Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
BMC Med Educ. 2024 Nov 26;24(1):1376. doi: 10.1186/s12909-024-06363-5.
Addressing a lack of diversity in the physician workforce is a priority in the Canadian healthcare system. Data describing demographics of residents and their experiences of discrimination, harassment, and racism at work are incomplete. The objective of this work was to describe the demographics and perceptions of workplace discrimination and harassment for postgraduate medical trainees in Alberta.
A cross-sectional survey based on the Chronic Workplace Discrimination and Harassment Scale was administered to all resident physicians in Alberta by e-mail invitation from the postgraduate medical education offices at the Universities of Alberta and Calgary, their residency training program directors, and the Professional Association of Residents of Alberta. Total score (median, interquartile range [IQR]) was compared by gender, racial, and intersecting gender and racial identities, with higher scores suggesting more frequent experiences of workplace discrimination and harassment (range 0 to 32). We performed thematic content analysis of open text responses.
There were 195 complete surveys returned from 1,752 Alberta residents (11.2% response rate), including 120 cisgender women (61.5%), 104 white participants (53.3%) and 74 white cisgender women (37.9%). The overall median score on the Chronic Workplace Discrimination and Harassment scale was 9 (IQR 5-14): cisgender women and gender diverse participants reported more frequent harassment, mistreatment, or discrimination than cisgender men (median 10 [IQR 6-15] versus 8 [4-13.5], p = 0.049). There was no difference in the frequency of reported discrimination between BIPOC and white respondents (median 9 [IQR 5-14.5] versus 9.5 [IQR 6-14], p = 0.72) or participants with intersecting race and gender identities (p = 0.26). Over 44% of BIPOC residents had been the target of a racial slur or joke from an attending physician or colleague in the past year and nearly 45% of all participants had witnessed an attending physician or colleague using a racial slur in the past year. Open text responses provided examples of mistreatment, harassment, discrimination, and racism from participants.
These results demonstrate an unacceptable prevalence of harassment and racism witnessed or experienced at work by Alberta residents. Urgent action to identify, prevent, and remediate racism in the healthcare system must be a priority of medical schools and regulatory bodies.
解决医生队伍中缺乏多样性的问题是加拿大医疗保健系统的当务之急。关于住院医师的人口统计学数据及其在工作中遭受歧视、骚扰和种族主义的经历并不完整。这项工作的目的是描述艾伯塔省研究生医学受训者的人口统计学特征以及他们对工作场所歧视和骚扰的看法。
通过阿尔伯塔大学和卡尔加里大学、其住院医师培训项目主任和艾伯塔专业住院医师协会向阿尔伯塔的所有住院医师发送电子邮件邀请，使用基于慢性工作场所歧视和骚扰量表的横断面调查。总分（中位数、四分位距 [IQR]）按性别、种族和交叉性别和种族身份进行比较，得分较高表示工作场所歧视和骚扰的经历更为频繁（范围 0 至 32）。我们对开放文本回复进行了主题内容分析。
从 1752 名艾伯塔居民中收到了 195 份完整的调查回复（11.2%的回复率），其中包括 120 名顺性别女性（61.5%）、104 名白种人参与者（53.3%）和 74 名白种顺性别女性（37.9%）。慢性工作场所歧视和骚扰量表的总体中位数评分为 9（IQR 5-14）：跨性别女性和性别多样化参与者报告的骚扰、虐待或歧视比顺性别男性更为频繁（中位数 10 [IQR 6-15] 与 8 [4-13.5]，p=0.049）。在报告的歧视频率方面，BIPOC 受访者和白人受访者之间没有差异（中位数 9 [IQR 5-14.5] 与 9.5 [IQR 6-14]，p=0.72），或具有交叉种族和性别身份的参与者之间也没有差异（p=0.26）。超过 44%的 BIPOC 居民在过去一年中曾受到主治医生或同事的种族侮辱或笑话的攻击，近 45%的参与者在过去一年中曾目睹主治医生或同事使用种族侮辱。开放文本回复提供了参与者受到的虐待、骚扰、歧视和种族主义的例子。
这些结果表明，艾伯塔省居民在工作中目睹或经历了令人无法接受的骚扰和种族主义。必须将确定、预防和纠正医疗保健系统中的种族主义作为医学院校和监管机构的当务之急。
