Gender and Racial Discrimination During Residency Training: Scoping Review.

Background: Women and visible minorities (VMs) continue to face discrimination while working in health care. These instances of discrimination can range from those perpetrated by individuals, such as misidentification, to prejudices held by institutions, such as a lack of commitment to hiring VMs. Furthermore, many residents face unique experiences of discrimination due to the intersection of gender and race. Although numerous studies have been published on the experiences of physicians with discrimination, there is a limited literature specifically on the experiences of residents. Objective: This study aimed to explore and analyze the impact of gender and racial discrimination on medical residents during their residency training. Methods: This scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A health sciences librarian searched 5 databases: Ovid Medline(R) ALL, Embase (via Ovid), APA PsycInfo (via Ovid), CINAHL Plus with Full Text (via EBSCOhost), and Scopus. No study design, country, or date restrictions were applied. Studies that explored the impact of both gender and racial discrimination on residents during their residency training were included. Two reviewers conducted title and abstract screening, followed by full-text screening, and any discrepancies were resolved through group consensus. This study's content was extracted using Microsoft Word to create tables for organizing and managing the information from the included studies. Results: After removing duplicates, the literature search revealed 2435 papers for title and abstract screening. A total of 340 papers were selected for full-text review, and ultimately, 26 papers met the inclusion criteria. Included papers were published between 1995 and 2024 in the United States (n=16), Canada (n=4), Australia and New Zealand (n=2), Saudi Arabia (n=1), Mexico (n=1), South Africa (n=1), and the United Kingdom (n=1). Our analysis revealed four themes: (1) forms of discrimination faced by VMs, (2) sources of discrimination, (3) ramifications of discrimination, and (4) ways for individuals and institutions to reduce gender and racial discrimination. Conclusions: This scoping review identified that discrimination primarily manifests as microaggressions against residents and revealed the negative impact it continues to have on their careers. Raising awareness about these issues can help programs and institutions develop tailored solutions to tackle these problems and provide a safe, inclusive training environment for all residents.