• Cynthia Kay, Joanne Bernstein, Natalie Yass, Jennifer Woodard, Sara Tesfatsion, and Cecilia Scholcoff.
• Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA. ckay@mcw.edu.
• J Gen Intern Med. 2022 Oct 1; 37 (13): 341934253419-3425.

BackgroundMicro- and macroaggressions are often stereotype threats that can have detrimental effects on the recipients. Survey data shows that these aggressions are happening. However, there are few qualitative studies on trainees and faculty physicians' experiences with such aggressions and their impact.ObjectiveExplore how micro- and macroaggressions impact physician trainees and faculty.Design, Setting, ParticipantsVirtual, one-on-one, semi-structured interviews were conducted between February and September 2021, among 14 physicians and trainees (medical students, residents, fellows, and faculty) at a tertiary, urban, US academic medical center and its associated hospitals. Participants shared their experiences with micro- and macroaggressions in training and the workplace, as well as their thoughts on intervention and education.ApproachQualitative interviews; grounded theory approach KEY RESULTS: A total of 14 physicians and trainees (5 faculty, 2 fellows, 5 residents, 2 students; 11 [79%] women) participated. Four themes with multiple subthemes surfaced: definition, the moment an aggression is experienced, aftereffect of an aggression, and education and training. While general definitions of micro- and macroaggressions were similar among participants, some may have overlooked the inclusion of a marginalized group as central to each term. Both types of aggressions had a range of effects on participants, with faculty noting a cumulative effect. Institutional diversity was identified as a key source of support. Ideas on how to combat such acts included mandatory educational programs and policies, with the acknowledgment that much effort and time are necessary to change mindset and culture.ConclusionsFaculty physicians and medical trainees shared their personal experiences with micro- and macroaggressions during work and training. Participants described various emotions in the moment but also noted that these aggressions often had lasting impacts. They recognized the challenges of finding a solution to micro- and macroaggressions. Institution-wide education was favored by many as a first step.© 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.

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