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November 7, 2019

Women in medicine more likely to experience 'microaggressions' than men. Here's what you can do about it.

Daily Briefing

    Female medical faculty members find "microaggressions"—indirect, fleeting comments that are "rooted" in "unconscious bias" against a marginalized group—common in the workplace, while male faculty say they seldom occur, according to a study published last week in Academic Medicine, the study's lead author VJ Periyakoil, writes for the New York Times' "Well." 

    Periyakoil is an associate professor at Stanford University School of Medicine.

    Study details

    A few years ago, Periyakoil started the Stanford Project Respect to study communication in health care and "foster mutually respectful interactions between health professionals and their patients."

    For the project, Periyakoil and her colleagues hired professional actors to reenact 34 different microagression scenarios as well as control—or "nontoxic"—versions of the scenarios. The interactions were recorded and turned into 68 videos that medical faculty at four medical schools across the country viewed in random order. The faculty members were then asked to rate each scenario on the frequency in which they occurred in real life.

    The sample group consisted of 124 people, 79 of whom were women and 45 of whom were men.

    Key findings

    The results, published last week in Academic Medicine, showed female faculty were more likely than male faculty to say the microaggression scenarios were common in the workplace.

    The female faculty members reported that workplace microaggressions were frequent overall. On the other hand, male faculty from the same workplaces said microaggressions were uncommon.

    The researchers as part of the project also collected stories of microaggressions from health care workers across the country. One female surgeon recalled being interviewed by a panel of men, which she called a "manel," and being asked how she would, "be able to effectively communicate in the operating room as a woman."

    Another said that when she asked her boss about being promoted to a different position, he responded, "Well, I'm just deciding, you know, if I'd like to give you an engagement ring or not. You have to convince me."

    In one situation that Periyakoil calls particularly "appalling," a lecturer selected a female student to be a model for his ultrasound skills demonstration and called a certain angle of the instrument probe a "money-shot."

    Can this change?

    Based on her research, Periyakoil offers suggestions about how medical faculty can confront microaggressions and create a better climate for female faculty and students.

    In the moment, calling out microagressions can be "daunting," Periyakoil writes, but at a closer look, "we see that microaggressions are rooted in our unconscious biases that are fed by the gender and racial tensions that seethe under the surface and bubble up when we least expect them."

    As a result, the first step to changing the culture is acknowledging the problem, Periyakoil writes.

    "If you are the perpetrator and you catch yourself in the act, apologize immediately and sincerely for your misstep. If you are the recipient, speak up respectfully and promptly in the moment," she writes.

    Bystanders can also play a critical role in mitigating the culture by calling out microaggressions and supporting victims of the comments.

    For example, during a gynecology seminar, a professor asked a female student if she could tell how much estrogen she has inside of her body when she's ovulating. The "mortified" female student sat in silence, but then a male classmate stepped in.

    "Professor, I've never, um, ovulated before, but I think I can take this question," he said (Periyakoil, New York Times, 10/31; Vyjeyanthi et al., Academic Medicine, 10/29).

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