J. Mpalirwa is a family physician, Casey House, and a member of the Black Physicians' Association of Ontario, Toronto, Ontario, Canada.
A. Lofters is a family physician, associate professor, and clinician-scientist, Department of Family and Community Medicine, Women's College Hospital and University of Toronto, adjunct scientist, ICES, and a member of the Black Physicians' Association of Ontario, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0002-7322-0894.
Acad Med. 2020 Nov;95(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 59th Annual Research in Medical Education Presentations):S51-S57. doi: 10.1097/ACM.0000000000003648.
Black physicians' and trainees' experiences of racism are not well documented in Canada, reflecting a knowledge gap needing correction to combat racism in Canadian health care. The authors undertook a descriptive study of Black physicians and trainees in the Canadian province of Ontario. The goal of this study was to report upon racism experienced by participant Ontarian physicians to challenge the purported rarity of racism in Canadian health care.
An anonymous online survey of physicians and trainees who self-identify as Black (African/Afro-Canadian/African American/Afro-Caribbean) was administered in March and April 2018 through the Black Physicians' Association of Ontario (BPAO) listserv. The survey was modeled on qualitative interview guides from American studies. Snowball sampling was employed whereby BPAO members forwarded the survey to eligible colleagues (non-BPAO members) to maximize responses. Survey data were analyzed and key themes described.
Survey participants totalled 46, with a maximal response rate of 38%. Participants reported positive experiences of collegiality with Black colleagues and strong bonds with Black patients. Negative discrimination experiences included differential treatment and racism from peers, superiors, and patients. Participants reported race as a major factor in their selection of practice location, more so than selection of career. Participants also expressed a lack of mentorship, and there was a strong call for increased mentorship from mentors with similar ethno-racial backgrounds.
This study challenges the notion that racism within Canadian health care is rare. Future systematic collection of information regarding Black physicians' and trainees' experiences of racism will be key in appreciating the prevalence and nature of these experiences.
在加拿大,针对黑人员医医生和受训医生的种族主义经历,相关记录并不完善,这反映出需要纠正知识上的空白,以打击加拿大医疗保健领域的种族主义。作者对加拿大安大略省的黑人员医医生和受训医生进行了描述性研究。本研究的目的是报告参与者在安大略省所经历的种族主义,以挑战所谓的加拿大医疗保健中种族主义罕见的说法。
2018 年 3 月至 4 月,通过安大略省黑人医生协会(BPAO)的电子邮件列表,对自认为是黑人(非裔加拿大人/非洲裔美国人/非洲裔加勒比人)的医生和受训医生进行了匿名在线调查。该调查是基于美国研究中的定性访谈指南制定的。采用了雪球抽样法,BPAO 成员将调查转发给符合条件的同事(非 BPAO 成员),以最大限度地增加回复人数。对调查数据进行了分析,并描述了主要主题。
共有 46 名参与者完成了调查,最大回复率为 38%。参与者报告了与黑人同事的融洽关系和与黑人患者的牢固关系的积极经历。负面的歧视经历包括来自同行、上级和患者的不同待遇和种族主义。参与者表示,种族是他们选择执业地点的主要因素,而不是选择职业的主要因素。参与者还表示缺乏指导,强烈呼吁增加具有相似族裔背景的导师的指导。
本研究挑战了加拿大医疗保健领域的种族主义罕见的观点。未来系统地收集有关黑人员医医生和受训医生种族主义经历的信息,将是了解这些经历的普遍性和性质的关键。