To the Editor:
As the COVID-19 pandemic unfolded in 2020, 2 trainees at Tulane University were threatened by a gunman who said, “If you are Chinese or Japanese, I’m going to kill you.” 1 The debriefing organized by our community, students and alumni of the Asian Pacific American Medical Student Association (APAMSA), was “Zoom-bombed” with anonymous racist messages. While Asian American Pacific Islander (AAPI) medical trainees work as part of the pandemic response, we have needed to guard against more than respiratory droplets. AAPI trainees have also been subjected to waves of COVID-19-related harassment and violence across the country.
AAPIs comprise 1 in 5 physicians, 1 in 10 nurse practitioners, and 1 in 10 registered nurses. 2 We are here to help. We are here to treat everyone—including those who denigrate us. This racial hostility, however, evokes familiar feelings of being other. Some of the charged remarks that resident physicians have received on duty include, “I don’t want to see that Asian doctor!” “Go back to your country!” and “You people eat bats!” 3 Harassment of AAPIs will be a source of distress and burnout unless it is addressed at all levels, from the individual to institutional.
Trainees can reduce uncertainty about handling bigotry by using Paul-Emile’s clinician–patient relationship model. 4 Though uncomfortable, debriefing with mentors and peers can be therapeutic and help trainees identify how to respond effectively. 5 Supervisors can find resources for supporting AAPI trainees at places such as the Massachusetts General Hospital Center for Cross-Cultural Student Emotional Wellness. Bystanders can speak up by using bystander intervention models. 6
Institutions can lead through proactive responses and policymaking. For example, when an anesthesiology resident in Boston was followed home by a man shouting racial epithets, the institutional response included phone calls from her program director, department chair, campus security, and counseling services, as well as a webinar and email sent to all community members. 2 These are some of the ways that institutions can support AAPI trainees who are being targeted during this time.
Footnotes
Funding/Support: M.Z. Wang was supported by the National Institute of Mental Health’s Translational Research Activities in Neuropsychiatry (TRAIN) grant (#R25MH101078, M.H. Trivedi, PI).
Other disclosures: None reported.
Ethical approval: Reported as not applicable.
References
- 1.Umholtz K. Tulane “affiliates” threatened by gunman who asked if they’re “Chinese or Japanese,” police say. NOLA.com. https://www.nola.com/news/crime_police/article_142ae8c8-794b-11ea-bd9f-dbd9a274956d.html. Published April 7, 2020. Accessed February 22, 2021
- 2.U.S. Bureau of Labor Statistics. Employed persons by detailed occupation, sex, race, and Hispanic or Latino ethnicity 2020. https://www.bls.gov/cps/cpsaat11.htm. Updated January 22, 2021. Accessed February 18, 2021
- 3.Jan T. Asian American doctors and nurses are fighting racism and the coronavirus. Washington Post. https://www.washingtonpost.com/business/2020/05/19/asian-american-discrimination. Published May 19, 2020. Accessed February 18, 2021
- 4.Paul-Emile K, Smith AK, Lo B, Fernández A. Dealing with racist patients. N Engl J Med. 2016; 374:708–711 [DOI] [PubMed] [Google Scholar]
- 5.Whitgob EE, Blankenburg RL, Bogetz AL. The discriminatory patient and family: Strategies to address discrimination towards trainees. Acad Med. 2016; 91(11 Association of American Medical Colleges Learn Serve Lead: Proceedings of the 55th Annual Research in Medical Education Sessions):S64–S69 [DOI] [PubMed] [Google Scholar]
- 6.Center for Urban Pedagogy. Show Up: Your Guide to Bystander Intervention. https://www.ihollaback.org/app/uploads/2016/11/Show-Up_CUPxHollaback.pdf. Published 2017. Accessed February 18, 2021
