• Women and underrepresented minorities (URMs) being mistaken as nonphysicians.


• A team leader not acknowledging the contribution or idea of a woman and lauding the same contribution by a male peer.


• A team leader consistently verbally cutting off minority team members while allowing white counterparts to fully express themselves.


• “Mansplaining” a concept directly to a woman with existing knowledge of the subject.


Microinvalidations: Acts that invalidate, dismiss or undermine thoughts, feelings and experiences of a person. For example:


• A straight person telling a gay colleague that homophobia doesn’t exist anymore since gay people can marry.


• In professional settings, female colleagues being referred to by their first name while male counterparts are referred to with their honorific.


• A URM physician being told by colleagues, “I don’t see color.”


• Leaders insisting that their workplace is a meritocracy when challenged on workforce disparities with objective data.


• Leaders telling aggrieved parties that they’re imagining discrimination or being “overly sensitive.”


• Women leading clinical programs being excluded from strategic decision-making processes while men in similar circumstances are included.


• A team member consistently avoiding being partnered with or speaking to a LGBTQ colleague.


Environmental: Environmental microaggressions are exhibited when microassaults, microinsults and microinvalidations become adopted and expressed in the culture, processes and climate of the workplace. For example:


• Honors and awards being named exclusively after men or white individuals.


• Indifference to a lack of childcare resources promulgating unwelcoming feelings for physicians with young families.


• Leadership denying academic time for staff studying or promoting healthcare


The exacted toll is unacceptable when trying to create a pipeline of necessary talent in medicine.


disparities, diversity, equity and inclusion in their department.


• Leadership opting not to investigate workplace complaints regarding racism in the workplace.


• Leadership opting to unevenly investigate workplace complaints regarding minorities vs. nonminority counterparts.


While microaggressions may be more difficult to identify than overt forms of discrimination, their aggregated effects create as much stress and harm to the recipients. Microaggressions can cause the target to exist in a hypervigilant state, always on guard for the next assault, and lead to internalized feelings of professional inadequacy based on their immutable human and cultural characteristics. Perceived discrimination contributes to lower self-esteem and is linked to depression and anxiety in its victims.4


Microaggressions are


exceedingly challenging for those facing discrimination where there is intersectionality with race, gender, sexual orientation and gender identity. The exacted toll is unacceptable when trying to create a pipeline of necessary talent in medicine.


Microaggressions in real life The following case examples, submitted anonymously by practicing IRs, provide a real-life look at how subtle discrimination can seep into the workplace every day.


• “I served on my medical school’s admissions committee as a liaison from the Student National Medical Association (SNMA). During one meeting, the dean of admissions exclaimed, ‘I knew you were our SNMA representative, but I was surprised to just find out that you’re also one of our best students!’ I accepted her words as a compliment, but I’ve always have held some discomfort


that she was surprised that the SNMA representative could also possess academic excellence.”—A Black IR


• “In the 1980s, during medical school and internship, we had a lot of patients with end-stage HIV. They were profoundly ill with so much need and so little hope. Every patient, without exception, was the object of a negative comment by someone on the medical team regarding their illness or sexual orientation. Jokes, contempt and indifference were almost routine. In the 1990s, there was an


intense and enduring controversy regarding a local LGBT military service organization that was denied access to march in the city’s annual St. Patrick’s Day parade. Several IR colleagues laughingly discussed the topic and said it was ‘ridiculous’ and ‘totally unnecessary’ for them to disrupt a ‘family day.’ I learned from my peers that being gay—inside and outside of the hospital—was very much not OK. Gays were regarded as immoral subhumans all having HIV, almost deservingly so, and their presence was considered offensive and threatening to society. This led to a deep schism between my professional life )and personal life. I felt unworthy of mentorship and was directionless and without support in my professional development.” —A gay IR


• “Every safety report becomes a conversation for me and the Latinx residents, but not for my white colleagues.”—A Black radiology resident


• “I always won the ‘Best Resident Case Presentation’ award, but when it came time to pick teams for projects, I was always left out.” —A Black female practicing IR


• “Attendings and colleagues, when hearing my last name have made ‘jokes’ along the lines of:


o You’re not part of Al Qaeda/ISIS/ ISIL, are you?


o Are you Muslim? Do you believe in Shariah law?


What is most frustrating in this present moment is the outright refusal of the field to not unequivocally acknowledge implicit bias and prejudice amongst


sirweb.org/irq | 15


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40