Objectives
- Assess how religious identity impacts workplace discrimination, accommodation, and several psychological and professional outcomes among Muslim physicians.
- Examine Muslim physicians’ experiences with discrimination and accommodation, and identify barriers to the inclusion of Muslim physicians.
Methodology
To obtain a sample of physicians who self-identify with Islam, we sought out national Muslim clinician organizations that explicitly integrated religious and professional identities in their organizational title and mission statements. Our sample was recruited from the Islamic Medical Association of North America (IMANA), American Muslim Health Professionals (AMHP), and the US Muslim Physician Network. In collaboration with these groups, we conducted an online cross-sectional survey and interviewed a purposive sample of respondents from March-August 2021.
To be eligible for participation, physicians had to be:
- English-speaking.
- Self-identify as Muslim.
- Currently work and affiliated with a university-hospital in the US in the past 20 years.
This study was approved by the institutional review board at the Medical College of Wisconsin. Informed consent was obtained from all subjects involved in the study.
Survey Participants
The 264 participants who completed the survey had a mean age of 39.5 years. Most were male (61%), born in the US (55%), completed medical school in the US (72%), and had a visible marker of Muslim identity, i.e., beard or hijab (51%), and Sunni (70%). Fifteen percent identified as African American/Black, 21% as Arab/Arab American, 31% as South Asian, and 27% as European/White.
A majority (63%) attended congregational religious services greater than a few times a month, engaged in private religious activities (53%) two or more times per week, experienced the presence of the Divine in their lives (73%), based their whole life approach on their Islamic beliefs (75%), tried to carry Islam into all dealings in their lives (74%) and considered religion to be of high importance in their lives (74%).
Interview Participants
When completing the survey, 186 participants met the eligibility criteria and indicated an interest in an interview. Of those participants, 18 were interviewed.
The average age of interviewees was 41.5 years, and over half of the group (11/18) were female. Most of the participants interviewed were South Asian (13/18), and half (9/18) were born in the United States.
To better situate their experiences in the context of the interviewees, a couple of survey items were used to categorize interviewees as experiencing either high religious discrimination or low religious discrimination; nine participants fell into each group. Similarly, they were categorized as experiencing either high religious accommodation or low religious accommodation; there were 12 participants in the first category and 6 participants in the second category.
Results
Over the past 10 years, an increased number of Muslim physicians are experiencing religious discrimination, job turnover, and having patients refuse care.
The following results reveal the impact of religious discrimination on the professional and psychological outcomes for Muslim physicians in the healthcare workplace.
Muslims Physicians Increasingly Experience Religious Discrimination in the Healthcare Workplace
In the 2021 survey:
- 53% reported frequently encountering religious discrimination in their career.
- 36% currently experience discrimination at work directed at their religious identity or otherwise.
- 33% reported patients refusing their care on account of the treating clinician, e.g., the survey participant, being Muslim.
- 57% believed they had been passed over for professional advancement due to their religious identity.
Multivariate data analysis revealed that:
- Religious importance was positively associated with discrimination from patients.
- Engaging in congregational religious activities was negatively associated with discrimination from patients and job turnover.
Furthermore, interviews with 18 physicians revealed that this physician group experienced discrimination from all corners, including colleagues, administration, and patients, and that these experiences included being subject to additional scrutiny and Islamophobic comments. For example, one South Asian female participant noted a lack of support from leadership :
Muslim Physicians are Experiencing Depression, Anxiety, and Burnout
Survey participants reported experiencing symptoms of depression, anxiety, and burnout. Forty-eight percent of participants noted having little to no interest in doing things over the past two weeks. Participants who felt religion was important to their lives had higher rates of depression. Moreover, experiencing greater levels of religious discrimination over one’s career correlated with depressive symptoms.
Forty-seven percent of participants reported feeling down, depressed, or hopeless in the past two weeks. Twenty-one percent of participants screened positive for depression.
Twenty-nine percent of participants acknowledged one or more symptoms of burnout, such as physical or emotional exhaustion.
