References
- Lam JTH, Coret M, Khalil C, Butler K, Giroux RJ, Martimianakis MA (Tina). The need for critical and intersectional approaches to equity efforts in postgraduate medical education: A critical narrative review. Medical Education. 2024 May 15;
medu.15425 . DOI: 10.1111/medu.15425 - Wyatt TR, Taylor TR, White D, Rockich-Winston N. “When No One Sees You as Black”: The Effect of Racial Violence on Black Trainees and Physicians. Academic Medicine [Internet]. 2021 Aug 3 [cited 2021 Oct 9];Publish Ahead of Print. Available from:
https://journals.lww.com/10.1097/ACM.0000000000004263 - Wyatt TR, Rockich-Winston N, White D, Taylor TR. “Changing the narrative”: a study on professional identity formation among Black/African American physicians in the U.S. Adv in Health Sci Educ. 2021 Mar;26(1):183–98. DOI: 10.1007/s10459-020-09978-7
- Wyatt TR, Balmer D, Rockich-Winston N, Chow CJ, Richards J, Zaidi Z. ‘Whispers and shadows’: A critical review of the professional identity literature with respect to minority physicians. Med Educ. 2021 Feb;55(2):148–58. DOI: 10.1111/medu.14295
- Fnais N, Soobiah C, Chen MH, Lillie E, Perrier L, Tashkhandi M, et al. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med. 2014;89(5):817–27. DOI: 10.1097/ACM.0000000000000200
- Chilakala A, Camacho-Rivera M, Frye V. Experiences of race- and gender-based discrimination among Black female physicians. J Natl Med Assoc. 2022;114(1):104–13. DOI: 10.1016/j.jnma.2021.12.008
- Desbiens NA, Vidaillet HJJ. Discrimination against international medical graduates in the United States residency program selection process. BMC Med Educ. 2010;10(101088679):
5 . DOI: 10.1186/1472-6920-10-5 - Sotto-Santiago S, Mac J, Slaven J, Maldonado M. A Survey of Internal Medicine Residents: Their Learning Environments, Bias and Discrimination Experiences, and Their Support Structures. Advances in medical education and practice. 2021;12(101562700):697–703. DOI: 10.2147/AMEP.S311543
- Warsame RM, Asiedu GB, Kumbamu A, Cook J, Hayes SN, Thompson CA, et al. Assessment of Discrimination, Bias, and Inclusion in a United States Hematology and Oncology Fellowship Program. JAMA netw open. 2021;4(11):
e2133199 . DOI: 10.1001/jamanetworkopen.2021.33199 - Lall MD, Bilimoria KY, Lu DW, Zhan T, Barton MA, Hu YY, et al. Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US. JAMA Netw Open. 2021 Aug 19;4(8):
e2121706 . DOI: 10.1001/jamanetworkopen.2021.21706 - Hu YY, Ellis RJ, Hewitt DB, Yang AD, Cheung EO, Moskowitz JT, et al. Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training. N Engl J Med. 2019 Oct 31;381(18):1741–52. DOI: 10.1056/NEJMsa1903759
- Mateo CM, Williams DR. Addressing Bias and Reducing Discrimination: The Professional Responsibility of Health Care Providers. Academic Medicine. 2020 Dec;95(12S):S5–10. DOI: 10.1097/ACM.0000000000003683
- CanRAC. General Standards of Accreditation for Institutions with Residency Programs. Ottawa, ON: CanRAC; 2021.
