Minority physicians in residency programs in the United States are regularly victims of racism

By Linda Carroll

(Reuters Health) – A new study suggests that minority doctors in training systematically deal with prejudices, sometimes subtle, sometimes less subtle.

According to the study published in the JAMA Network Open, the researchers found that resident physicians from racial and ethnic minorities faced a daily flow of obvious microagressions and prejudices.

"Minority residents appear to be facing additional challenges in an era already marked by considerable stress.Residency program managers and accreditation agencies must work to address these issues not only the main perpetrator of the study, Dr. Aba Osseo-Asare, an assistant professor of medicine at the Yale School of Medicine in New Haven, Connecticut.

Although blacks, Hispanics and Native Americans together make up one-third of the country's population, these three minorities make up only 9 percent of doctors, the researchers said. And part of this disparity could be due to prejudices that minorities encounter in the pipeline, said Osseo-Asare in a phone interview.

By writing about the residents' experiences, the researchers hope to educate people, Osseo-Asare said. "Awareness can help a lot," she added. "Sometimes people feel that they are not racist because they are not aware of their unconscious bias."

Osseo-Asare and his colleagues conducted in-depth individual interviews with 27 minority residents from 21 residency programs.

A common problem for these residents was to be mistaken for the support staff, even for concierges, although they wore a white jacket, a stethoscope, and an identification badge showing that they were in the dark. they were doctors.

A young doctor described such a meeting. The aunt of a patient was visiting and when the mother came in, the aunt told her about the "janitor" who was taking care of the patient. The mother spoke to the resident about her conversation with the aunt: "She told me," The concierge was so smart. He told everyone what to do. He really knew his stuff. "

Other residents talked about how people could not differentiate between them: "Six of us are black women who constantly interchange our names, constantly exchanging people who do not know each other. do not even look like that. "

Sometimes the aggression was more obvious. A Hispanic resident spoke of a meeting with a xenophobic patient, who said: "Someone like you should come back from where you come.You enjoy our resources and all these students would like to get into medical school, those who come here and from the United States and who do not come in. And then you come, take our places and take our jobs, and you do not even have citizenship, and you do not do not even speak English. "

The results of the study did not surprise Dr. Anthony Watkins, assistant professor of surgery in New York City, at the New York-Presbyterian Medical Center / Weill Cornell. Watkins, an African-American, said, "This is the kind of story we are discussing between us.Many of what I've read (in the study) that I have personally experienced or learned from shared experiences ".

And, Watkins said, this is not just something that medical students and residents must manage. He remembers including the story of a surgeon. "When he entered the operating room, they started telling him what needed to be cleaned up," Watkins said. He told them, "I am the surgeon. "

A few days ago, Watkins himself had a similar experience. "I came in to talk to a patient," he told Reuters Health during a phone interview. "I introduced myself and as soon as I finished taking the story and doing the physical test, the patient asked," When will I see Dr. Watkins? "

While Watkins and others have learned to live with the bias, it takes its toll. "I do not take it personally," he said, "but the challenge is the high rate of attrition among minorities, that it is medical students, of Residents or even teachers Some are jaded when they deal with all the micro-aggression They have a hard time finding a mentor They feel socially isolated And there is an effect on the whole system when people drop out. "

For Watkins, however, the problem is not limited to medicine. "It's a small piece of the biggest problem we face in America," he said.

SOURCE: http://bit.ly/2KVMa1V JAMA Network Open, online September 28, 2018.