Interview participants shared the psychological health toll of workplace discrimination. Out of the 18 participants, 12 feared revealing their religious identity; 10 harbored stress due to microaggressions; and 10 experienced depression/anxiety. One South Asian female participant noted:
Muslim Physicians’ Religious Identity is Inadequately Accommodated at Work
In the 2021 survey, almost three-fourths of respondents agreed with the statement that their workplace accommodates their religious identity. Multivariate data analysis revealed that:
- Religious importance was negatively associated with prayer accommodations in the workplace.
- Engaging in congregational religious activities was positively associated with accommodations for prayer and general religious identity accommodation.
Interview participants shared that notions of accommodation focused on their own initiatives rather than the institutional outreach. In other words, many participants felt ‘accommodated’ through their own efforts at managing prayer or getting holidays covered by colleagues. Participants did not find a proactive and welcoming environment where they were being granted religious accommodations by their employers. This ‘self-accommodation’ may have started at the beginning of their careers with their choice of specialty. As one Arabic female participant mentioned:
Physician interviews revealed that not having a designated neutral prayer space at hospitals was a barrier and that the burden fell on them to secure time and space to pray. For example, participants noted being fearful of negative outcomes should they ask supervisors or administrators to accommodate their need to pray, fast, or observe holidays and religious dress codes. This fear of judgment was most pronounced during training, when medical students and residents were evaluated, in part, on how well they meshed within workplace hierarchies. Interview participants also identified being unable to routinely secure scheduling accommodations for Ramadan fasting and the holidays of Eid, and challenges in maintaining Islamic dress codes, for example the ḥijāb.
The following suggestions were provided by interview participants for how their religion could be better accommodated at work (see infographic for more details):
- Providing support and designated spaces for daily and Friday prayer.
- Acknowledging the practice of Ramadan fasting and Islamic holidays.
- Creating policies to protect Muslim dress code in the workplace.
- Recognizing Muslim dietary preferences and restrictions.
- Instituting a faith community liaison position.
- Medical education should account for religious identity.
The following results video the impact of religious Discrimination and the professional and Psychological outcome and the Symphysition and health care work.
Muslims Physicians Increasingly Experience Religious Discrimination in the Healthcare Workplace
In the 2021 survey:
- 53% reported frequently encountering religious discrimination in their career.
- 36% currently experience discrimination at work directed at their religious identity or otherwise.
- 33% reported patients refusing their care on account of the treating clinician, e.g., the survey participant, being Muslim.
- 57% believed they had been passed over for professional advancement due to their religious identity.
Multivariate data analysis revealed that:
- Religious importance was positively associated with discrimination from patients.
- Engaging in congregational religious activities was negatively associated with discrimination from patients and job turnover.
Furthermore, interviews with 18 physicians revealed that this physician group experienced discrimination from all corners, including colleagues, administration, and patients, and that these experiences included being subject to additional scrutiny and Islamophobic comments. For example, one South Asian female participant noted a lack of support from leadership :
Muslim Physicians are Experiencing Depression, Anxiety, and Burnout
Survey participants reported experiencing symptoms of depression, anxiety, and burnout. Forty-eight percent of participants noted having little to no interest in doing things over the past two weeks. Participants who felt religion was important to their lives had higher rates of depression. Moreover, experiencing greater levels of religious discrimination over one’s career correlated with depressive symptoms.
Forty-seven percent of participants reported feeling down, depressed, or hopeless in the past two weeks. Twenty-one percent of participants screened positive for depression.
Twenty-nine percent of participants acknowledged one or more symptoms of burnout, such as physical or emotional exhaustion.
Interview participants shared the psychological health toll of workplace discrimination. Out of the 18 participants, 12 feared revealing their religious identity; 10 harbored stress due to microaggressions; and 10 experienced depression/anxiety. One South Asian female participant noted:
Muslim Physicians’ Religious Identity is Inadequately Accommodated at Work
In the 2021 survey, almost three-fourths of respondents agreed with the statement that their workplace accommodates their religious identity. Multivariate data analysis revealed that:
- Religious importance was negatively associated with prayer accommodations in the workplace.
- Engaging in congregational religious activities was positively associated with accommodations for prayer and general religious identity accommodation.
