Experiences for affirmative actions: strategies against ethnic-racial discrimination in medicine

Introduction:   Slavery has left inequalities that still affect access to healthcare and education. In Medicine, affirmative actions have expanded access, yet challenges remain regarding the retention and legitimization of Black and Indigenous students in academic settings.

Objective:   To understand, from a collaborative learning perspective, situations of racial and ethnic discrimination and strategies to confront racism in medical education.

Method:   This qualitative study employed an ethnographic approach, utilizing participant observation and focus groups to gather insights into racial and ethnic discrimination and strategies to combat racism in Medicine. Three academic experiences were conducted, during which participants documented their experiences on index cards and proposed solutions, each session lasting approximately one hour. Thirty-three participants were involved, including 16 self-identified as Black or mixed-race and 2 Indigenous individuals from the Mundurucu and Borari ethnic groups. Data analysis followed collaborative learning theoretical frameworks, employing Minayo’s thematic analysis technique. The study protocol was approved by the Research Ethics Committee under opinion number 5,736,372.

Results:   The study revealed subtle forms of racism characterized by the normalization of discrimination and a logic of denial, expressed through microaggressions, identity denial, challenges in occupying and navigating medical spaces, and the perpetuation of stereotypical images of Black and Indigenous individuals. Conversely, it highlighted individual and collective strategies to combat racism, such as reporting incidents, promoting anti-racist dialogue, education on racial and ethnic relations, legal penalties, and raising awareness among the population about the experiences of being Black or Indigenous.

Conclusion:   Racism continues to permeate university and healthcare environments, negatively impacting the experiences of Black and Indigenous students. Nevertheless, the study identifies pathways of resistance that underscore the importance of affirmative actions, racial consciousness, and transformative approaches in Medical Education. Integrating ethnic-racial discourse into health education is crucial for fostering inclusive and socially engaged learning environments.

Keywords:
Racial discrimination; Social medicine; Equity; Medical education