“Instead, their slow accumulation during a childhood and over a lifetime is in part what defines a marginalized experience, making explanation and communication with someone who does not share this identity particularly difficult. Social others are microaggressed hourly, daily, weekly, monthly.”

Christy Byrd, assistant professor of Psychology at UC Santa Cruz (UCSC), spent the 2015–16 school year studying microaggressions and their effects on UCSC students. Byrd told UCSC’s Newscenter that perceived microaggressions, after controlling for gender, race, and social class, “were associated with lower self-esteem, lower feelings of competence for daily life, more depressive symptoms, and more stress.” Byrd connected microaggressions to “lower feelings of belonging,” a “lack of confidence in abilities” and “poor performance.” She also highlighted a dearth of research on intervention strategies for students to respond to microaggressions.

Lest anyone view so-called “thoughtless” or “harmless” microaggression as just political correctness on steroids, it’s time for reflection and empathy.  There is a website (www.microaggressions.com/) where people from all races, ethnic groups, religions and sexual orientation post their personal experiences with microaggression and how it has affected them.

Here’s some examples of their experiences:

1. In response to “You talk white.”

As a young Latina, this was expressed to me numerous times after displaying an ‘extensive’ vocabulary or my use of grammatically correct English. It also usually went hand in hand with “you’re not like the rest of them.” I felt angry, sad, despondent. I would go talk to my mom afterwards in my frustration and luckily she would tell me how wrong what they said was and that being intelligent was NOT exclusively ‘white’, supported with many examples of educated people of color.   

2. In response to a friend, holding a brown-colored stick: “Look, it’s you!” and then he throws stick over fence.

“I’m Latina, and my friend thought it would be funny to make a joke about me “illegally immigrating” to the US from Mexico. My family is El Salvadorian.”

3. “I am Latina and I come from a low income family. Because I have excelled academically, I am applying to several Ivy League institutions. I approached the elderly woman sitting at the office front desk so I can have her send my transcript to these universities. She takes a look at the list of schools I provided and she asks, ‘Are you sure you can get into these schools? Do you even have a backup school?’ Before I could even answer, she says, ‘Oh wait, you’re Spanish, never mind.’ I was so upset. I have worked hard to get into these schools and she is telling me that the only reason I would get accepted is because of my race.”

4. In response to: “Well, it’s only because she has that Hispanic last name (Martinez). You know, they are always looking for minorities.”

“My neighbor, when finding out I (and not her son) was awarded a very prestigious and large scholarship to pay for my undergraduate education and study abroad. I worked extremely hard to get this scholarship all throughout high school.”

5. “Sitting around the circle at a teen feminist, riot grrrl meeting, someone said they named their duck ‘Jose the Mexican duck’. They said ‘we gave him a Mexican mustache so we call him Jose.’ They found it really funny. White girls laughed and spoke, my sisters and I (who are Hispanic) were quiet. Made me feel marginalized in a group that was supposed to be supportive on a social, cultural, and personal level.”

6. “I told my white woman classmate that I had been street harassed on the way to school.  She said, ‘Ugh, I hate when Latino guys harass me! They’re so misogynistic, and Spanish makes those comments sound even slimier!’  I told her that the harasser was actually a white Wall Street-type, and she said, ‘Oh, that’s not so bad then.  I wouldn’t mind being harassed too much if the guy was attractive and wealthy.’”

7. “My friend was frustrated that she couldn’t put anything under ‘disadvantages’ on her application, so she says, ‘Sometimes I wish I was half black and half Latino, then I’d get into everything.’”

8. In response to: “Too bad about all the damn Cubans down there.’”

“My boyfriend’s family friend to my boyfriend and me, about Miami. I am half-Cuban with a clearly Latin@ name, and we were in Miami to visit my father and grandfather, both Cuban immigrants.” •

Sources: Association of American Medical Colleges (AAC&U) and The Kirwan Institute for the Study of Race and Ethnicity at The Ohio State University, www.bordercrossers.org, the NAACP, Kirwan Institute for the Study of Race and Ethnicity and Psychology Today, microaggressions.com, Yale News and Yale Daily News.

Unconscious Bias In Academic Medicine

In 2017, the Association of American Medical Colleges and The Kirwan Institute for the Study of Race and Ethnicity at The Ohio State University produced a report entitled “Proceedings of the Diversity and Inclusion Innovation Forum: Unconscious Bias in Academic Medicine: How the Prejudices We Don’t Know We Have Affect Medical Education, Medical Careers, and Patient Health.” The study points out the ripple effect microaggression and unconscious bias can have in preparing the future physicians of our society. This excerpt of the report points to a possible way to mitigate these effects:

“Unconscious Bias Testing In Medical School Admissions: An Institutional Profile From The Ohio State University College Of Medicine”

By Quinn Capers IV, MD, Associate Dean of Admissions, Associate Professor of Medicine (Cardiovascular Medicine)

Unconscious bias has been associated with discriminatory behavior in the criminal justice, education, and health care systems, but little is known about the presence or impact of such biases in the medical school admissions process. If operational in medical school admissions, these biases could contribute to health care disparities by impeding the entry of underrepresented minorities (URM) into the medical profession. Awareness is the first step to addressing and reducing unconscious biases. Recognizing this, in 2012, each member of The Ohio State University College of Medicine admissions committee took the Implicit Association Test (IAT). The group specifically sought to assess for “implicit white preference,” defined as the unconscious association of a white face with positive words and feelings and a black face with negative words and feelings. Aggregate findings were then shared with the committee along with a presentation on implicit bias and bias reduction strategies.

Following the implicit bias exercise and the subsequent admissions cycle, nearly half of the committee members reported agreement with the statement “when I interview candidates, I have my individual IAT results in mind,” and nearly a quarter reported that their knowledge of their individual IAT scores had an impact on their evaluation of candidates. While a causal relationship cannot be proven, in the admissions cycle immediately following the implicit bias exercise, the committee selected the most diverse class in the college’s history.

Thus, taking the IAT can be an important exercise in self-awareness for medical school admissions committees. •