No way are you my doctor; you are not old enough. As a young female physician, I've had my fair share of age- or gender-related comments like this.
I am often called “too young,” “too pretty,” or “nurse” by my patients. Although I greatly respect nurses, it used to bother me that patients would assume I am a nurse solely based on my gender or that I am too inexperienced to be their doctor simply because I look younger than my actual age. I know that I am not alone.
We asked residents, “Have you encountered any form of bias (gender, racial, religious, other) in residency, and if so, what did you do to address or cope with it?” Here’s what they had to say.
Assumptions based on gender
Tina Yang, DO: "Almost every shift I work in the emergency department, I’ve been mistaken for a nurse at least once. This is not just by patients either; this has happened with EMS, police officers, technicians, and transporters.
"It is also shocking to me how many times other female physicians and I have had our plans questioned by staff and patients. In contrast, if a male doctor comes up with the same plan, it’s just automatically accepted without question. Oftentimes, male doctors don’t even comprehend that this happens and chalk it up to, 'You just have to be more adamant about your treatment plan.' "
"There was one occasion when I introduced myself and was talking with a patient when a male nurse walked over, and the patient immediately stopped the conversation with me and asked if he was his doctor. "
— Tina Yang, DO
Olivia Sutton, MD: "There's plenty of bias in the OR and ICU environments. I get called a nurse by patients, providers, etc., even after introducing myself as a doctor. Circulators often assume I'm a CRNA because I'm a woman rather than an MD anesthesiologist."
"Many times, I don't get addressed or listened to in critical situations, even when I'm the expert in the room. I try to let these things roll off my back and gently correct people."
— Olivia Sutton, MD
Bias based on culture and nationality
Gurinder Kumar MD: "I have encountered bias in my residency. Residents with a particular cultural and national background were given more preference and opportunities than me."
"For example, I was not selected to participate in a specific research study. This was reported to the GME office, who intervened and helped."
— Gurinder Kumar, MD, MetroHealth Medical Center, Cleveland
Vignesh Ramachandran, MD: "During my dermatology residency, I did encounter a situation that involved bias, specifically racial bias, which was a deeply unsettling experience. I was working with a patient who appeared uncomfortable from the outset, and it became clear that the patient's discomfort stemmed not from the skin condition but from my racial background. The patient made several insensitive comments and insinuations that were based on stereotypes associated with my race."
"This behavior created an environment that was not conducive to providing the best medical care, and it was a stark reminder of the systemic racial biases that persist in our society."
— Vignesh Ramachandran, MD, Department of Dermatology, NYU
Kelechi Acholonu, DO: "As a black woman, it is often that I’ve experienced bias, particularly when patients or other medical professionals call in to question my expertise due to prior misconceptions about people who look like me."
"I utilized the support from friends and family to get me through my worst days."
— Kelechi Acholonu, DO
Other similar experiences:
Hanish Jain, MD, SUNY Upstate: "Gender bias. Patients and nurses alike give preference to male physicians."
Saddam Yasin, MD: "Racial bias. Attendings give more value to white residents."
Jeffery Taylor, MD, University of Chicago: "Gender. Attendings are more willing to teach female residents."
Mistreatment in the form of bias is never appropriate toward patients, physicians, or any other healthcare staff, but unfortunately, it happens, whether purposefully or inadvertently. I like to presume that patients do not intentionally mean to be derogatory toward their physicians.
Regardless, it is our duty to stand up for ourselves and correct them in a calm and empathetic manner. Phrases such as “I do not appreciate that language or behavior” or “Please keep in mind that I am your physician” can be gentle approaches to addressing any biased behaviors.
Unfortunately, we may have to encounter these behaviors throughout our careers. Hopefully, we can adopt the language, mindset, and skills to let patients know that stereotyping is inappropriate.
Every medical resident has a question to ask and a story to tell—a comical moment, a prickly patient encounter, or a hack for staying sane during residency. We survey medical trainees for their best questions and answers and bring them to you in this column. Engaging, enlightening, and entertaining—from resident to resident!