Obstetrician and Gynaecologist Resources

Black man and Asian woman hold up signs detailing their experiences with racism Kiyun Kim

Definitions: [1] 

  • Prejudice: 
    • Prejudice is a “preconceived, unsubstantiated opinion of others based on perceived categorical differences.”
    • Prejudiced opinions may be held against individuals or groups.
    • Prejudiced beliefs can include stereotypes. For example, the belief that a particular race is intellectually inferior or that foreigners are to be feared or mistrusted.
  • Discrimination:
    • Discrimination refers to the "unjust treatment of persons based on perceived differences." 
    • While prejudiced beliefs are opinions, discrimination is when those opinions are acted upon.
    • Discrimination can be based on various identities such as race, ethnicity, gender, nationality, sexual orientation, religion, age, or (dis)ability.
  • Racism 
    • Racism is a “system of power entwined with practices and beliefs that produce and maintain an ethnic and racial hierarchy.” 

What is implicit bias? [2]

  • Implicit bias refers to attitudes, thoughts, or feelings that may exist outside of conscious awareness and may be difficult to deliberately acknowledge and control.
  • These implicit attitudes can reflect negative stereotypes of members of marginalized groups. An individual, for example, may have implicit bias against Indigenous people, Black people, other people of colour or individuals who are transgender. There may also be a bias against people of a particular sexual orientation, nationality, religion, educational background, etc.
  • Negative implicit attitudes contribute to disparities in quality of healthcare received.
  • Implicit bias is prevalent amongst healthcare professionals. [3]
    • A systematic review of implicit bias amongst healthcare professionals found evidence of low-to-moderate levels of implicit bias against people of colour. 
    • These implicit biases translated into poorer patient care.
    • In a paediatric study on analgesia, a vignette of White and Black patients was provided. Paediatricians in the study were more likely to prescribe adequate pain treatment to White children than to Black children.

LGBTQ+ Health

Black Health

Indigenous Health

Patients who are Substance-Involved

Patients without a Home

Patients who are Newcomers and Refugees 

Patients with High BMI

Microaggressions

  • Microaggressions in medicine. 
  • Three steps to interrupt microaggressions.
  • Examples of racial microaggressions (created by Simon Fraser University students and staff for the iBelong initiative December 2018):
    • What is it? Microaggressions are indirect, subtle, sometimes unintentional statements or actions that show a bias against people based on groups that they belong to.
THEME Microaggression message
When Asian Canadians/Latino Canadians are assumed to be foreign-born "Where are you from?"
"Where were you born?"
"You speak good English."
You are not Canadian. You are a foreigner.
Assigning intelligence to a person of colour on the basis of their race "You are a credit to your race."
"You are so articulate."
People of colour are generally not as intelligent as Whites.
A person of colour if presumed to be dangerous or criminal on the basis of race A White man or woman clutching their purse or checking their wallet as a Black of Latino approaches or passes. You are a criminal. You are going to steal. You do not belong. You are dangerous.
Statements that indicate that a White person does not want to acknowledge race "When I look at you, I don't see colour."
"There is only one race, the human race."
Denying a person of colour's racial experiences. Assimilate to the dominant culture.
The notion that the values and communication styles of the dominant/White culture are ideal Asking a Black person: "Why do you have to be so loud? Just calm down." Assimilate to dominant culture. Leave your cultural baggage outside.

Retrieved from: Wing, Capodilupo, Torino, Bucceri, Holder, Nadal, Esquilin (2007). Eacial Microaggressions in Everyday Life: Implications for Clinical Practice. American Psychologist, 62, 4, 271-286.

Resources

[1] Fish, J., & Syed, M. (2019). The Multiple Levels of Racism, Discrimination, and Prejudice.
[2] Megan Drupals, M & Ware, M. (2021). Toronto Notes 2021: Comprehensive medical reference and review for Medical Council of Canada Qualifying Exam (MCCQE) and United States Medical Licensing Exam (USMLE) Step 2. Toronto, Canada. Canada: Toronto Notes for Medical Students
[3] Hall, W. J., Chapman, M. V., Lee K. M., et al. (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. AJPH 2015 Nov 6; 105(12):https://doi.org/10.2105/AJPH.2015.302903
[4]Newman, T. (2018). Sex and Gender: Meanings, definition, identity, and expression.
[5] Henry, F. (2004). Concepts of race and racism and implications for OHRC policy.
[6] CanLit Guides. (2016). A Note on Indigenous Terminology.
[7] Department of Justice. (2016). Statistical Overview on the Overrepresentation of Indigenous Persons in the Canadian Correctional System and Legislative Reforms to Address the Problem.
[8] The Canadian Press. (2011). Native children in care surpass residential school era