Microaggression and Medicine

Medicine and medical education are currently undergoing a period of transition around addressing and welcoming diversity and inclusion. To that end, the Association of American Medical Colleges (AAMC) has developed a Diversity and Inclusion Toolkit with a website full of resources. It explores ways to integrate diversity and inclusion into our understanding of modern medicine in schools and the workplace. One way to challenge discrimination in the form of unconscious bias in the workplace is microaggression awareness training.

As originally discussed by psychiatrist Chester Pierce, “microaggression” described the everyday slights that Blacks/African Americans encounter from White individuals. Now expanded to other underrepresented groups such as GLBTQI, persons with disabilities, and individuals of low socioeconomic status, microaggressions occur in everyday life.  A leading researcher and psychologist who studies microaggressions, Derald Wing Sue, defines them as “brief, everyday exchanges that send denigrating messages to certain individuals because of their group membership.” The persons making the comments may be otherwise well-intentioned and unaware of the potential impact of their words (Wikipedia). Check out this video and this video for interviews with Dr. Sue.

The AAMC has posted a PowerPoint by Vicki T. Sapp, Ph.D. on Understanding Microaggressions in the Workplace. Medical students, residents, and physicians may encounter microaggressions regardless of their stage of training or years of experience. That is, assumptions from patients, colleagues, and professors may impact the daily lived experience of medical professionals. Common microaggressions in medicine include comments that suggest that a medical student or professional doesn’t belong. To exemplify, a professor, fellow student, or patient may confuse the role of the individual and inquire if they are housekeeping or janitorial staff, failing to recognize their professional role or training role in health care. Gender-based biases are another example when assuming a female is a nurse, and a male is a doctor.

Such microaggressions are compared to mosquito bites in this short video. Students, residents, and physicians are not immune to the sting of microaggressions. When they are “stung” multiple times by such zingers, the impact can be cumulative and emotionally exhausting. Checking assumptions is an important part of collaborating in the workplace. Allies should do the work to regularly examine and deconstruct their assumptions and assertions. intentional and unintentional mosquito bites can have the same effect. Medical students and professionals who have experienced microaggression can focus on finding safe outlets to process their feelings. Microaggressions in the workplace require examination, as band-aid solutions do little to treat the annoying itch of mosquito bites, especially when there are too many of them.

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