Microaggressions and the Female Physician Experience in a Children's Hospital: A Qualitative Study

Objective

To explore how microaggressions are understood and experienced by female physicians in a pediatric academic hospital and to describe the impact of those microaggressions.

Study design

We conducted a qualitative study using in-depth individual interviews completed between March and December 2021. Subjects were included if they were female staff pediatricians at The Hospital for Sick Children, which is affiliated with the University of Toronto, and actively involved in clinical work. Convenience sampling was used and followed by secondary, purposeful sampling to ensure a representative sample of 27 participants who completed interviews; 24 interviews were included in the analysis. Interview transcripts were analyzed for recurrent and emergent themes using the grounded theory methodology.

Results

All participants provided examples of microaggressions, including environmental microaggressions, microassaults, microinsults, and microinvalidations. Examples of microaggressions were provided, such as being scrutinized in clinical decisions, being mistaken consistently for a trainee or nonphysician, and receiving dismissive or degrading comments. Themes regarding impacts of microaggressions included effects on career trajectories, clinical decision-making, and self-identity.

Conclusions

Microaggressions experienced by female physicians are pervasive even within the female-dominant clinical work environment in an academic pediatric hospital. Understanding these experiences will allow for systemic changes within institutions to improve the culture of pediatric academic medicine.