How should I deal with racist microaggressions at work?
The psychological impact of racism can be significant so it is important to tackle in any workplace. International medical graduates are particularly at risk so how can they tackle it? Here a medico-legal expert gives his advice.
For any international medical graduate (IMG), embarking on their medical career in the UK can be both exciting and challenging.
However one of the more insidious challenges faced by IMGs is dealing with racist microaggressions in the workplace.
A recent survey (November 2023) of MDDUS members found 58% of the IMGs who responded had experienced racist microaggressions.
Many said they lacked faith in being heard or the issue being taken seriously if they raised the problem at work.
Of those IMGs who reported experiencing racist microaggressions in the workplace:
- 72% did not report incidents
- 66% did not report incidents because they had no confidence their concerns would be taken seriously
- 41% feared that reporting an incident would impact their job.
What are racist microaggressions?
Racist microaggressions are defined as patterned behaviours that (intentionally or unintentionally) undermine, belittle, stereotype, or insult those in minority ethnic groups.
Examples include patients asking for another doctor because they assume that an IMG cannot treat them as well as a white British doctor. Other patient comments might be less explicit, but still have totally unfounded assumptions of incompetence underlying them.
We have also heard reports of IMGs being advised to abbreviate their names to make them easier to pronounce for patients, and being told they need to accept the system is biased against them.
Such microaggressions are the most common form of covert, interpersonal racism and are often minimised as simple verbal mistakes or cultural missteps. But studies have shown that these subtle racist interactions cause significant distress. The term ‘micro’ doesn’t mean the impact on the victim is small.
What practical steps can you take to tackle microaggressions?
- Recognise it: The first step is to recognise when a microaggression occurs. These incidents can be subtle and easily dismissed, but it is important to trust your instincts and acknowledge your feelings.
- Call it out: If you experience microaggressions, it is good to call it out, but only if you feel safe to do so. And remember, the responsibility to call it out does not rest solely on you, the person experiencing the microaggression, when there are witnesses.
- Document it: Keep a record of what occurred, noting what was said or done, who was involved, when it happened, the context, and how it made you feel.
- Report it: Almost a third (28%) of IMGs we surveyed did not know how to report microaggressions. Familiarise yourself with the processes for reporting these incidents in your trust, board or practice. For example, speaking to your line manager, a senior member of staff that you trust or human resources (HR).
- Seek support: Talk to a trusted friend, family member, colleague or well-being service about what happened. Sharing experiences can validate your feelings and help you find a way forward.
Navigating professional risks
For IMGs, there is often an added layer of complexity when addressing microaggressions due to unfamiliarity with local systems and fear of professional repercussions.
The General Medical Council (GMC) increasingly recognises the importance of considering cultural and human factors in disciplinary cases. Seek advice from your medical defence organisation if you are concerned about a disciplinary or regulatory matter.
Racist microaggressions should not be tolerated in any workplace. By recognising, documenting, addressing, and educating one another about these incidents, we can all help to create a safer and more inclusive environment.
The psychological impact of microaggressions can be significant, affecting your emotional wellbeing and mental health, so it’s crucial to look after yourself by seeking support from colleagues, professional networks, and mental health resources.
Remember, you are not alone, and your medical defence organisation can support you. Stand firm in your right to a respectful and equitable workplace, and do not hesitate to seek the help and resources available to you.
About the author
Naeem Nazem is head of medical at MDDUS. He is a doctor and a lawyer, specialising in healthcare and litigation.