- Walker Z, Murphy E, Sain C, Ohiomoba R, Lasic M, Lanes A, et al. The impact of intersectionality on the experience of medical trainees. Postgrad Med J [Internet]. 2024;(pfx, 0234135). Available from:
https://myaccess.library.utoronto.ca/login?url=http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&DO=10.1093%2fpostmj%2fqgae130 - Nguyen M, Gonzalez L, Stain SC, Dardik A, Chaudhry SI, Desai MM, et al. Association of Socioeconomic Status, Sex, Racial, and Ethnic Identity With Sustained and Cultivated Careers in Surgery. Ann Surg. 2024;279(3):367–73. DOI: 10.1097/SLA.0000000000006029
- Pugazenthi S, Malacon K, Kim NC, Stuebe CM, Yoh N, Bhanja D, et al. Barriers to neurosurgery for medical students: a national study focused on the intersectionality of gender and race. J Neurosurg. 2024;141(5):1395–406. DOI: 10.3171/2024.2.JNS232038
- Keshinro A, Butler P, Fayanju O, Khabele D, Newman E, Greene W, et al. Examination of Intersectionality and the Pipeline for Black Academic Surgeons. JAMA Surg. 2022;157(4):327–34. DOI: 10.1001/jamasurg.2021.7430
- Johnson S, Konopasky A, Wyatt T. In Their Own Voices: A Critical Narrative Review of Black Women Faculty Members’ First-Person Accounts of Racial Trauma Across Higher Education. Teach Learn Med. 2024;(dx5, 8910884):1–11.
- Sharp S, Hixson A, Stumpff J, Williamson F. Understanding the Experiences of Black Women Medical Students and Residents: A Narrative Review. Front public health. 2022;10(101616579):
879135 . DOI: 10.3389/fpubh.2022.879135 - Ly D, Chakrabarti R. “I’m looking as white and as straight as possible at all times”: a qualitative study exploring the intersectional experiences of BAME LGBTQ+ medical students in the UK. BMJ Open. 2024;14(8):
e086346 . DOI: 10.1136/bmjopen-2024-086346 - Sorgini A, Istl AC, Downie ML, Kirpalani A. Pride & prejudice: A scoping review of LGBTQ + medical trainee experiences. Med Teach. 2024;46(1):73–81. DOI: 10.1080/0142159X.2023.2229503
- Rezaiefar P, Abou-Hamde Y, Naz F, Alborhamy YS, LaDonna KA. “Walking on eggshells”: experiences of underrepresented women in medical training. Perspect Med Educ. 2022;11(6):325–32. DOI: 10.1007/s40037-022-00729-5
- Alkhatib M, Hasan I, Ali A, Zaidi Z. Unveiling the Invisible: Challenges Faced by Arab Women International Medical Graduates in U.S. Academia. Acad Med. 2024 Nov;99(11):1199–207. DOI: 10.1097/ACM.0000000000005822
- Irshad U. “Where Are You From?”-on Separation, Belonging and Imposter Syndrome as an International Medical Graduate. J Gen Intern Med. 2024;39(12):2324–5. DOI: 10.1007/s11606-024-08922-4
- Bowleg L. The Problem With the Phrase Women and Minorities: Intersectionality—an Important Theoretical Framework for Public Health. American Journal of Public Health. 2012 July;102(7):1267–73. DOI: 10.2105/AJPH.2012.300750
- Tsouroufli M, Rees CE, Monrouxe LV, Sundaram V. Gender, identities and intersectionality in medical education research: commentaries. Medical Education. 2011 Mar;45(3):213–6. DOI: 10.1111/j.1365-2923.2010.03908.x
- Eckstrand KL, Eliason J, St.Cloud T, Potter J. The Priority of Intersectionality in Academic Medicine. Academic Medicine. 2016 July;91(7):904–7. DOI: 10.1097/ACM.0000000000001231
- Monrouxe LV. When I say… intersectionality in medical education research. Medical Education. 2015 Jan;49(1):21–2. DOI: 10.1111/medu.12428
- Wyatt TR, Johnson M, Zaidi Z. Intersectionality: a means for centering power and oppression in research. Adv in Health Sci Educ. 2022 Aug;27(3):863–75. DOI: 10.1007/s10459-022-10110-0
- Hancock AM. When Multiplication Doesn’t Equal Quick Addition: Examining Intersectionality as a Research Paradigm. Persp on Pol. 2007 Mar;5(1):63–79. DOI: 10.1017/S1537592707070065
- McCall L.
