Anti-Black racism in medical school: a study from one school

A study from the University of Saskatchewan’s College of Medicine provides a picture of anti-Black racism in medical school at a Canadian university. The study is published in CMAJ (Canadian Medical Association Journal).

“Our findings provide empirical evidence to reveal the extent and specific nature of racism in a Canadian medical school; we suspect Black students in many other medical schools experience similar racism,” writes Dr. Jacob Alhassan, University of Saskatchewan, Saskatoon, Saskatchewan, with coauthors.

This racism stems from historical, anti-Black policies, which endure in subtle and pernicious forms in today’s medical system and medical education. 

Based on interviews conducted at the medical school between May and July 2022, the study revealed 5 central themes describing experiences with, and exposures to, racism in medical education that can worsen as learners progress through the medical system. Anti-Black racism negatively affects medical learners – for example, repeatedly questioning their competence fosters self-doubt and low confidence in their medical abilities – as well as patients.

“Experiences of racism are encountered through microaggressions and uncomfortable encounters, blatant comments, the medical curriculum, and medicine’s inherent hierarchical structures. Intersecting oppressions (e.g., being Black and a woman) compound experiences of anti-Black racism and, as learners progress in medical education, racist experiences may worsen,” the authors write. 

They suggest that the medical system needs to reorient its perspectives and practices as part of an ongoing process. This should include a yearly review of medical curriculum to ensure that Black representations are appropriate and accurate. 

“[M]uch of this discussion highlights the need for decolonization of medicine and an examination of how the structure of medical education contributes to racist encounters between Black learners and medical faculty,” write the authors. “Although some form of hierarchy can be useful for role modelling and maintaining order in the clinical setting, many of the negative experiences described by Black medical learners show that a toxic combination of hierarchy, power, and prestige can breed unaccountability, expressed in blatant racism.”

In a commentary on a related topic, authors emphasize that Canada’s Black population is very diverse and that this diversity – and associated unique experiences of anti-Black racism and racial discrimination – should be recognized in health research and health care.

“Ignoring the diverse identities and social positions of Black people can lead to overgeneralized findings that fail to recognize nuanced intersections with anti-Black racism that drive inequities in health and health care,” writes Khandideh K.A. Williams, McGill University, Montréal, Quebec, with coauthors.

“Without acknowledging the within-group diversity of Canada’s Black communities, health care policies and interventions aimed at addressing anti-Black racism are unlikely to make much of a difference,” they conclude.

“Variegated racism: exploring experiences of anti-Black racism and their progression in medical education” and “Embracing Black heterogeneity: the importance of intersectionality in research on anti-Black racism and health care equity in Canada” were published June 10, 2024.