has received other grant support from Women At Risk at Columbia University Medical Center and an American Cancer Society Pilot grant for her research on RAGE, receptor for advanced glycation endproducts in the treatment of breast cancer. She was recently selected as a Southwest Oncology Group Young Investigator and the recipient of the 2004 AACR Minority Scholar Award in Cancer Research. This past January, Dr. Joseph was selected by Crain’s New York Business weekly as one of the top 40 under 40 rising stars in New York City.