P3C134: Experiences with and Reporting Racism During Medical Education

Background: The Association of American Medical Colleges 2022 Graduation Questionnaire notes 9.5% of all medical students’ report being subject to racism during their medical education. Discrimination faced by African American/Black medical students can lead to increased stress, fatigue, depression and anxiety. To help create an anti-racist environment, it is important to understand the experience of racism from medical students and why some students may not report it to their medical school. The objectives of this study were: 1) understand the experience of racism from medical students at two geographically similar medical schools but one being a predominately White institution (PWI) and the other a historically Black college and university (HBCU), 2) recognize similarities and differences in the racism students experience, and 3) explore why students do not report the racism they experience.

Methods: 3rd and 4th year medical students from both schools were recruited via e-mail for this phenomenological qualitative study. Consent and demographic data were collected via REDCap. Focus groups and one-on-one interviews were conducted via Zoom Telehealth. To protect anonymity, each student was identified by a participant number only. Focus groups and interviews were audiotaped and transcribed using Rev transcription services (www.rev.com/transcription) and analyzed by the research team using Dedoose software (www.dedoose.com). The research team collected enough data that when analyzed provided sufficiency of information.

Results: Four focus groups and 7 one-on-one interviews were conducted with a total of 21 students participating. Thirty-three percent of students identified as Black/African American and 29% as Asian American Indian. Students at both institutions experienced racism from medical staff and patients. Compared to students from the PWI, students at the HBCU reported more experiences with racism both from students in their class and from students rotating at the same hospital from the PWI. Students at the PWI reported more experiences with racism from attendings as compared to students from the HBCU. Students from both institutions discussed a fear of reprisal and a sense of futility as barriers to reporting racism (Table 1).

Conclusion: Our study provides a deeper understanding of students’ perspective of their experiences with racism during their medical education. These insights may support interventions medical schools can take to be anti-racist and inclusive.