This post was originally published on St. Louis American

By Chris King

Dineo Khabele, MD is the first Black department chair, ever, at Washington University School of Medicine in St. Louis, which was founded in 1891. She serves as the Mitchell & Elaine Yanow Professor and Chair of the Department of Obstetrics & Gynecology at the medical school.

She joined Washington University in June 2020 from the University of Kansas School of Medicine, where she was a professor of obstetrics and gynecology and of cancer biology, director of the Division of Gynecological Oncology, and vice chair for research in the Department of Obstetrics and Gynecology. She is board-certified in Obstetrics and Gynecology and Gynecologic Oncology.

Dr. Khabele’s ovarian cancer research is funded by the National Institutes of Health/National Cancer Institute. Her ovarian cancer research interests include chemotherapy resistance, DNA repair, epigenetic targets for therapy, and targeting the tumor microenvironment. She also is an outspoken researcher and critic of racism in the medical field and the profession’s failures in training, recruiting and retaining diverse medical professionals, particularly in elite subspecialties such as her own.

Dr. Khabele obtained undergraduate and medical degrees from Columbia College and Columbia College of Physicians and Surgeons of Columbia University in New York. She completed her residency in obstetrics and gynecology at The New York Presbyterian Hospital, Weill-Cornell University Medical Center, followed by a clinical fellowship in gynecologic oncology and post-doctoral research training in cancer biology at Albert Einstein College of Medicine and Montefiore Medical Center. She was a scholar of the Reproductive Scientist Development Program and the Amos Medical Faculty Development Program Scholar/Robert Wood Johnson Foundation.

The St. Louis American spoke to her about her work as an administrator, researcher and clinician and how she is trying to get the hang of St. Louis, having moved here during the COVID pandemic and its socially isolating protocols.

The St. Louis American: What is new and upcoming with the Department of Obstetrics & Gynecology at Washington University School of Medicine?  

Dineo Khabele, MD: We are really excited that our obstetrics and gynecology specialty at Barnes-Jewish Hospital is ranked #3 in the country by US News and World Report. This speaks to the incredible talent, dedication and expertise of our teams at Washington University School of Medicine and Barnes-Jewish Hospital. We are continuing to recruit to support our mission to deliver exceptional clinical care, cutting-edge research, and innovative educational programs. I am honored to lead our teams who have done incredible work while meeting the challenges of persistent COVID surges, financial set-backs, and staff shortages.   

The St. Louis American: In recruiting, what are your methods and how is diversity integrated in your recruiting efforts?

Dineo Khabele, MD: For our senior leadership, we conduct national searches, with assistance from our internal search firm. We take a holistic approach, using a search committee, and we try to identify talent in a systematic way. For faculty positions, we have a holistic approach to make sure we’re not biasing the process. In terms of diverse candidates, we show them all the wonderful things we’re doing here in targeted ways. We show how we make a difference in providing exceptional clinical care to patients (including those from underserved areas in the region), conducting exciting new research, and training the next generation. If you have those values in mind, this is a great place to work. I am proud to say we have recruited 11 faculty from around the country since I started in 2020 and that 13% of our faculty in our department, are Black. This includes senior leadership; I myself am the first Black chair this medical school has had.

The St. Louis American: What is new and upcoming with your own research?

Dineo Khabele, MD: My research is focused on discovering new approaches to treat chemotherapy-resistant ovarian cancer. We use preclinical models of ovarian cancer to test new drug combinations that will hopefully be developed into clinical trials. I also support efforts to reduce disparities in cancer care for Black patients diagnosed with ovarian, uterine, and cervical cancers.  

The St. Louis American: How do we reduce disparities in cancer care for Black patients?

Dineo Khabele, MD: I’ve created an office in our department called IDEA2 (squared), which stands for Inclusion and Innovation, Diversity and Discovery, Equity and Excellence, and Advancement and Advocacy. IDEA2 is our cultural pillar for how we provide clinical service, research and education. We are working on recruiting a more diverse workforce; we are tracking our metrics; and we are addressing our curriculum in collaboration with the rest of the medical school to make sure we are teaching people about ways to overcome health disparities.

From a clinical standpoint, we are finding innovative ways to create more patient-focused care. How can we better advocate for patients who are most vulnerable and entering into a complex healthcare system for treatment? We think that partnering with patient advocates will help. We are also conducting research on how to address a patient’s unmet needs. If a patient is late for their appointment, well, it turns out that they didn’t have transportation. How do we show empathy and understanding? And how do we connect them with transportation services?