Interview participants shared that notions of accommodation focused on their own initiatives rather than the institutional outreach. In other words, many participants felt ‘accommodated’ through their own efforts at managing prayer or getting holidays covered by colleagues. Participants did not find a proactive and welcoming environment where they were being granted religious accommodations by their employers. This ‘self-accommodation’ may have started at the beginning of their careers with their choice of specialty. As one Arabic female participant mentioned:
Physician interviews revealed that not having a designated neutral prayer space at hospitals was a barrier and that the burden fell on them to secure time and space to pray. For example, participants noted being fearful of negative outcomes should they ask supervisors or administrators to accommodate their need to pray, fast, or observe holidays and religious dress codes. This fear of judgment was most pronounced during training, when medical students and residents were evaluated, in part, on how well they meshed within workplace hierarchies. Interview participants also identified being unable to routinely secure scheduling accommodations for Ramadan fasting and the holidays of Eid, and challenges in maintaining Islamic dress codes, for example the ḥijāb.
The following suggestions were provided by interview participants for how their religion could be better accommodated at work (see infographic for more details):
- Providing support and designated spaces for daily and Friday prayer.
- Acknowledging the practice of Ramadan fasting and Islamic holidays.
- Creating policies to protect Muslim dress code in the workplace.
- Recognizing Muslim dietary preferences and restrictions.
- Instituting a faith community liaison position.
- Medical education should account for religious identity.
Summary and Implications
The survey data revealed that religious importance was positively associated with discrimination from patients and depression, and negatively associated with prayer accommodations in the workplace. However, engaging in congregational religious activities was negatively associated with discrimination from patients and job turnover. Arabs, South Asians, and Whites had lower odds of experiencing workplace discrimination, job turnover, burnout, and depression than African Americans.
Qualitative analysis of physician interviews (n=18) revealed that American Muslim physicians regularly face discrimination because of their religious identity and lack adequate institutional accommodation for their religious practices (e.g., time or space for prayers). These experiences link to several negative downstream outcomes including low sense of belonging in academic medicine, job turnover, and abandoning religious practices.
This study highlights how religious identity and religiosity negatively impact workplace experiences and well-being among Muslim physicians and highlights the deep psychological and career effects of working in a space perceived to be non-accommodating of religious practices. This research calls attention to the urgent need for academic medical centers to ameliorate workplace discrimination and pursue policies of workplace accommodation for physicians with strong religious identities.
Publications
- Religious Identity Discrimination in the Physician Workforce: Insights from Two National Studies of Muslim Clinicians in the US. Journal of General Internal Medicine. 2023.
Presentations
Community Conferences
- Muslim Clinicians in the Medical Academy, Anesthesiology Grand Rounds DEI, Medical College of Wisconsin, Milwaukee, WI, 2/2022.
- Being Muslim in Academic Medicine, Nagamia Institute of Islamic Medicine and Sciences (NIIMS), Rolling Meadows, IL, 7/2022.
Academic Conferences
- Religious Identity Discrimination in the Physician Workforce: Insights from Two National Surveys of Muslim Clinicians in the US, Conference on Medicine and Religion, Portland, OR, 3/2022.
- Religious Accommodation or Professional Indoctrination? Experiences of Muslim Physicians in Academic Medicine, Conference on Medicine and Religion, Portland, OR, 3/2022.
- Advancing Institutional Workforce Equity: Insights From Muslim Physicians in Academic Medicine, The Academy for Professionalism in Health Care, Philadelphia, PA, 6/2022.
- Religiosity Predicts Discrimination, Accommodation, and Career Outcomes for Muslim Physicians in Academic Medicine, The Academy for Professionalism in Health Care, Philadelphia, PA, 6/2022.
- The Impact of Practicing Both Medicine and Religion: Muslim Identity as a Predictor of Discrimination, Accommodation, and Careers Outcomes in Academic Medicine, The Association of American Medical College, Nashville, TN, 11/2022.
- Religious Identity Discrimination in the Physician Workforce: Insights from Two National Surveys of Muslim Clinicians in the US, American Muslim Medical Students Association, Ann Arbor, MI, 8/2022. Poster.
