Perception of Accent Modification Programs: Assimilation or Racism?

Abstract

Background: International medical graduates (IMGs) represent approximately 25% of practicing physicians in the United States (US), including residents and fellows. Unfortunately, often non-American English accents often challenge professional credibility. In fact, many healthcare providers and scholars in the US face linguistic discrimination. This type of discrimination has not been examined in great depth, especially in academic medicine. Objective: The objective of this study is to examine IMG perspective as they relate to linguistic accent, explore accent modification programs, and analyze the message such programs may send to trainees. Methods: The authors utilized semi-structured interviews. The interviews took place virtually for 30 to 45 minutes. Interviews were transcribed and all response summaries were relayed back to the participant to assure correct meaning. Data was analyzed by 3 authors using the constant comparative method to extract recurrent themes. Secondary data specifically explores accent modification programs. Selection of institutions was purposeful and derived from web searches. We selected eight institutions, which allowed for a content analysis of each institutional website. A final thematic analysis was performed via discussing the themes as a group, inclusive of the publicly available institutional messages. Results: We identified three main themes: (1) perception of accent modification as racist and as forced assimilation, and (2) accent as linguistic discrimination and deficit-based thinking (3) hidden message in accent modification programs. Conclusions: Our research highlights an unsettling sentiment among IMGs: accent modification programs might harbor a racist undertone, potentially suggesting forced assimilation and covert biases. A significant number of participants expressed that perceived accents can be a source of discrimination.