IDEA2 work is not something that happens with the waving of a magic wand, right? This is hard, slow work, and we have to make sure that all of our clinicians and health care workers understand its importance. IDEA2 is now an integrated part of our mission as a department. It’s a cultural pillar and one of our values. If it’s not one of your values, then it’s not important; you’re not going to pay attention to it and that.

The St. Louis American: Your ovarian cancer research is funded by the National Institutes of Health/National Cancer Institute – how do you build and maintain such enviable relationships?

Dineo Khabele, MD: It’s really rough; it’s been tough; it’s been a long, steady career. Only 0.1% of investigators who receive RO1-level – the gold standard of NIH research funding, are Black – 0.1%! So, it has not been easy. I’ve had to find mentors and had to persist in finding ways to show them I could do research. And then I’ve had some mentors who believed in me more than I believed in myself; I’ve been told you can do it. I’ve had these targeted programs that provided funding to protect my time so that I could develop skills and apply for these bigger grants. Those are the things that help to support an early career, and having support from your institution to bridge funding and protect your time has been important for me as well.

The St. Louis American: You’re the lead author on a paper that offers perspective on James Marion Sims. Tell people who was James Marion Sims and why this was an important perspective.

Dineo Khabele, MD: J. Marion Sims is considered in many circles to be the father of gynecology, which is the specialty I practice, and, unfortunately, he performed experiments on enslaved Black women to perfect his procedure on how to fix a fistula, which is a hole that occurs from birth injury, from prolonged labor. (You can develop a hole between the vagina and the bladder, and you can develop a hole between the vagina and the rectum.) In particular, one enslaved woman, he operated on over 30 times. The only names we know for them are Lucy, Anarcha and Betsy. It is really hard to be in a field where someone is lauded as the father of your field when he performed experiments on people who look like me and who could have been my ancestors, and he continued to do this work even after anesthesia was available.

So, what we’ve done in our department, in honor of Lucy, Anarcha and Betsy, is we have created a lab award. In order to get funding, people must understand the history of J. Marion Sims, and we have a community advisory board that reviews these grants to make sure we are doing due diligence. Of course, research on human subjects now is very well regulated, and it’s important that everyone gets a chance to participate in it willingly, because that’s how you advance medicine. So, as a scientist, I thought it was really important that we reframe this story and what J. Marion Sims actually did to honor the women themselves.

The St. Louis American: You also have published on the role of race and gender in the career experience of Black surgeons, as well as intersectionality and the pipeline for Black academic surgeons. What is important about that research?

Dineo Khabele, MD: There are not enough Black surgeons. What’s really interesting and relevant to St. Louis is that Homer G. Phillips Hospital was one of three places in the country where Black surgeons could train after medical school. It was Howard University, Hubbard Hospital at Meharry College (where I used to work), and Homer G. Phillips. Howard is still around, and Hubbard is still around, but we don’t have Homer G. Phillips. A lot of that history is lost, and it’s still so difficult to train as a Black person in any surgical subspecialty. There are so few of us.

And, unfortunately, we are seeing that where Blacks students are entering these subspecialty programs, they have a higher rate of not finishing compared to their white counterparts. I am a member of the Society of Black Academic Surgeons, where some of this work is being published, and we are trying to do something nationally to change these dismal statistics: the opportunities for us to rise in the ranks, the recruitment, the training, paying attention to micro-aggressions, pipeline programs, all of these things are very important. I benefitted from targeted programs, from great mentors, and I’ve had the qualifications to do research and get grant funding and be subspecialty-trained, and I don’t want to be unique person in that regard. I want to make sure that whatever I do in this role is paving the way for that next generation.

The St. Louis American: You do so many things as an administrator, researcher and clinician. How do you find your balance? 

Dineo Khabele, MD: I really love what I do. I just got out of the operating room just now. I love the patients. It’s a privilege to do what I do. To honor it, I want to make sure I’ve dedicated my time and my life to it. I have a very supportive spouse; we’ve been together since I was pre-med in college. We have one son in New York who has graduated from college. And then I have a very committed extended family. So, I do work really, really hard, long hours, but it’s very important work and I find it deeply satisfying. If we overcome challenges, if we’re able to pave the way for somebody else, I’m really driven to do that. It’s really hard to be a first and an only, and that’s been a lot of my career. I think you’ll see that, with a lot of people who are the first to do something that drives them to want to make sure that they’re not the last.

The St. Louis American: I never had heard of the Albert Einstein College of Medicine in the Bronx. Why is that where you ended up going for your training?

Dineo Khabele, MD: That’s one of the examples – the person who ran that program at Einstein believed in me. It was really hard to get a spot in this the field of gynecological oncology; at the time that I applied, there were only 30 spots positions across the country. The person who ran the program at Einstein at that time thought I would be great fit for their program and that launched my career.