Blessings from Puerto Rico

Sneezing doesn’t make Sylk Sotto think of illness. It reminds her of blessings. In her homeland of Puerto Rico, when someone sneezes three times in a row, they get a different blessing each sneeze: salud (health), dinero (money) and amor (love).

Sotto, EdD, MPS, MBA, now updates those traditional blessings, swapping out “dinero” for “educación” (education). A first-generation college student, Sotto demonstrated resilience and persistence as she navigated her way through higher education, earning three graduate degrees beyond her bachelor’s in chemistry. Today she is vice chair for faculty affairs and professional development and vice chair for diversity, health equity and inclusion in the Department of Medicine at Indiana University School of Medicine.

She’s heard—and rebutted—the criticism of multiple degrees meaning a person “just didn’t know what they wanted to do.” Sotto sees it differently. Each of her educational pursuits were valuable pieces of the grand-purpose puzzle, fitted neatly together to build a career focused on faculty development, research ethics and equity in academic medicine.

“A few years ago, I was asked to describe my roles without using my title. My answer was that I’m making historically marginalized students and faculty feel like they belong and being a cheerleader to all in their professional journey,” Sotto said.

Hearing someone sneeze in succession reminds her of her purpose.

“Sneezes keep me motivated,” she said. “It’s health, education and love—and by love, I mean equal treatment of everyone.”

Department of Medicine Chair David Aronoff, MD, said Sotto uses scholarship to challenge institutional practices for the betterment of all.

“Dr. Sotto is an archetype for a leader and champion for diversity, equity, inclusion and justice,” he said. “We are extremely fortunate to benefit from her tireless advocacy.”

Building a career in academic medicine

Sotto knows how it feels to be an outsider. When she left Puerto Rico to attend Colorado State University, she traded the ocean for the Rockies. She also experienced being part of a minoritized population for the first time.

“I was the only Latina or Hispanic or any person of color in my chemistry program,” Sotto recalled.

In Puerto Rico, Sotto attended the highly selective CROEM residential high school, which focuses on sciences and math. She patched together a small scholarship, a Pell Grant and student loans to pay for college. If Colorado State had a student affairs office, she didn’t know about it. She wasn’t aware of any Latina sororities, either.

“I sum up my first-gen experience as not knowing what support systems could’ve contributed to a better college experience for me,” Sotto said. “That’s part of the reason I do what I do now. I don’t want any other student from a minoritized population not having the resources or support systems they need to be successful.”

At IU School of Medicine, Doriann Alcaide Amador, a third-year medical student from Puerto Rico, said Sotto has been her constant supporter and mentor since day one.

“It’s easy to relate to Dr. Sotto because she gets it—she understands where I’m from, she understands my culture, what I’m missing and what I left behind,” Alcaide said. “Whenever I talk with Dr. Sotto, I feel a connection back to my roots and I feel like my true self.”

In many ways, Sotto is a trailblazer for Hispanic women in academic medicine.

“I admire that she is making headway, opening doors and making paths in increasing diversity in medicine,” Alcaide said. “Her passion and devotion for improving the culture of the medical field is admirable.”

Sotto’s journey has been both meandering and intentional. After graduating from Colorado State, she went to work as an analytical chemist for a biotech company.

“I realized the business side had no idea what the science side was doing,” she recalled. “They demanded results, not understanding how long it takes to do research. That was the reason I went for my MBA.”

In order to attend business school in the evenings, Sotto accepted a research associate position at University of Colorado Health Sciences Center, now known as Anschutz Medical Campus. She studied lung cancer and pulmonary hypertension with leaders in these areas today.

After earning her MBA from the University of Denver, Sotto became a research compliance and integrity officer. As political debate heated up over the Affordable Healthcare Act, Sotto remembers conversations about its potential impact on health research. The University of Denver offered a Master of Professional Studies (MPS) in health care leadership with a focus on health policy, law and ethics. Sotto enrolled, thinking it might lead to a health law career.

She eventually realized her passion wasn’t law—it was in academic medicine. So, she took an administrative position in the Department of Medicine at the University of Colorado School of Medicine. By this time, she was married with three kids and facing another career crossroads.