- Health Policy & Advocacy Priorities for American Muslims Centering Equity, National American Muslim Policy Conference, Virtual, 6/2022.
- The Impact of Practicing Both Medicine and Religion: Muslim Identity as a Predictor of Discrimination, Accommodation, and Career Outcomes in Academic Medicine. AAMC. 2022.
- Religious Identity Discrimination in the Physician Workforce: Insights from Two National Studies of Muslim Clinicians in the US. 04 January 2023.
Media Highlights
Links to Resources
- Know Your Rights – A fact sheet describing religious rights in the workplace and what steps to take if your rights have been disregarded, Muslim Advocates.
- Filing a Conscience and Religious Freedom Complaint – File a complaint online about religious discrimination. Federal Conscience and Religious Freedom Laws help to protect you from coercion, discrimination on the basis of conscience or religion, and burdens on the free exercise of religion, Office of Civil Rights.
- Ḥijāb in the OR – A guide to ḥijāb in the operating room, written by Dr. Deena Kishawi.
Employee Resources:
- An Employer’s Guide to Islamic Religious Practices – A pamphlet designed to aid employers in formulating and implementing policies to create a culturally inclusive workplace, Council on American-Islamic Relations.
- Religious Diversity Manager Training – A session designed for managers to learn how to respond to accommodation requests and foster an inclusive work environment, Tanenbaum Foundation.
- TAHSN Standards for Religious Attire for Health Care Workers, Learners and Volunteers in Hospital Areas with Sterile Procedure – Standards and shared expectations related to clothing worn by religiously observant individuals working in hospital areas with sterile procedures, The Toronto Academic Health Science Network (TAHSN)
- Muslim Resident Cases– A chapter in the book, Diversity and Inclusion in Quality Patient Care: A Case-Based Compendium (pgs. 305-314), that presents four cases of ethical challenges in healthcare provision for Muslim patients.
Policy Reports
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Muslims Physicians Increasingly Experience Religious Discrimination in the Healthcare Workplace
In the 2021 survey:
- 53% reported frequently encountering religious discrimination in their career.
- 36% currently experience discrimination at work directed at their religious identity or otherwise.
- 33% reported patients refusing their care on account of the treating clinician, e.g., the survey participant, being Muslim.
- 57% believed they had been passed over for professional advancement due to their religious identity.
Multivariate data analysis revealed that :
- Religious importance was positively associated with discrimination from patients.
- Engaging in congregational religious activities was negatively associated with discrimination from patients and job turnover.
Furthermore, interviews with 18 physicians revealed that this physician group experienced discrimination from all corners, including colleagues, administration, and patients, and that these experiences included being subject to additional scrutiny and Islamophobic comments.
For example, one South Asian female participant noted a lack of support from leadership:
15%
Started a new career after completing these courses
20%
Got a tangible career benefit from this course
Muslim Physicians are Experiencing Depression, Anxiety, and Burnout
Survey participants reported experiencing symptoms of depression, anxiety, and burnout. Forty-eight percent of participants noted having little to no interest in doing things over the past two weeks. Participants who felt religion was important to their lives had higher rates of depression. Moreover, experiencing greater levels of religious discrimination over one’s career correlated with depressive symptoms.
Forty-seven percent of participants reported feeling down, depressed, or hopeless in the past two weeks. Twenty-one percent of participants screened positive for depression.
Twenty-nine percent of participants acknowledged one or more symptoms of burnout, such as physical or emotional exhaustion.
Interview participants shared the psychological health toll of workplace discrimination. Out of the 18 participants, 12 feared revealing their religious identity; 10 harbored stress due to microaggressions; and 10 experienced depression/anxiety. One South Asian female participant noted:
Muslim Physicians’ Religious Identity is Inadequately Accommodated at Work
In the 2021 survey, almost three-fourths of respondents agreed with the statement that their workplace accommodates their religious identity. Multivariate data analysis revealed that:
- Religious importance was negatively associated with prayer accommodations in the workplace.
- Engaging in congregational religious activities was positively associated with accommodations for prayer and general religious identity accommodation.
