'Is this worth getting into a big fuss over?' - Everyday racism in medical school

Introduction Faced with an increasingly diverse student body, educators in the health professions struggle for ways to foster equality and understand racism. The concept of 'everyday racism' provides an important tool for examining subtle processes that construct a racialised climate in medical schools and other institutions. Objectives To examine the ways racism is understood and experienced within one medical school and investigate the micro level interactional processes that may perpetuate inequality. Methods A survey (n = 72) and interviews (n = 25) were conducted with third year students at one Canadian medical school. A second class was surveyed (n = 61) 3 years later and 25 more students were interviewed. Results Students identified the linguistic advantage enjoyed by some classmates from ethno-cultural minority groups, but were less likely to identify the advantages enjoyed by white students, who may be more readily granted student-doctor status. Students from racialised minority groups experienced marginalisation through segregation, and struggled to respond appropriately to racist jokes and comments from patients and staff. A third (29%) of those who identified as 'minority' group members did not feel they fitted in particularly well at medical school, compared with only 7% of 'non-minority' students (chi(2) P = 0.006; t-test P = 0.004). Conclusion Medical students from racialised minority groups may experience 'everyday racism', mundane daily practices which intentionally or unintentionally convey disregard, disrespect or marginality. Such experiences are particularly difficult to deal with. Educators have a responsibility to counter with sustained antiracism, learning to acknowledge salient differences without reinforcing hierarchies of superiority and inferiority.