Fortitude: A Study of African Americans in Surgery in New York City

Fortitude: A Study of African Americans in Surgery in New York City

Robert S. Kurtz (SUNY Downstate Medical Center, USA)
DOI: 10.4018/978-1-5225-8870-2.ch008

Abstract

In New York City, from the 1990s to the present, covert racism is alive and well in the field of medicine and medical education. The most heavily impacted are African American and Caribbean American females and males. The inequitable treatment thus engendered has concrete results ranging from unwarranted criticism in residency education to forced changes of medical occupations and jobs, to false attributions of behavioral health issues. Combating these challenges requires fortified character armor, seeking percipient well positioned minority, white and off-whites allies, and a willingness to maintain continued vigilance. With persistence and tenacity, success is possible in terms of protecting minorities both in the educational process, and in a mature medical life.
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Background

Medicine like any other social institution is always in large part a manifestation of the culture in which it exists and traditionally racism and sexism have regrettably been endemic to the society in the United States (Loewy, 2008). When examining the complex issues of women of color in medicine, the depth and breadth of the research cuts across a number of intersections and weaves in and out of continua from medical education to residency and beyond. The examination begins with a look at the perception of female medical students and their perceived gains on gender equality (Heever and Frantz, 2011).

Gender bias has been ingrained in healthcare education, research and clinical training. In 2002 the World Health Organization implemented a gender policy committing itself to advancing gender impartiality and equity in health and to set right health inequities that are a consequence of gender roles and unequal gender-relations in society. Building on earlier international research, the goal of the study was to play a part in the understanding of women’s encounters with gender discrimination and inequality while partaking as learners in health education. The research question was whether the medical educational structures could be enabling the inequalities or contributing to the re-establishment of the discrepancies known to be real.

The study included all fourth-year female medical students at a university located in South Africa. Of the overall number of questionnaires disseminated, 48/72 fourth-year female medical students responded, generating a response rate of 68%. Of the respondents, 32% reported having the experience that they were not taken seriously by patients because they were women. In addition, 24% state that they were not taken seriously by their male peers. The findings point toward the inevitability of a requirement for supplementary support for women in medicine as well as addressing the gender role suppositions apparent in the educational experience through curriculum development.

What does this mean as the field considers the impact on the changing dynamic and composition of medical schools in the western world (Grbic and Brewer, 2012)?

Analysis In Brief (AIB) looks at: (1) the latest patterns in number and proportion of female applicants to medical school by first-time, repeat, and total applicants; (2) the patterns in medical school matriculation.

This forces the field to examine specific issues and in some cases women in the field as they are questioning themselves (Hinze, 2004). This study examines the everyday lives of women and men resident physicians to understand the context within which harassment unfolds. The narratives explored here reveal how attention is deflected from the problem of sexual harassment through a focus on women’s ‘sensitivity’. Women resist by refusing to name sexual harassment as problematic, and by defining sexual harassment as ‘small stuff’ in the context of a rigorous training program. Ultimately, both tactics of resistance fail. Closer examination of the relations shaping everyday actions is key, as is viewing the rigid hierarchy of authority and power in medical training through a gender lens.

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