Supporting & Retaining Diverse Residents

• EDI initiatives are constant and not limited to the recruitment cycle

  • • This 2018 Scientific American article distills the challenge of pursuing diversity during recruitment without ensuring inclusion and support:

      1. • "Once they are in school, they are told to leave precisely what they bring to the table at the threshold of the hospital. Women are taught to emulate men (but not too much) and leave gender politics out of the operating room. Some are asked to scrub their tongues clean of accents or Ebonics while queer and transgender students are trained to quiet their identities. Trainees struggling with chronic illnesses or disability learn early on not to associate too closely with their diagnoses, and black and brown students feel pressure to suffer explicit racial insults in silence."

• All residents need to be supported and guided in their professional identity formation with mentorship, linkage to early research opportunities, career counselling, and identification of positive role models

  • • Recognize that women and UIM physicians are likely to experience sexism, racism, and other forms of discrimination

      1. • From the CMAJ:

"Doctors on their own when dealing with racism from patients", 2018

When people hear "doctor," most still picture a man, 2019

Sexism in medical care: "Nurse, can you get me a blanket?", 2020

• • • 1. • This 2016 NEJM article describes an approach to racist patients

         • This 2016 Annals of Internal Medicine personal essay describes the lived experience of an Indian-American physician with racism

         • This 2019 JAMA Internal Medicine study reports biased patient behaviours leading to physicians and medical trainees experiencing exhaustion, self-doubt, cynicism, moral distress, and uncertainty about how to respond

         • This 2020 JAMA Internal Medicine study of over 27000 graduating American medical students shows that women, UIM, Asian, multiracial and LGB students experience disproportionately greater mistreatment during medical school

    • Recognize that LGBTQ physicians and medical learners experience discrimination and witness anti-LGBTQ stigma, which may lead to hiding of their identities and adverse mental health outcomes

      1. • Consider also the intersectionality of sexual- and gender-identity oppression with racism for nonwhite LGBTQ physicians

         • This 2015 Academic Medicine study found 29.5% of sexual and gender minority medical students in the United States and Canada concealed their identity; 43% reported doing so due to fear of discrimination in medical school

         • These two 2019 studies describe some of the unique challenges faced by LGBTQ physicians and medical students

    • Recognize that women and UIM physicians may be at higher risk of imposter syndrome

      1. • Dealing with imposter syndrome when you're treated as an imposter, New York Times, 2018

         • A 2020 systematic review suggests imposter syndrome is particularly prevalent among ethnic minority groups