"I have to resist simply to exist": Black Physician Trainees' Experiences of Professional Resistance

In medical education, acts of professional resistance have been studied across all racial and ethnic groups as an antidote to the social harm and injustice festering in medical education. However, not everyone experiences medical education in the same way; some groups experience it quite differently because of their social positions. In particular, Black physicians face anti-Black racism in medical education, which has the potential to shape their resistance in a particular way. This study was designed to understand what professional resistance looks like in Black residents/fellows in North America and how being Black shaped their experiences of resistance.

This qualitative study used Endarkened storywork to understand how Black GME physicians experienced acts of resistance. Endarkened storywork is a Black-centered approach to research and a way of reclaiming authority to create knowledge. It weaves Endarkened feminism, Afrofuturism, and Indigenous storywork to center storytelling as essential to Black ways of being. We conducted 14 semi-structured interviews and analyzed the data using thematic, theoretical, and emergent coding through the constructs of Re-storying, Endarkened Storywork, and Black quilting.

Black trainees' stories of resistance produced three quilting blocks to illuminate their experiences. First, resistance means continuing to exist in medicine despite all of the profession's efforts to eradicate Black physicians. Second, they work tirelessly to improve Black health and facilitate opportunities for the future of Black people to have a career in medicine. Third, their resistance must contend with a long history of anti-Black racism, which takes a significant toll on the emotional and mental well-being of Black trainees in ways that are best described as racial battle fatigue.

For Black trainees, professional resistance is nuanced and calls into the present a long history of anti-Black racism. Their resistance includes occupying space in medicine, securing a future where Black people exist as physicians, and resisting the emotional burden of doing this work. While all forms of professional resistance are worthy of study, researchers should pay particular attention to how it manifests in various racial groups to understand the nuances of different strategies.