Microaggressions in Residency: What’s Your Next Move?

by Jade G Pierre MS, MNM, MPH

Residency is already one of the most demanding stages of a physician’s journey with the long hours, steep learning curves, constant evaluation. Layer on microaggressions, those subtle, often unintentional slights based on race, gender, or other aspects of identity, and the weight can become crushing.

Research shows that nearly 84% of racial/ethnic–minority surgeons and anesthesiologists and 94% of women in surgery experience microaggressions at work, often linked to higher rates of burnout (Sudol et al., 2021). These aren’t “small” things. Over time, they erode confidence, impact patient care, and compromise well-being.

So what do you do when it happens? Here’s your playbook.

1. Recognize the Moment

Not every uncomfortable comment is a microaggression, but when words or actions carry hidden stereotypes or dismiss your belonging, it matters. Common forms in residency include:

• Being mistaken for a nurse or ancillary staff despite your badge.

• Comments about your “accent” or “looking too young to be a doctor.”

• Jokes that minimize your gender, race, or cultural background.

Naming the experience internally is the first step to reclaiming power.

2. Choose Your Response Lane

Hill Weller et al. (2023) developed a workshop for perioperative trainees that outlines a continuum of strategiesresidents can use. You don’t always have to confront directly—especially in a high-stakes or unsafe environment. Think of it as three lanes:

• Indirect Tools (low risk): Redirect, change the subject, or affirm someone else who was dismissed.

• Direct Tools (medium/high risk): Reflect back what was said (“Did you mean…?”), communicate the impact, or reaffirm boundaries.

• Allyship Tools: Step in for colleagues when they’re targeted. Sometimes the most powerful move is being an upstander.

  
  

3. Protect Your Energy

Responding to microaggressions is exhausting. Studies show that the compound effect of sexism and racism doubles burnout risk for minority women in surgery (Sudol et al., 2021). Protecting yourself means:

• Picking your battles—every incident doesn’t require your energy.

• Building a support crew (peers, mentors, affinity groups) where you can debrief safely.

• Using institutional channels (chief residents, GME offices, bias reporting systems) when needed.

  
  

4. Reflect and Reset

After the moment passes, take a pause. Ask yourself:

• What did I feel in that moment?

• What would I do the same or differently next time?

• Who can I talk to for perspective or support?

Residency isn’t just about clinical skills—it’s about developing professional resilience. Reflection transforms these moments from silent harm into opportunities for growth and advocacy.

5. Push for Culture Change

Microaggressions aren’t just an individual burden—they’re a systems issue. Institutions that train residents should be running DEI workshops, allyship training, and upstander simulations as part of core education (Hill Weller et al., 2023). If yours isn’t, advocate for it. Change happens when residents demand safer, healthier training environments.

Bottom Line

Microaggressions are real, harmful, and far too common in residency. But you are not powerless. By recognizing, responding, protecting your energy, and leaning into allyship and reflection, you not only survive these moments—you help shift the culture for those coming after you.

Residency is hard enough. Let’s make sure identity-based mistreatment isn’t part of the curriculum.

References

• Hill Weller, LaMisha, et al. Tools for Addressing Microaggressions: An Interactive Workshop for Perioperative Trainees. MedEdPORTAL, vol. 19, 2023, p. 11360.

• Sudol, Neha T., et al. “Prevalence and Nature of Sexist and Racial/Ethnic Microaggressions Against Surgeons and Anesthesiologists.” JAMA Surgery, vol. 156, no. 5, 2021, pp. e210265.

• Tsai, Jennifer, and Eric Lindo. “Critical Race Theory in Medical Education.” Academic Medicine, vol. 96, no. 12, 2021, pp. 1705–1707.

• Holdren, Sarah, et al. “Transformative Learning Theory in Graduate Medical Education: A Path Toward Equity.” Journal of Surgical Education, vol. 79, no. 6, 2022, pp. 1335–1342.

• Bonifacino, Emily, et al. “Minority Stress Theory and the Experiences of Underrepresented Residents.” Journal of Graduate Medical Education, vol. 13, no. 4, 2021, pp. 543–549.

• Weller, Jason, et al. “Communities of Practice: Building Belonging in Surgical Training.” Annals of Surgery Open, vol. 4, no. 1, 2023, pp. e287.