The complexity of intersectionality . In: Grabham E, editor. Intersectionality and beyond: law, power and the politics of location. Abingdon, Oxon; New York, NY: Routledge-Cavendish; 2009. (Social justice). - Zaidi Z, Partman IM, Whitehead CR, Kuper A, Wyatt TR. Contending with Our Racial Past in Medical Education: A Foucauldian Perspective. Teaching and Learning in Medicine. 2021 July 11;33(4):453–62. DOI: 10.1080/10401334.2021.1945929
- Rehman M, Santhanam D, Sukhera J. Intersectionality in Medical Education: A Meta-Narrative Review. Perspect Med Educ. 2023;12(1):517–28. DOI: 10.5334/pme.1161
- Paradis E, Nimmon L, Wondimagegn D, Whitehead CR. Critical Theory: Broadening Our Thinking to Explore the Structural Factors at Play in Health Professions Education. Academic Medicine. 2020 June;95(6):842–5. DOI: 10.1097/ACM.0000000000003108
- Blackie M, Wear D, Zarconi J. Narrative Intersectionality in Caring for Marginalized or Disadvantaged Patients: Thinking Beyond Categories in Medical Education and Care. Academic Medicine. 2019 Jan;94(1):59–63. DOI: 10.1097/ACM.0000000000002425
- Walby S, Armstrong J, Strid S. Intersectionality: Multiple Inequalities in Social Theory. Sociology. 2012 Apr;46(2):224–40. DOI: 10.1177/0038038511416164
- Staunæs D. Where have all the subjects gone? Bringing together the concepts of intersectionality and subjectification. Nora: Nordic Journal of Women’s Studies. 2003;11(2). DOI: 10.1080/08038740310002950
- Choo HY, Ferree MM. Practicing Intersectionality in Sociological Research: A Critical Analysis of Inclusions, Interactions, and Institutions in the Study of Inequalities. Sociological Theory. 2010 June;28(2):129–49. DOI: 10.1111/j.1467-9558.2010.01370.x
- Yuval-Davis Nira. The politics of belonging: intersectional contestations. Los Angeles: Sage; 2011. DOI: 10.4135/9781446251041
- Adams J, Padamsee T. Signs and Regimes: Rereading Feminist Work on Welfare States. Social Politics: International Studies in Gender, State & Society. 2001 Mar 1;8(1):1–23. DOI: 10.1093/sp/8.1.1
- Christensen AD, Jensen SQ. Doing Intersectional Analysis: Methodological Implications for Qualitative Research. NORA – Nordic Journal of Feminist and Gender Research. 2012 June;20(2):109–25. DOI: 10.1080/08038740.2012.673505
- Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies: Guided by Information Power. Qualitative Health Research.
8 . - Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006 Jan;3(2):77–101. DOI: 10.1191/1478088706qp063oa
- Braveman PA, Arkin E, Proctor D, Kauh T, Holm N. Systemic And Structural Racism: Definitions, Examples, Health Damages, And Approaches To Dismantling: Study examines definitions, examples, health damages, and dismantling systemic and structural racism. Health Affairs. 2022 Feb 1;41(2):171–8. DOI: 10.1377/hlthaff.2021.01394
- Osei-Tutu K, BHSc WEO, Sivananthajothy P, Rabi D. Antiracism as a foundational competency: reimagining CanMEDS through an antiracist lens. 2022;194(49). DOI: 10.1503/cmaj.220521
- Dryden O, Nnorom O. Time to dismantle systemic anti-Black racism in medicine in Canada. CMAJ. 2021 Jan 11;193(2):E55–7. DOI: 10.1503/cmaj.201579
- Mian O, Hogenbirk JC, Marsh DC, Prowse O, Cain M, Warry W. Tracking Indigenous Applicants Through the Admissions Process of a Socially Accountable Medical School. Academic Medicine. 2019 Aug;94(8):1211–9. DOI: 10.1097/ACM.0000000000002636
- Global News [Internet]. [cited 2023 Dec 2]. Indigenous representation in health care improving – but ‘enormous gaps’ remain – National | Globalnews.ca. Available from:
https://globalnews.ca/news/9994493/indigenous-health-care-representation-truth-and-reconciliation/ - Chen CL, Gold GJ, Cannesson M, Lucero JM. Calling Out Aversive Racism in Academic Medicine. N Engl J Med. 2021 Dec 30;385(27):2499–501. DOI: 10.1056/NEJMp2112913
- Dovidio JF, Gaertner SL.
