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Minority Resident Physicians’ Views on the Role of Race/Ethnicity in Their Training Experiences in the Workplace

Educational Objective
To understand the views of minority residents on the affect of race on their training
1 Credit CME
Key Points

Question  How do minority resident physicians view the role of race/ethnicity in their training experiences?

Findings  This qualitative study of 27 minority resident physicians found that participants described 3 major themes: a daily barrage of microaggressions and bias, minority residents tasked as race/ethnicity ambassadors, and challenges negotiating professional and personal identity while seen as “other.”

Meaning  Results of this study suggest that minority residents face extra workplace burdens during a period already characterized by substantial stress, warranting further attention from educators, institutions, and accreditation bodies.

Abstract

Importance  Black, Hispanic, and Native American physicians remain underrepresented in medicine despite national efforts to increase diversity in the health care workforce. Understanding the unique workplace experiences of minority physicians is essential to inform strategies to create a diverse and inclusive workforce. While prior research has explored the influence of race/ethnicity on the experiences of minority faculty and medical students, there is a paucity of literature investigating how race/ethnicity affects the training experiences of resident physicians in graduate medical education.

Objective  To characterize how black, Hispanic, and Native American resident physicians experience race/ethnicity in the workplace.

Design, Setting, and Participants  Semistructured, in-depth qualitative interviews of black, Hispanic, and Native American residents were performed in this qualitative study. Interviews took place at the 2017 Annual Medical Education Conference (April 12-17, 2017, in Atlanta, Georgia), sponsored by the Student National Medical Association. Interviews were conducted with 27 residents from 21 residency programs representing a diverse range of medical specialties and geographic locations.

Main Outcomes and Measures  The workplace experiences of black, Hispanic, and Native American resident physicians in graduate medical education.

Results  Among 27 participants, races/ethnicities were 19 (70%) black, 3 (11%) Hispanic, 1 (4%) Native American, and 4 (15%) mixed race/ethnicity; 15 (56%) were female. Participants described the following 3 major themes in their training experiences in the workplace: a daily barrage of microaggressions and bias, minority residents tasked as race/ethnicity ambassadors, and challenges negotiating professional and personal identity while seen as “other.”

Conclusions and Relevance  Graduate medical education is an emotionally and physically demanding period for all physicians. Black, Hispanic, and Native American residents experience additional burdens secondary to race/ethnicity. Addressing these unique challenges related to race/ethnicity is crucial to creating a diverse and inclusive work environment.

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Article Information

Accepted for Publication: July 18, 2018.

Published: September 28, 2018. doi:10.1001/jamanetworkopen.2018.2723

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2018 Osseo-Asare A et al. JAMA Network Open.

Corresponding Author: Aba Osseo-Asare, MD, Department of Internal Medicine, Yale School of Medicine, 1450 Chapel St, New Haven, CT 06511 (aba.osseo-asare@yale.edu).

Author Contributions: Dr Osseo-Asare had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr Osseo-Asare was solely responsible for the final approval of the manuscript and the decision to submit the manuscript for publication.

Concept and design: Osseo-Asare, Balasuriya, Huot, Keene, Berg, Nunez-Smith, Genao, Boatright.

Acquisition, analysis, or interpretation of data: Osseo-Asare, Balasuriya, Keene, Berg, Latimore, Boatright.

Drafting of the manuscript: Osseo-Asare, Balasuriya, Boatright.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Osseo-Asare, Balasuriya, Boatright.

Obtained funding: Osseo-Asare, Huot, Boatright.

Administrative, technical, or material support: Balasuriya, Huot.

Supervision: Berg, Nunez-Smith, Genao, Boatright.

Conflict of Interest Disclosures: None reported.

Funding/Support: This work was supported by funds from Dr Huot.

Role of the Funder/Sponsor: Dr Huot critically reviewed the manuscript but was not directly involved in data collection or analysis. Dr Huot funded this study in an effort to better understand the unique experiences of underrepresented minority resident physicians on a national level. Dr Huot sought to learn more about these unique experiences to inform his practices at Yale University and to disseminate these findings to other Accreditation Council for Graduate Medical Education officials. Dr Huot did not have a role in the collection, management, analysis, or interpretation of the data but was involved in the design and conduct of the study, as well as preparation, review, the approval of the manuscript, and decision to submit the manuscript for publication.

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