Article Figures & Tables
Figures
- Figure 1:
Parental income distribution of surveyed Canadian Black medical students (n = 52). The threshold for “low income” was approximated to $40 000 and for “high income” to $125 000 annual gross salary of the respondents’ household during youth. As shown by the graph, most Black medical students came from middle to high socioeconomic class.
- Figure 2:
Frequency distribution of Black medical students’ perceptions and experiences in Canadian medical schools by survey dimensions (n = 51). Answers were graphed by frequency of positive (blue) or negative (green) responses. Six-point Likert scale responses were grouped as negative if coded from 1 (strongly disagree) to 3 (disagree), and as positive if coded from 4 (agree) to 6 (strongly agree). The resilience and discrimination survey domains had a smaller sample (n = 26) because experience with discrimination was a prerequisite to respondents answering these specific questions. Overall, we can visualize academic inclusion, clinical inclusion and resilience to have positive responses while all other domains were reported to be experienced as negative by survey participants.
Tables
- Table 1:
Statistical characteristics of the survey domains’ assessment of minority experience among Black medical students
Reliable domains and item description No. of items Cronbachα Academic inclusion Feeling welcomed in faculty, ease to make friends in medical school, able to create strong friendships in medical school, ethnicity as a barrier to fit in with peers (R). 5 0.751 Clinical inclusion Ethnicity as a barrier to feel welcomed by preceptors (R), ethnicity as a barrier to fit in medical team (R), ethnicity as a barrier to feel welcomed by patients (R). 3 0.893 Discrimination Reported incident (Y/N), sought institutional support (Y/N), received institutional support (Y/N). 3 0.847 Resilience Impact of discrimination by peer or medical personnel on confidence (R), impact of discrimination by peer or medical personnel on career advancement (R), impact of discrimination by patient on confidence (R), impact of discrimination by patient on career advancement (R). 4 0.780 Wellness Increasing negative feelings regarding clinical work or school (R), feeling drained in clinic or at school (R). 2 0.775 Career advancement Discrimination seen as a barrier to professional success (R), discrimination seen as a barrier to professional satisfaction (R), perceived academic performance, refused opportunities because of ethnicity (R), evaluations affected by ethnicity (R), mentorship opportunities affected by ethnicity (R), facilitated mentorship with concordant ethnicity (R), acquiring letters of recommendations affected by ethnicity (R), specialty choice affected by ethnicity (R), city of training affected by ethnicity (R). 10 0.821 Minority tax Pressure to work more than peers (R), tasked to find solutions for diversity (R), tasked to serve minority patients (R), tasked to respond to questions related to minorities (R), pressure to be a minority ambassador (R), pressure to dedicate more time to equity causes than peers (R), consecrates more time than peers to equity causes (R), closer ties to minority peers (R), professional development time affected by equity causes (R). 8 0.878 Diversity in medical education Class perceived as ethnoculturally diverse, class perceived as diverse (not including ethnicity), available faculty program promoting diversity, faculty promotes diversity in curriculum and composition, curriculum responsive to clinical ethnocultural factors. 5 0.814 Note: (R) = reverse coded question, (Y/N) = dichotomic question to which the answer can be yes or no.
- Table 2:
Sociodemographic and professional characteristics of surveyed Black medical students in Canadian medical institutions
Characteristic No. (%) of students
n = 52Demographics Gender Female 39 (75) Male 13 (25) Native language, n = 51* English 28 (55) French 14 (28) Other 9 (18) Academic demographics Geographic region of attended medical school† Ontario 28 (54) Quebec 11 (21) Western 9 (17) Atlantic 4 (8) Learner academic level First-year medical student 12 (23) Second-year medical student 12 (23) Third-year medical student 13 (25) Fourth-year medical student 7 (13) First-year resident 7 (13) MD/PhD student 1 (2) Ethnocultural identity Self-reported identity, n = 51* Black 49 (96) Mixed Black 2 (4) Ethnicity Monoethnic Black African 15 (29) Afro-Canadian 9 (17) Afro-Caribbean 4 (8) Black Nova Scotian 1 (2) Multiethnic Black‡ 12 (23) Multiethnic mixed Black§ 11 (21) ↵* There are discrepancies in sample size with certain questions when participants provided no response or declined to answer.
↵† We received responses from the following schools in each region: Ontario (University of Toronto, McMaster University, University of Ottawa, Queen’s University, Western University, Northern Ontario School of Medicine), Quebec (Université Laval, Université de Montréal, McGill University), Western (University of British Columbia, University of Alberta, University of Calgary) and Atlantic (Dalhousie University). There were no respondents from 4 faculties, including University of Manitoba (Western), University of Saskatchewan (Western), University of Newfoundland and Labrador (Atlantic) and Université de Sherbrooke (Quebec).
↵‡ As opposed to monoethnic Black, individuals who are multiethnic Black identify with multiple groups of African descent.
↵§ Multiethnic mixed Black refers to individuals who identify with at least 1 other non-Black ethnocultural group.
- Table 3:
Surveyed Black medical students’ experiences with discrimination in Canadian medical school
Variable Response No. (%) of students Dealing with experiences of discrimination Student experienced discrimination in medical school, n = 51 Yes 30 (59) No 19 (37) Did not answer 2 (4) Student shared experience with other student peers, n = 26* Yes 21 (81) Institutional support Student sought institutional support, n = 26* Yes 8 (31) Student received institutional support, n = 22* Yes 6 (27) Quality of institutional support, n = 8† Poor 2 (25) Fair 3 (38) Good 3 (38) Very good 0 Excellent 0 Sources of discriminatory experiences for respondents, n = 26* Patient 13 Student peer or resident 11 Professor or lecturer 6 Hospital staff (staff physicians) 6 Preceptor 5 Hospital staff (nurses) 5 Hospital staff (allied health) 3 Note: The sample size varied in function of nonrespondents or nonapplicable participants with certain questions (i.e., only students who answered “yes” to having experienced discrimination could answer the [*] marked prompts and only students who received institutional support could answer the [†] prompts). This question was also multiple choice, meaning the total n is greater than the number of respondents.
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