Aversive Racism . In: ADV EXP SOC PSYCHOL. United States: Elsevier Science & Technology; 2004. p. 1–52. (Advances in Experimental Social Psychology; vol. 36). DOI: 10.1016/S0065-2601(04)36001-6 - Mickleborough TO, Martimianakis MA (Tina). (Re)producing “Whiteness” in Health Care: A Spatial Analysis of the Critical Literature on the Integration of Internationally-Educated Health Care Professionals in the Canadian Workforce. Academic Medicine [Internet]. 2021 Aug 3 [cited 2021 Sept 14];Publish Ahead of Print. Available from:
https://journals.lww.com/10.1097/ACM.0000000000004262 - Beagan BL. Neutralizing differences: producing neutral doctors for (almost) neutral patients. Social Science. 2000;51(8):1253–65. DOI: 10.1016/S0277-9536(00)00043-5
- Beagan BL. “Is this worth getting into a big fuss over?” Everyday racism in medical school. Med Educ. 2003 Oct;37(10):852–60. DOI: 10.1046/j.1365-2923.2003.01622.x
- Taylor JS. Confronting ‘“Culture”’ in Medicine’s ‘“Culture of No Culture.”’ Academic Medicine. 2003;78(6):555–9. DOI: 10.1097/00001888-200306000-00003
- Crutcher RA, Szafran O, Woloschuk W, Chatur F, Hansen C. Family medicine graduates’ perceptions of intimidation, harassment, and discrimination during residency training. BMC Med Educ. 2011;11(101088679):
88 . DOI: 10.1186/1472-6920-11-88 - Wheeler DJ, Zapata J, Davis D, Chou C. Twelve tips for responding to microaggressions and overt discrimination: When the patient offends the learner. Medical Teacher. 2019 Oct 3;41(10):1112–7. DOI: 10.1080/0142159X.2018.1506097
- Bonilla-Silva E. The Structure of Racism in Color-Blind, “Post-Racial” America. American Behavioral Scientist. 2015 Oct;59(11):1358–76. DOI: 10.1177/0002764215586826
- Banaji MR, Greenwald AG. Blindspot: hidden biases of good people. New York: Delacorte Press; 2013.
- Hirshfield LE, Joseph TD. ‘We need a woman, we need a black woman’: gender, race, and identity taxation in the academy. Gender and Education. 2012 Mar;24(2):213–27. DOI: 10.1080/09540253.2011.606208
- DiAngelo R. Nice racism: how progressive white people perpetuate racial harm. Boston, Massachusetts: Beacon Press; 2021.
- Lam J, Martimianakis MA, Hafferty FW.
Socialization and the Hidden Curriculum in Medical Professionalism . In: Merlo G, Harter TD, editors. Medical Professionalism [Internet]. 1st ed. New York: Oxford University Press; 2025 [cited 2025 Dec 6]. pp. 49–70. Available from:https://academic.oup.com/book/59503/chapter/501511916 - Capers Q, Clinchot D, McDougle L, Greenwald AG. Implicit Racial Bias in Medical School Admissions. Academic Medicine. 2017 Mar;92(3):365–9. DOI: 10.1097/ACM.0000000000001388
- Hauer KE, Park YS, Bullock JL, Tekian A. “My Assessments Are Biased!” Measurement and Sociocultural Approaches to Achieve Fairness in Assessment in Medical Education. Academic Medicine. 2023 Aug;98(8S):S16–27. DOI: 10.1097/ACM.0000000000005245
- Sukhera J, Watling CJ, Gonzalez CM. Implicit Bias in Health Professions: From Recognition to Transformation. Academic Medicine. 2020 May;95(5):717–23. DOI: 10.1097/ACM.0000000000003173
- Edje L, Casillas C, O’Toole JK. Strategies to Counteract Impact of Harmful Bias in Selection of Medical Residents. Academic Medicine. 2023 Aug;98(8S):S75–85. DOI: 10.1097/ACM.0000000000005258