“Managing a multi-million-dollar budget was not what was giving me joy,” she realized. “I consider myself an administrator-practitioner-scholar. When I thought about what part of my job gave me the most joy, it has always been supporting faculty and students of color.”

Sotto decided to pursue a Doctorate in Higher Education (EdD) and did her dissertation on the experiences of Black and Latino faculty in academic medicine, studying the organizational structures which create barriers to their advancement.

“The first-gen identity doesn’t go away even when you’re a faculty member,” she added. “There’s still a lot I don’t know in terms of resources. That’s one of the reasons I focus so much on faculty development and support. I want to be part of others’ successes.”

Championing equity

In 2015, Sotto was recruited to IU School of Medicine for a position as vice chair for faculty affairs and diversity in the Department of Medicine.

“Because of my interest in faculty and professional development, I knew that IU School of Medicine had one of the strongest programs and offices in the nation,” she said. “It was an institution I had looked to, in terms of, ‘They’re doing cool stuff there, and I want to be part of that.’”

Sotto’s current work falls into four “buckets.”

1. Faculty affairs and professional development—this includes career development and DEI programming.
2. Inclusive learning environments—this includes the education continuum of undergraduate programs, medical school, residency training and fellowships.
3. Organizational leadership and administration—this focuses on organizational equity and accountability, including dismantling policies and practices that perpetuate institutional biases.
4. Research ethics and health equity—this includes informed consent for non-English speakers and efforts to increase participation of minoritized populations in clinical research.

“Dr. Sotto brings a consistent and relentless focus on equity and inclusion within academic medicine,” said Gustavo Arrizabalaga, PhD, professor of pharmacology and toxicology and assistant dean for professional development and diversity affairs at IU School of Medicine. “She is particularly effective in advocating for diversity, equity and inclusion because her efforts are deeply rooted in scholarship and understanding of best practices.”

Sotto is affiliated with the Indiana Clinical and Translational Institute (CTSI), where she serves as co-director of workforce development and director of All IN for Health, a community engagement program and statewide clinical trials registry. She also serves as health equity lead for the Office of Community Outreach and Engagement at the IU Simon Comprehensive Cancer Center, and she is affiliated with the IU Center for Bioethics and the National Institute for Transformation and Equity. In April, she received the 2022 Administrators of Internal Medicine (AIM) Distinguished Service Award.

Carrying the spirit of Puerto Rico

When Sotto gives presentations to colleagues, she typically wears a palm tree necklace and Puerto Rican flag earrings to remind her of her island home.

“Where I come from is part of where I draw my own resilience and fight,” she said. “I keep in mind that academia in the U.S. wasn’t built for people like me. So, I am always amazed that I am here. I do not take it for granted.”

When Sotto visits family in Puerto Rico, she also visits the island’s four accredited medical schools, viewing their medical students as potential recruits for residency programs and faculty positions at IU School of Medicine. She has forged institutional partnerships to help build those pathways.

Her passion for increasing diversity and inclusion in both academia and health care starts at home. Her husband is from eastern Africa, and their three Afro-Latina daughters—ages 17, 14 and 10—motivate her to keep working for equity every day.

“The world is not as I would want it for them,” Sotto said. “Behind the work I do is thinking about the world of higher education they will soon be in and how they will navigate the health system.”

Sotto admires the persistence of the Puerto Rican people, who have stood up against political corruption and femicide and have carried on after dozens of devastating hurricanes and earthquakes.

“Even in the worst moments, you can’t take the music away,” she said.

Sharing cultural traditions: Mofongos & Piña Coladas

Mofongo is a popular Puerto Rican dish starring fried green plantains, mashed with chicharron (crunchy pork skin), garlic and other seasonings.

“My recipe comes from observing my mom, and the seasoning really depends on the music she was listening to at the time of cooking,” said Sotto. “It truly depends on rhythm!”

She likes to enjoy her mofongo with a classic piña colada. Since Sotto’s mother didn’t use a recipe when cooking, try this Puerto Rican Mofongo recipe from Tablespoon.com.