On Thursday, the Tulane University School of Medicine in New Orleans dismissed physician Princess Dennar as the program director of its combined internal medicine and pediatrics residency program. She had been the first and only Black woman to be program director at Tulane’s medical school.

By Friday, the social media furor had begun.

The hashtag #DNRTulane, or “Do Not Rank Tulane,” flared on Twitter, referring to the match process medical students go through to express their preferred residency programs, as did #JusticeForDrDennar. Now, the outpouring of posts and petitions decrying the termination of Dennar’s position at Tulane is generating a national conversation about racial inequities and discrimination that physicians of color, especially underrepresented women of color, face in academic medicine.

Dennar’s termination from her program director position comes about five months after she filed a lawsuit against Tulane, alleging persistent discrimination and calling out specific faculty members for racist remarks and behavior — including one comment that White students might not rank Tulane favorably if it had a Black program director.

On Saturday, as a cohort of medical students and physicians of color gathered with Dennar on Zoom to express support for her and discuss next steps, the pain began to crescendo.

“I didn’t just cry, I sobbed,” said Russell Ledet, 34, a third-year medical student at Tulane on the Zoom call who considers Dennar a mentor. “There’s pain, like trauma, that Black medical students and Black residents and colleagues are going through right now. For me, I’m losing a medical mom. When I was trying to figure out how to balance parenthood, being a husband and a leader and a medical student, she was the person I called to talk me off the ledge from giving up on medical school.”

In addition to social media angst, the dismissal has spawned a student-driven demand for more information regarding Dennar’s dismissal and a letter insisting on Dennar’s reinstatement, with a promotion, signed by hundreds of doctors of color all over the country. Another letter, published Monday by the Medicine-Pediatrics Program Directors Association, reads, “Dr. Dennar’s dismissal is shocking, and highly concerning for a lack of transparency, cause, or due process.”

Brittani James, co-founder of the Institute for Antiracism in Medicine, said she felt compelled to advocate for Dennar on social media because she feels academic institutions are not listening to the concerns of Black women.

“We’re fed up,” said James, 33, who’s also assistant professor of clinical family and community medicine at the University of Illinois College of Medicine in Chicago. “For me personally, I feel like I could be, I am, Dr. Dennar in a lot of ways. Black women in academia have been systematically abused, silent, gaslit and really just mistreated for so long, and without recourse and without fanfare, and blamed for our own oppression at the hands of these institutions, at the hands of leadership who have really oppressed us.”

Dennar said “it is very humbling to see all the support.” She said she believes her “termination from the position of program director for the Med-Peds program is a result of my lawsuit and retaliation for having filed my lawsuit, as well as speaking up about the atrocities with racism and sexism occurring at Tulane.”

In an email statement, Michael Strecker, executive director of Tulane University public relations, said “the change in leadership of the Med-Peds program in Tulane’s School of Medicine came about following a recommendation by the Graduate Medical Education Committee (GMEC), which is composed of a diverse panel of 15 peers and includes individuals from other healthcare institutions. This review was triggered after the Accreditation Council for Graduate Medical Education, the body responsible for accrediting all graduate medical training programs for physicians in the United States, placed the Med-Peds program on ‘warning status.’ Dr. Dennar has the opportunity to appeal that recommendation, and she remains a member of our faculty regardless of the outcome of this process.”

Strecker also said that Jeffrey Wiese, whose conduct Dennar details in her discrimination lawsuit and who usually chairs Tulane’s Graduate Medical Education Committee, had recused himself from the review of the Med-Peds program. Strecker added that the recommendation for Dennar’s dismissal by the committee was unanimous.

Dennar, who in addition to staying on the faculty of Tulane’s medical school, also retains her position as medical director of the Tulane Internal Medicine and PCAT Clinic at University Medical Center New Orleans, said Tuesday that she was not told by Tulane she could appeal the decision. She also wrote in an open letter on Tuesday to Michael A. Fitts, president of Tulane University, that the accreditation council had removed its warning status before she was terminated from her program director position. Strecker said late Tuesday that “university leadership is reviewing Dr. Dennar’s open letter.”

