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Patients, Pride, and Prejudice: Exploring Black Ontarian Physicians' Experiences of Racism and Discrimination.

PURPOSE
Black physicians' and trainees' experiences of racism are not well documented in Canada, reflecting a knowledge gap needing correction to combat racism in Canadian health care. The authors undertook a descriptive study of Black physicians and trainees in the Canadian province of Ontario. The goal of this study was to report upon racism experienced by participant Ontarian physicians in order to challenge the purported rarity of racism in Canadian health care.


METHOD
An anonymous online survey of physicians and trainees who self-identify as Black (African/Afro-Canadian/African-American/Afro-Caribbean) was administered in March and April 2018 through the Black Physicians' Association of Ontario (BPAO) listserv. The survey was modeled on qualitative interview guides from American studies. Snowball sampling was employed whereby BPAO members forwarded the survey to eligible colleagues (non-BPAO members) to maximize responses. Survey data was analyzed and key themes described.


RESULTS
Survey participants totalled 46, with a maximal response rate of 38%. Participants reported positive experiences of collegiality with Black colleagues and strong bonds with Black patients. Negative discrimination experiences included differential treatment and racism from peers, superiors, and patients. Participants reported race as a major factor in their selection of practice location, more so than selection of career. Participants also expressed a lack of mentorship, and there was a strong call for increased mentorship from mentors with similar ethno-racial backgrounds.


CONCLUSIONS
This study challenges the notion that racism within Canadian health care is rare. Future systematic collection of information regarding Black physicians' and trainees' experiences of racism will be key in appreciating the prevalence and nature of these experiences.