• Nientara Anderson, Elle Lett, Emmanuella Ngozi Asabor, Amanda Lynn Hernandez, Nguemeni TiakoMax JordanMJYale School of Medicine, New Haven, CT, USA., Christen Johnson, Roberto E Montenegro, Tara M Rizzo, Darin Latimore, Marcella Nunez-Smith, and Dowin Boatright.
• Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA. nientara.anderson@yale.edu.
• J Gen Intern Med. 2022 Feb 1; 37 (2): 298307298-307.

BackgroundDespite substantial research on medical student mistreatment, there is scant quantitative data on microaggressions in US medical education.ObjectiveTo assess US medical students' experiences of microaggressions and how these experiences influenced students' mental health and medical school satisfaction.Design And ParticipantsWe conducted a cross-sectional, online survey of US medical students' experiences of microaggressions.Main MeasuresThe primary outcome was a positive depression screen on the 2-item Patient Health Questionnaire (PHQ-2). Medical school satisfaction was a secondary outcome. We used logistic regression to model the association between respondents' reported microaggression frequency and the likelihood of a positive PHQ-2 screen. For secondary outcomes, we used the chi-squared statistic to test associations between microaggression exposure and medical school satisfaction.Key ResultsOut of 759 respondents, 61% experienced at least one microaggression weekly. Gender (64.4%), race/ethnicity (60.5%), and age (40.9%) were the most commonly cited reasons for experiencing microaggressions. Increased microaggression frequency was associated with a positive depression screen in a dose-response relationship, with second, third, and fourth (highest) quartiles of microaggression frequency having odds ratios of 2.71 (95% CI: 1-7.9), 3.87 (95% CI: 1.48-11.05), and 9.38 (95% CI: 3.71-26.69), relative to the first quartile. Medical students who experienced at least one microaggression weekly were more likely to consider medical school transfer (14.5% vs 4.7%, p<0.001) and withdrawal (18.2% vs 5.7%, p<0.001) and more likely to believe microaggressions were a normal part of medical school culture (62.3% vs 32.1%) compared to students who experienced microaggressions less frequently.ConclusionsTo our knowledge, this is the largest study on the experiences and influences of microaggressions among a national sample of US medical students. Our major findings were that microaggressions are frequent occurrences and that the experience of microaggressions was associated with a positive depression screening and decreased medical school satisfaction.© 2021. Society of General Internal Medicine.

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