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Beyond Silence and Inaction

Changing the Response to Experiences of Racism in the Health Care Workforce

Premkumar, Ashish, MD; Whetstone, Sara, MD, MHS; Jackson, Andrea V., MD, MAS

doi: 10.1097/AOG.0000000000002868
Contents: Clinical Practice: Current Commentary

The issue of race and ethnicity within obstetrics and gynecology has come to the forefront in the current social and political climate. Understanding the ill effects of racism within the clinical space requires an acknowledgment of both the ongoing problem and current limitations in the state of knowledge and praxis among clinicians, trainees, and educators alike. In this commentary, the issue of race and racism within obstetrics and gynecology is discussed through a case of discrimination experienced by an intern working in an urban, academic hospital. By attending to the different layers of hierarchy within medical education and care as well as the multitude of silences from potential allies, we demonstrate a critical need to understand racism and inequality in the clinical and educational space. We deconstruct the issue of race and racism by contextualizing it with ongoing discussions in the social sciences and public health as well as wider discussions of the relationship of race with professional training and employment in biomedical fields. Finally, we offer both action items and calls for future educational and practice-based solutions to affect change in the way obstetrics and gynecology is taught and practiced.

The issue of racism within obstetrics and gynecology extends through education and practice and is in need of critical remediation.

Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, California.

Corresponding author: Ashish Premkumar, MD, 250 E Superior Street, Room 05-2185, Chicago, IL 60611; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal’s requirements for authorship.

© 2018 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.