Micro- and Macroaggressions Experienced by Physicians and Trainees: A Nationwide Qualitative Study

OBJECTIVES: Most of the literature on micro- and macroaggressions from the perspectives of physicians and learners derives almost exclusively from surveys and focus groups. A more thorough understanding of individual perspectives is necessary to further advance this subject. The objective of this study was to explore physicians' and physician trainees' experiences with micro- and macroaggressions in the clinical setting and their thoughts on how to address such aggressions. METHODS: This was a nationwide, qualitative study. Virtual one-to-one interviews were conducted between October 2021 and March 2022. A volunteer sample of 18 faculty physicians and trainees (medical students, residents, and fellows) representing all regions of the United States were interviewed. Grounded theory was used to analyze transcripts and create a code book. Codes were finalized through constant comparison and developed into themes and subthemes. RESULTS: Thirteen participants identified as female. Eight were non-White. Eleven were faculty. All levels of learners were included. The average interview duration was 43 minutes. Participants described a wide range of aggressions, their resultant emotions and thoughts in response to an event, the complexity of addressing aggressions, and their self-reflection on what transpired and their roles within medicine and society. CONCLUSIONS: Most participants, regardless of level, felt responsible to respond to micro- and macroaggressions when individuals more junior to them were present. Most also admitted feeling unprepared and unsure of how to respond, however.