Workplace discrimination and harassment among Alberta postgraduate medical trainees: a cross-sectional survey.

backgroundAddressing a lack of diversity in the physician workforce is a priority in the Canadian healthcare system. Data describing demographics of residents and their experiences of discrimination, harassment, and racism at work are incomplete. The objective of this work was to describe the demographics and perceptions of workplace discrimination and harassment for postgraduate medical trainees in Alberta.

methodsA cross-sectional survey based on the Chronic Workplace Discrimination and Harassment Scale was administered to all resident physicians in Alberta by e-mail invitation from the postgraduate medical education offices at the Universities of Alberta and Calgary, their residency training program directors, and the Professional Association of Residents of Alberta. Total score (median, interquartile range [IQR]) was compared by gender, racial, and intersecting gender and racial identities, with higher scores suggesting more frequent experiences of workplace discrimination and harassment (range 0 to 32). We performed thematic content analysis of open text responses.

resultsThere were 195 complete surveys returned from 1,752 Alberta residents (11.2% response rate), including 120 cisgender women (61.5%), 104 white participants (53.3%) and 74 white cisgender women (37.9%). The overall median score on the Chronic Workplace Discrimination and Harassment scale was 9 (IQR 5-14): cisgender women and gender diverse participants reported more frequent harassment, mistreatment, or discrimination than cisgender men (median 10 [IQR 6-15] versus 8 [4-13.5], p = 0.049). There was no difference in the frequency of reported discrimination between BIPOC and white respondents (median 9 [IQR 5-14.5] versus 9.5 [IQR 6-14], p = 0.72) or participants with intersecting race and gender identities (p = 0.26). Over 44% of BIPOC residents had been the target of a racial slur or joke from an attending physician or colleague in the past year and nearly 45% of all participants had witnessed an attending physician or colleague using a racial slur in the past year. Open text responses provided examples of mistreatment, harassment, discrimination, and racism from participants.

interpretationThese results demonstrate an unacceptable prevalence of harassment and racism witnessed or experienced at work by Alberta residents. Urgent action to identify, prevent, and remediate racism in the healthcare system must be a priority of medical schools and regulatory bodies.