Religious Accommodation or Professional Indoctrination? Experiences of Muslim Physicians in Academic Medicine
Aasim Padela, MD, MSc, Professor of Emergency Medicine, Bioethics and Medical Humanities, Medical College of Wisconsin
Minority physicians’ experiences with workplace discrimination adversely impacts their personal career trajectories and health, as well as the workplace climate. As the medical academy pays greater attention to addressing workplace discrimination and promoting inclusion, little is known about the sorts of accommodations needed to achieve these goals. Moreover, while most efforts focus on racial/ethnic, gender and sexual identity-based issues, religious identity-based concerns are under-investigated. We tackled these lacunae by examining Muslim physicians’ experiences with discrimination and accommodation, and in so doing sought to identify barriers to the inclusion of Muslim physicians in academic medicine.
We recruited physicians from the Islamic Association of North America, American Muslim Health Professionals, US Muslim Physician network for in-depth semi-structured interviews using emails on closed listservs and social media channels of these associations. Inclusion criteria included self-identifying as Muslim, being English-proficient and currently practicing, and having worked at an academic medical center in the past 20 years. Potential interviewees completed a pre-interview questionnaire eliciting sociodemographic descriptors and responses to two ‘sorting’ questions which covered perceived religious discrimination and accommodation over the careers. Maximum diversity purposive sampling was used to select interviewees and thematic saturation on experiences of discrimination and accommodation was the sampling endpoint. Interviews were digitally recorded and transcribed prior to inductive analysis using a framework approach. After ensuring interrater reliability of 80%, transcripts were independently coded.
Eighteen physicians participated in interviews. The sample averaged 13 years of experience, ranged between 29 and 77 years of age, and were mostly female (61%) and South Asian (72%). Half were born in the US and graduates of US medical schools. Nearly all (89%) considered Islam as the most or a very important part of their life.
Religious practices such as daily prayer, Friday congregational prayers, and Ramadan fasting were a source of significant challenge for physicians. Those who were more regular with these practices encountered greater workplace discrimination overall and received fewer accommodations for such practices. Most commonly, clinicians used self-management strategies, such as finding time between patients to perform prayer, and less frequently soliciting assistance from peers such as asking for coverage to attend Friday prayer. In terms of religious holidays such as Eid, or observances such as halal food, similar issues were reported; a lack of structural accommodations and reliance on self-management. The added work and stress of fitting in their religious practices increased their sense of vulnerability to religion-based discrimination. Subsequently, many reported feeling out of place, less apt to succeed, and targeted because of their religious identity. Several left their positions as result, while others coped by compromising or abandoning their religious practices and values to fit in and manage their workloads.
We recruited physicians from the Islamic Association of North America, American Muslim Health Professionals, US Muslim Physician network for in-depth semi-structured interviews using emails on closed listservs and social media channels of these associations. Inclusion criteria included self-identifying as Muslim, being English-proficient and currently practicing, and having worked at an academic medical center in the past 20 years. Potential interviewees completed a pre-interview questionnaire eliciting sociodemographic descriptors and responses to two ‘sorting’ questions which covered perceived religious discrimination and accommodation over the careers. Maximum diversity purposive sampling was used to select interviewees and thematic saturation on experiences of discrimination and accommodation was the sampling endpoint. Interviews were digitally recorded and transcribed prior to inductive analysis using a framework approach. After ensuring interrater reliability of 80%, transcripts were independently coded.
Eighteen physicians participated in interviews. The sample averaged 13 years of experience, ranged between 29 and 77 years of age, and were mostly female (61%) and South Asian (72%). Half were born in the US and graduates of US medical schools. Nearly all (89%) considered Islam as the most or a very important part of their life.
Religious practices such as daily prayer, Friday congregational prayers, and Ramadan fasting were a source of significant challenge for physicians. Those who were more regular with these practices encountered greater workplace discrimination overall and received fewer accommodations for such practices. Most commonly, clinicians used self-management strategies, such as finding time between patients to perform prayer, and less frequently soliciting assistance from peers such as asking for coverage to attend Friday prayer. In terms of religious holidays such as Eid, or observances such as halal food, similar issues were reported; a lack of structural accommodations and reliance on self-management. The added work and stress of fitting in their religious practices increased their sense of vulnerability to religion-based discrimination. Subsequently, many reported feeling out of place, less apt to succeed, and targeted because of their religious identity. Several left their positions as result, while others coped by compromising or abandoning their religious practices and values to fit in and manage their workloads.