Discipline Is Not Neutral: Racial Disparities in Resident Physician Disciplinary Action

Area of Science:

• Medical Education
• Health Equity
• Physician Training

Background:

• Disparities in medical education are well-documented.
• Little is known about how race and socioeconomic status influence disciplinary actions during residency.

Purpose of the Study:

• To investigate the association between racial and socioeconomic factors and disciplinary actions experienced by resident physicians.

Main Methods:

• A cross-sectional anonymous survey was administered to resident physicians.
• Data collected included demographics and experiences with feedback, remediation, and discipline.
• Descriptive statistics and logistic regression were used for analysis.

Main Results:

• Black participants had higher odds of meeting with program leadership and being on remediation compared to White participants.
• Black residents were 55% more likely to experience any disciplinary action after adjustment.
• Hispanic and Asian participants did not show increased odds of disciplinary action compared to White participants.

Conclusions:

• Racial inequities in residency discipline challenge the notion that discipline is solely merit-based.
• Medical residency programs must implement transparent disciplinary processes and foster supportive environments for all trainees.