Most Black orthopedic surgeons report workplace discrimination during residency
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Published results showed most Black orthopedic surgeons reported experiencing workplace discrimination, bias and exclusion that could be categorized as subtypes of racial microaggressions during orthopedic residency.
“Leaders in orthopedic departments need to take a step back and realize that this is likely happening at their program, and they need to be more proactive at reaching out to their Black, and particularly Black female, trainees to ask them if this is happening and how they can help,” Jaysson T. Brooks, MD, assistant professor at UT Southwestern and staff pediatric orthopedic surgeon at Scottish Rite for Children, told Healio. “I think being passive is not going to work. [Orthopedic leaders] need to be more proactive in providing support for their residents.”
Between July 1, 2020, and Sept. 1, 2020, Brooks and colleagues administered an anonymous survey to practicing orthopedic surgeons, residents and fellows in the J. Robert Gladden Orthopaedic Society database who self-identified as Black. Using a modified version of the single-item Perceived Occupational Discrimination Scale, respondents reported their perception of discrimination in the residency workplace. Researchers also asked participants to recall any specific examples of experiences with racial discrimination, bias or exclusion during their training, which were later categorized as different subtypes of racial microaggressions, quantified through a descriptive analysis and compared by gender.
Workplace discrimination
Of the 455 Black orthopedic surgeons in practice and 140 Black orthopedic residents or fellows who met the study criteria, 243 practicing surgeons (53%) and 67 current residents or fellows (48%) responded. Results showed 34% of survey respondents perceived “a lot” of residency workplace discrimination, 44% perceived “some” residency workplace discrimination, 18% perceived “a little” residency workplace discrimination and 4% perceived no residency workplace discrimination.
When looking at categorized examples of racial microaggressions experienced in residency, researchers found 87% of respondents reported being confused for nonphysician medical staff, such as a nurse or physician’s assistant, and 81% of respondents reported being confused for nonmedical staff, such as janitorial or dietary services. Researchers also noted 61% of respondents reported receiving racially explicit statements during residency training, of which 38% of statements were made by patients and 18% were made by attending faculty.
Of the 50% of respondents who reported receiving at least one of nine potentially exclusionary or devaluing feedback statements during residency training, 87% perceived at least one of the statements to be racially biased in its context, according to results. The three feedback statements most frequently perceived as racially biased in context included that the respondent “matched at their program to fulfill a diversity quota,” the respondent was “unfriendly” compared with their peers or that the respondent was “intimidating or makes those around him/her uncomfortable.”
Gender differences
When researchers compared results by respondents’ gender, 97% of Black women reported being mistaken for janitors and dietary service staff vs. 77% of Black men. During orthopedic residency training, 100% of Black women reported being mistaken as nurses or physician assistants vs. 84% of Black men, and Black women also more frequently reported receiving potentially devaluing or exclusionary feedback statements, according to researchers.
“Black people experience microaggressions in workplace discrimination [and] females experience workplace discrimination and microaggressions. So when you have a Black female, they’re a double minority, both by gender and by race, and that seems to heighten them being the recipient of certain types of microaggressions and workplace discrimination,” Brooks said.
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