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Black International Medical Professional Guide Cheat Sheet (DRAFT) by

Racial discrimination continues to plague healthcare workplaces. Many doctors seek employment opportunities outside their countries of medical training. Entering new and unfamiliar work environments can be daunting. The fear of losing these newfound economic and career advancement opportunities causes many new doctors to ignore and dismiss harmful race-based behaviours. Their acceptance creates a never-ending cycle of aggression, devaluation and disrespect. These helpful tips protect you.

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Microa­gre­ssion

Subtle, often uninte­ntional driscr­imi­natory comments or behaviours
Document Incidents: Keep detailed records of discri­min­atory behaviour, with dates, times and other persons present who can serve as witnesses
While it is called microa­ggr­ess­ions, many acts are intent­ional and are often driven by stereo­typic and prejud­icial behavi­ours. You did not illicit the aggression and should not be afraid to speak out against the repeated actions of others.

Workplace Social Isolation

Being not invited to informal social outings organized by colleagues or team events such as work retreats, lunch or dinner meetings.
Identify allies within your workplace and connect with other Black medical profes­sionals who can provide support for you.
The common phrase "I forgot to add you to the general email" is inexcu­sable. When you are new to a work enviro­nment a seasoned colleague should be assigned to you. Someone who can introduce you to the "­lan­gua­ge" spoken within the organi­zation which helps you become familiar with and learn the dynamics of the space. This ensures you don't miss out on important events. If one is not assigned to you, be proactive and ask for a colleague to help you transition and be successful in your new role.

Biased Evalua­tions

Evalua­tions are a powerful tool used within organi­zat­ions. When used malici­ously you can receive unfair negative perfor­mance reviews
Report concerns to the Human Resources department
Poor perfor­mance evalua­tions can have a negative impact on job security and career advanc­ement. If you feel discri­minated against:
- Speak directly (but in a profes­sional manner) to the person conducting the evaluation to determine the reason for the poor perfor­mance scores.
- Reach out to a Human Rights Consultant or the Human Rights Commission for advice.
- Discuss your concerns with the Human Resources Depart­ment.
- Speak with a repres­ent­ative from your local medical associ­ation.

Assumption of Inferi­ority

When colleagues call into question you qualif­ica­tions or skills
Being a Black intern­ational medical graduate comes with the challenge of having your degree and skills viewed as inferior. While there is no truth about the Black race being intell­ect­ually inferior the narrative continues to be perpet­uated. The truth is, it is important for you to believe that you are equally qualified and skilled (often more so) than your locally trained collea­gues. The role you play is signif­icant and you positively impact patient outcomes.

Dispro­por­tionate Blame

Is there a blame rather than learn culture within the organi­zation? Are your mistakes singled out and taken out of propor­tion? It always seems your fault and your qualif­ication and skills once again called into question
Are discri­min­atory policies and practices that disfavors Black practi­tioners
Maybe you were not the physician attending to a particular patient yet you were wrongfully discip­lined
Have you been targeted by colleagues and other members of the healthcare team and blamed for an error or omission? Was the punishment grossly out of proportion to the mistake made? Document the event. Report your concerns with leadership and speak with a trusted colleague to help you
  

Tokenism

Tokenism occurs when organi­zations hire Black doctors to check a diversity box to appear to be a diverse and inclusive workplace but rather it is a symbolic effort.
File a complaint with your Human Resources department
It can also present itself as you being asked to speak for all Black people as though you were the expert.
Most organi­zations use metrics to track whether they are meeting diversity markers. These markers reflect the number of visible minorities (including Black physic­ians) hired. Black physicians may find themselves being either the only one or a part of a small group of colleagues with similar racial backgr­ounds. You may be assigned all the Black patients or questions regarding Black patients may be regularly filtered to you.

Unequal Work Assign­ments

Patterns where you are being given less desirable tasks or work considered menial are red flags
Understand and become familiar with anti-d­isc­rim­ination laws as well as your rights within the workplace
Pay particular attention to the roles you are repeatedly assigned especially following instances where you spoke up regarding a wrong committed against you or another colleague, Retali­ation and discri­min­atory practices are a violation of your human rights. Learn about how your organi­zation handles racially charged compla­ints.

Derogatory Jokes and Comments

Racially insens­itive jokes or comments made about you in your hearing or commun­icated to you by another staff or patient are inappr­opriate
Speak with a member of the leadership team who can serve as a mediator to bring about amicable resolution
 
Document the comment made, date and time and witnesses present.
Racially insens­itive behaviour is never accept­able. Keep a detailed account of each incident that occurs. This allows you to establish patterns of behaviour and strengthen your evidence should the matter be escalated and legal procee­dings are required.

Biased Patient Assignment

Being assigned more compli­cated patients or less desirable patients who are themselves being discri­minated against
Set clear boundaries and commun­icate them effect­ively with your colleagues
 
Speak up for yourself
A constant barrage of patients with complex needs can result in burnout. It increases the time you spend and the mental and physical stamina required to carefully assess and create a plan of care. This can have catast­rophic conseq­uences physically and emotio­nally leading to patient errors. If your staff lead is delibe­rately passing difficult patients to you, SPEAK UP and find assistance in resolving the matter.