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Acts Committed and Omitted

Acknowledging Racial and Gender Bias in Medicine

Rao, Sandhya

doi: 10.1097/ACM.0000000000002655
Letters to the Editor

Fourth-year medical student, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire;; ORCID:

Disclosures: None reported.

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To the Editor:

The interactions were not malicious, and I had accepted they were intrinsic to being a female minority medical student. Some patients would greet me with “Namaste” when I entered or ask me “what I was.” Some would only shake the male doctors’ hands, forgetting to acknowledge the female resident and me. Others called me “nurse.” I mentioned these encounters to my clerkship director, and she empathized and apologized. But we shared an understanding that we could not control what our patients said or did, and as health care providers, we needed to learn to tolerate these behaviors. I have since realized that we need to remain professional and respectful to our patients, but not at the cost of perpetuating biases against minorities and women. Several months later, I found myself surprised when a male reached out to shake not only the male physician’s hand but mine as well. I did not expect him to want to shake my hand. I had subconsciously internalized acts of bias committed and omitted, and I had devalued myself in the process.

As a student, I have felt powerless in these situations, silenced by the threat of ostracism or bad evaluations. I would have liked my attendings or residents to support me, emphasize to the patient my professional capabilities over the color of my skin or recognize that the patient should acknowledge me as well, despite my gender.

Perhaps my future peers were unaware of these slights, not seeing the world from my perspective. I once voiced to a male colleague how I felt ignored by our supervisor, a male physician. At first, he denied any extra attention he was receiving, but then he reflected and agreed that he was given additional words of encouragement and recognition.

The academic medicine community is aware of the increasing number of female physicians, but there is a dearth of females leading clinical departments.1 For medical education institutions to foster a more welcoming environment for underrepresented groups, I believe we need to create standardized awareness and communication training for teaching clinicians and trainees to navigate the realities of addressing racial and gender bias in medicine.

Sandhya Rao

Fourth-year medical student, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire;; ORCID:

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1. Rochon PA, Davidoff F, Levinson W. Women in academic medicine leadership: Has anything changed in 25 years? Acad Med. 2016;91:1053–1056.
© 2019 by the Association of American Medical Colleges