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Recognizing and Reacting to Microaggressions in Medicine and Surgery

Educational Objective
To define and understand microaggressions and how and when to respond to them.
1 Credit CME

Diversity and inclusion in medicine, and in surgery in particular, still merit substantial attention in 2019. With each increase in academic rank there are fewer women, with only 24% of full professors in medicine being women. Underrepresented minorities face similar challenges, with only 3% of medical faculty being black and 4% of medical faculty being Hispanic or Latino; only 2% of full professors are Hispanic or Latino and only another 2% are black. Explicit discrimination unfortunately still does exist, but in many environments, more subtle forms of bias are more prevalent. Microaggressions, which are categorized as microassaults, microinsults, microinvalidations, and environmental microaggressions, are indirect expressions of prejudice that contribute to the maintenance of existing power structures and may limit the hiring, promotion, and retention of women and underrepresented minorities. The primary goal of this communication is to help readers understand microaggressions and their effect. We also provide suggestions for how recipients or bystanders may respond to microaggressions.

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Article Information

Accepted for Publication: April 15, 2019.

Corresponding Author: Arghavan Salles, MD, PhD, Division of Minimally Invasive Surgery, Department of Surgery, Washington University in St Louis, 4901 S Euclid Ave, Ste 920, St Louis, MO 63108 (arghavan@alumni.stanford.edu).

Published Online: July 10, 2019. doi:10.1001/jamasurg.2019.1648

Author Contributions: Drs Torres and Salles are co–first authors.

Conflict of Interest Disclosures: Dr Salles has received honoraria from Medtronic for speaking and consulting. Drs Torres, Salles, and Cochran are members of the Association of Women Surgeons (AWS) #HeForShe Taskforce; this work was produced under its auspices and endorsed by the AWS Executive Council.

Additional Contributions: We thank the individual quoted for granting permission to publish this information.

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