Yale study: Asian-American medical students experience racism

Asian-American medical students often experience racism and feel overlooked at school, according to a Yale School of Medicine-led study published Monday.

The study, published  in the journal JAMA Network Open, was conducted at 17 U.S. medical schools by Dr. David Yang, a fellow in the Department of Emergency Medicine at Yale School of Medicine.

The study suggested medical schools must work to become more inclusive, according to a statement.

Yang, lead author of the study, decided to look into the issue after experiencing racism related to COVID-19. During the pandemic, Asians in the United States and Asian Americans were victims of racist acts and epithets because the coronavirus was first discovered in China.

Yang took on the study because he wondered whether his experience was more widely shared. He found there was little research on the issue, according to the statement.

He interviewed 25 Asian-American medical students, seeking common themes. He focused on racism, microaggressions, the schools’ support for students and suggested improvements, according to the statement.

“We wanted to make sure we had a broad range of perspectives,” Yang said in the statement. “So we intentionally recruited students who are classically less represented in medicine, such as Vietnamese Americans and Filipino Americans, in addition to those who are more visible like Chinese Americans and Indian Americans.”

He found most students reported experiencing racism, such as patients telling them they had COVID-19 or a doctor joking that a Pakistani-American medical student was a member of the Taliban, according to the release.

Students also said they felt “invisible,” including being mistaken for other students and being thought of broadly as “Asian,” the release said.

There also was little about Asian-American experiences included in medical school curricula, they said, making them feel isolated and exhausted, according to the statement. Some reported suicidal feelings and questioned continuing their training.

“The students described themselves as not being able to work or focus, unable to even think about medicine because of these constant racist experiences that kept appearing during their training,” said Yang in the statement.

“I know from my own experience that this type of environment can lead to a lot of mental health problems, burnout, and, at the very worst, suicide attempts and deaths by suicide,” he said.

The problem can influence workforce diversity, Yang said.

“Asian Americans as a whole would be considered overrepresented in medicine based on the population of the United States, but there are more than 17 different populations represented within the umbrella term of ‘Asian American,’” said Yang.

“Some of those populations may indeed be overrepresented, but there are so many communities that aren’t represented at all, and that can affect the Asian communities we treat,” he said. 

He said other underrepresented groups besides Asian Americans should be addressed as well.

Students in the study suggested ways to improve medical school learning environments, including not lumping together Asian ethnicities in admissions, adding Asian-American health to the curriculum and increasing Asian-American representation among leadership and mental health personnel, the release said.

“It’s important to have mental health personnel that really understand racialized experiences,” Yang said in the statement. “Students said they felt most heard when they had a therapist that was either knowledgeable about or was open to talking about racism.”

Dr. Gunjan Tiyyagura, associate professor of pediatrics at Yale School of Medicine and senior author of the study, said in the statement, “Among a diverse group of Asian American medical students, discrimination during medical training took on many forms from daily microaggressions to acts of overt racial aggression, which increased during the COVID pandemic.

“Yet students described numerous barriers to feeling supported or visible. This study is the first to delineate practical strategies that institutions can pursue to start mitigating the invisibility felt by many students and addressing discrimination during a formative period for students.”

Ed Stannard can be reached at estannard@courant.com.