In her lawsuit, Dennar, who joined Tulane’s medical school faculty in 2008, alleges that Wiese and Lee Hamm, dean of Tulane’s medical school, engaged in discriminatory conduct and created a hostile work environment.

The lawsuit alleges that when Dennar originally interviewed for the directorship, Hamm told her the school did not “want to change the face of Tulane” and that “I’m afraid that white medical students wouldn’t follow or rank favorably a program with a black program director; [however] we’ll be comfortable with you sharing a position as co-director with the previous [White male Med-Peds] program director.”

The lawsuit accuses Wiese of retaliation when Dennar advocated for medical residents of color who pointed out discriminatory behavior, and alleged he imposed a tool that would rank medical programs at historically Black colleges and universities at the bottom (with international medical schools) when considering applicants for Tulane’s residency and fellowship programs.

Strecker said that “Dr. Hamm and Dr. Wiese categorically deny the racist statements attributed to them in the lawsuit.”

In a letter to Tulane’s medical school community published Sunday, Fitts, Tulane’s president, and Robin Forman, senior vice president for academic affairs and provost, said the university would “immediately engage a third-party firm to facilitate dialogue and discussion at the School of Medicine” in order to “deepen understanding of the precise experiences of our residents, faculty, staff, and other students relative to race and sex” and “solicit suggestions and develop targeted recommendations for consideration by Tulane’s leadership by the end of the academic year.”

Fitts and Forman added that Tulane would conduct a university-wide equity, diversity and inclusion climate survey this fall.

LaShyra Nolen, a second-year student at Harvard Medical School and president of the Class of 2023, said she’s concerned academic medical institutions are just being performative.

“A lot of folks have come out with different statements saying that they are pledging to become anti-racist,” she said. “And they have decided to create different task forces and committees. And just being a student and being in this system, I’ve seen how people will create these task forces and nothing comes out of them, people lose the momentum, the conversation doesn’t go anywhere. It’s just a lot of lip service without real action.”

Nolen, 26, who believes that Dennar “put her career on the line, her livelihood on the line,” by filing the lawsuit, suggests that institutions look at the retention of Black faculty, including satisfaction levels, and think about how Black faculty members are being recruited. She said academic medicine needs to undergo a value shift.

“You publish, you publish, or you perish,” she said. “But there’s not really opportunities for us to show and create value for community interventions and for actually doing meaningful things for the people who live beyond the walls of our institutions. We need to be thinking about how we can incentivize mentorship, how we can incentivize people getting community grants, and following up on those grants, rather than just publishing papers, and how that in itself can be an anti-racist act.”

Gayatri Menon, an osteopathic core faculty member at HealthPoint Community Health Center in Auburn, Wash., said she learned of Dennar’s dismissal through a Facebook group for physician moms.

“It is absolutely unacceptable for retaliatory action,” said Menon, 39, who added that she suspects institutional racism played a role in Dennar’s dismissal as program director. “They are missing out on having the contributions of a highly qualified woman of color guiding and teaching future doctors.”

Menon, who is South Asian American, added that “while I have experienced microaggressions, the institutionalized racism against Black doctors and patients is appalling and needs to be addressed.”

Afia Albin, a third-year medical resident at HealthPoint, who is Black, said starting from her intern year at the hospital, even while wearing a purple badge with large letters stating “Physician,” she would experience at least five or six encounters a day in which patients or other staff would ask her to fetch water or do a blood draw.

“It was kind of frustrating to me, because I don’t mind doing these things,” she said, “but I wish that you knew what my position was and didn’t just see my face or see my age or see my gender and then make an assumption.”

These experiences, Albin said, propelled her to help implement diversity, equity and inclusion measures in her program. One surveyed residents and found women were disproportionately subject to discriminatory comments.

“Why is this still happening?” Albin said, noting that half of younger physicians are female. “I think it’s a deep-rooted discrimination we have in the United States that I’m hopeful we’ll get over one day. We still have a lot of work.”