- Caretta-Weyer HA. An Outcomes-Oriented Approach to Residency Selection: Implementing Novel Processes to Align Residency Programs and Applicants. Acad Med. 2022;97(5):626–30. DOI: 10.1097/ACM.0000000000004614
- Anderson N, Nguyen M, Marcotte K, Ramos M, Gruppen LD, Boatright D. The Long Shadow: A Historical Perspective on Racism in Medical Education. Academic Medicine [Internet]. 2023 Apr 19 [cited 2023 Apr 20];Publish Ahead of Print. Available from:
https://journals.lww.com/10.1097/ACM.0000000000005253 - Boatright D, Edje L, Gruppen LD, Hauer KE, Humphrey HJ, Marcotte K. Ensuring Fairness in Medical Education Assessment. Academic Medicine. 2023 Aug;98(8S):S1–2. DOI: 10.1097/ACM.0000000000005244
- Sukhera J, Goez H, Brown A, Haddara W, Razack S. Codesigning Policy-Based Solutions to Discrimination and Harassment in Academic Medicine: An Inclusive Approach. Acad Med [Internet]. 2023 Oct 6 [cited 2023 Dec 8]; Available from:
https://journals.lww.com/10.1097/ACM.0000000000005466 - Lai CK, Marini M, Lehr SA, Cerruti C, Shin JEL, Joy-Gaba JA, et al. Reducing implicit racial preferences: I. A comparative investigation of 17 interventions. Journal of Experimental Psychology: General. 2014;143(4):1765–85. DOI: 10.1037/a0036260
- Dovidio JF, Gaertner SL, Pearson AR.
Aversive Racism and Contemporary Bias . In: Sibley CG, Barlow FK, editors. The Cambridge Handbook of the Psychology of Prejudice [Internet]. 1st ed. Cambridge University Press; 2016 [cited 2023 Nov 9]. pp. 267–94. Available from:https://www.cambridge.org/core/product/identifier/CBO9781316161579A023/type/book_part - Forscher PS, Lai CK, Axt JR, Ebersole CR, Herman M, Devine PG, et al. A meta-analysis of procedures to change implicit measures. Journal of Personality and Social Psychology. 2019 Sept;117(3):522–59. DOI: 10.1037/pspa0000160
- Penner LA, Gaertner S, Dovidio JF, Hagiwara N, Porcerelli J, Markova T, et al. A Social Psychological Approach to Improving the Outcomes of Racially Discordant Medical Interactions. J GEN INTERN MED. 2013 Sept;28(9):1143–9. DOI: 10.1007/s11606-013-2339-y
- Dovidio JF, Pearson AR, Penner LA.
Aversive Racism, Implicit Bias, and Microaggressions . In: Torino GC, Rivera DP, Capodilupo CM, Nadal KL, Sue DW, editors. Microaggression Theory [Internet]. 1st ed. Wiley; 2018 [cited 2023 Dec 4]. p. 16–31. Available from:https://onlinelibrary.wiley.com/doi/10.1002/9781119466642.ch2 - Mylopoulos M, Steenhof N, Mickleborough T, Atkinson A, Martimianakis MA (Tina). From struggle to strength: Embracing productive failure in clinical learning. Medical Teacher. 2025 Dec 2;47(12):1903–10. DOI: 10.1080/0142159X.2025.2550477
2020–2021 Annual Learner Experience Report [Internet] . Toronto, ON: Temerty Faculty of Medicine; [cited 2022 Mar 17]. Available from:https://pgme.utoronto.ca/wp-content/uploads/2021/11/2021-Annual-Learner-Experience-Report-Final.pdf - Sivananthajothy P, Adel A, Afhami S, Castrogiovanni N, Osei-Tutu K, Brown A. Equity, diversity, and…exclusion? A national mixed methods study of “belonging” in Canadian undergraduate medical education. Adv in Health Sci Educ [Internet]. 2023 Aug 10 [cited 2023 Aug 13]; Available from:
https://link.springer.com/10.1007/s10459-023-10265-4