Internationally Trained Female Oncologists Face Multiple Kinds of Discrimination in the U.S.
Article Summary
- Looking beyond Sylvester, oncologist Coral Olazagasti, M.D., surveyed oncologists who graduated from medical schools outside the continental U.S. to better understand their experiences of discrimination and cultural adaptation.
- Dr. Olazagasti found that female oncologists in the survey were more likely to report gender-, race- or ethnicity-based discrimination.
- She will present this work at the American Society of Clinical Oncology’s annual meeting.
When Coral Olazagasti, M.D., first moved to New York to start her residency after graduating from medical school in her native Puerto Rico, she was surprised at how hard her adjustment was. Not only was the culture shock worse than she’d expected but her superiors and colleagues in her program chastised her for speaking too loudly or made fun of her for her accent.
“Puerto Rico is a U.S. territory, so when I moved to New York, I thought it wasn’t going to be a big change,” said Dr. Olazagasti, an assistant professor of clinical medical oncology at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine. “I went through a significant number of adjustments and challenges. That time was really lonely. Not many people in my situation were talking about the challenges they were experiencing.”
Dr. Olazagasti wondered if the difficulties she faced adjusting to the very different culture in the U.S. while reckoning with that culture’s biases against certain immigrants and ethnic minorities might be even worse for female immigrants. So, she decided to find out.
In a study she will present at the American Society of Clinical Oncology’s annual meeting June 3, Dr. Olazagasti surveyed oncologists working or training in the U.S. who’d graduated from international or Puerto Rican medical schools. Female oncologists in the survey reported much higher levels of gender- or race/ethnicity-based discrimination than their male counterparts, she found.
Layers of Discrimination
The survey included non-U.S. or Puerto Rican oncologists who were either training in a residency or fellowship program in the U.S. or who had completed training and were practicing as independent oncologists. In the survey, more than 50% of female respondents reported gender discrimination during their training or practice, compared to fewer than 5% of male respondents. And nearly 70% of female respondents reported racism or ethnicity-based discrimination during their training, compared to only 38% of male respondents.
“It’s not surprising to me that women experienced more racial and ethnic discrimination,” in addition to more gender discrimination, Dr. Olazagasti said. “Society still sees us as inferior to men, and that translates beyond our gender to also include our race or ethnic background.”
Her survey also found that female oncologists report more culture shock than male oncologists, with 65% of women saying they had challenges adapting to American traditions versus 44% of men.
Dr. Olazagasti pointed out that, because the survey relies on self-reporting, some of the results could also be due to differences in how men and women perceive cultural adaptation challenges or discrimination. For example, women may more readily admit to struggling to adapt than men, even in an anonymous survey, she said.
Advocating for Change
To chip away at these problems, Dr. Olazagasti believes representation at all levels is important. If universities and other employers want to attract and retain women and racial and ethnic minorities as physicians, they need to ensure these candidates see their identities reflected and celebrated throughout the organizations.
“If you want to create a diverse community and attract people from diverse backgrounds, you have to have representation throughout all the tiers, up to leadership,” she said.
Dr. Olazagasti was looking for that representation herself when she considered different positions after her training. One of the reasons she chose Sylvester is because she saw many people like her in different leadership positions there, she said.
“One of the big reasons I chose to move here to Miami and work at Sylvester is because they’re very welcoming to different backgrounds and different cultures,” she said. “I feel like my identity is celebrated here. It’s important to find a place that celebrates you because they are out there.”
Tags: ASCO, ASCO 2024, Diversity and Inclusion, Dr. Coral Olazagasti, Equity and Inclusion, Sylvester Comprehensive Cancer Center