Interview participants shared that notions of accommodation focused on their own initiatives rather than the institutional outreach. In other words, many participants felt ‘accommodated’ through their own efforts at managing prayer or getting holidays covered by colleagues. Participants did not find a proactive and welcoming environment where they were being granted religious accommodations by their employers. This ‘self-accommodation’ may have started at the beginning of their careers with their choice of specialty. As one Arabic female participant mentioned:
Physician interviews revealed that not having a designated neutral prayer space at hospitals was a barrier and that the burden fell on them to secure time and space to pray. For example, participants noted being fearful of negative outcomes should they ask supervisors or administrators to accommodate their need to pray, fast, or observe holidays and religious dress codes. This fear of judgment was most pronounced during training, when medical students and residents were evaluated, in part, on how well they meshed within workplace hierarchies. Interview participants also identified being unable to routinely secure scheduling accommodations for Ramadan fasting and the holidays of Eid, and challenges in maintaining Islamic dress codes, for example the ḥijāb.
The following suggestions were provided by interview participants for how their religion could be better accommodated at work (see infographic for more details):
- Providing support and designated spaces for daily and Friday prayer.
- Acknowledging the practice of Ramadan fasting and Islamic holidays.
- Recognizing Muslim dietary preferences and restrictions.
- Creating policies to protect Muslim dress code in the workplace.
- Instituting a faith community liaison position.
- Medical education should account for religious identity.
Islamic bioethics, as a subject of scholarly inquiry and as a repository of guidance, remains a field-in-formation for its content, scope and methodology are subject to debate. Ambiguities regarding the contours of an Islamic bioethics do
About this Course
An Introduction to the field of Islamic Bioethics
Islamic bioethics, as a subject of scholarly inquiry and as a repository of guidance, remains a field-in-formation for its content, scope and methodology are subject to debate. Ambiguities regarding the contours of an Islamic bioethics do not stem from the lack of a moral theology outlined by scripture, nor from a dearth of ethico-legal judgments about biomedicine formulated by Islamic jurists. Rather, the contemporary challenge is to devise bioethical frameworks that are both rooted in Islamic theology and law, yet are fully informed, and thus practically address, the needs of patients, clinicians, religious advisors, and policymakers.
The challenges for “Islamic” bioethics are made more profound by the fact that notions about moral norms, the good, and the ethical are scattered across different Islamic sciences including moral theology (uṣūl al-fiqh), scholastic theology (ʿilm al-kalām), jurisprudence and law (fiqh), as well as within various genres and practices related to moral formation and spiritual development (taṣawwuf and adab). The multidisciplinary nature of bioethical inquiry also leads to a crisis of epistemology and legitimacy; it is not clear how much weight should be accorded to the reality on the ground (what is) when considering the moral ordering of society (what should be) as well as which register of contemporary bioethical discourse (clinical, political, societal) Islamic bioethics should attend to.
Consequently, this self-paced, intensive course introduces learners to
(i) critical concepts in Islamic theology and law that undergird normative ethical frameworks,
(ii) scholarly discussions regarding the methods, content and scope of an Islamic bioethics, and
(iii) extant normative rulings and discursive products of applied Islamic bioethics related to end-of-life care, organ donation, and reproductive health.
- Describe the sources of Islamic morality
- Identify the producers, consumers and the discursive material of Islamic bioethics
- Describe the contentions around what constitutes the "Islamic" in Islamic bioethics
- Apply critical analysis skills to decipher gaps in the Islamic bioethics discourse
- Delineate the major Islamic juridical views on end-of-life healthcare, organ donation, and reproductive health
At a glance
Institution: Initiative on Islam and Medicine
Subject: Introduction to field of Islamic bioethics
Level: Introductory
Prerequisites: None (This is an introductory course)
Language: English
Language: English
What you'll learn
Who this course is for
- 1. Physicians and allied healthcare practitioners
- 2. Medical students and trainees
- 3. Chaplains and religious leaders
- 4. Bioethicists
- 5. Others interested in the intersection of religious ethics and healthcare
15%
Started a new career after completing these courses
20%
Got a tangible career benefit from this course
Self paced
Progress through the course at your own pace within the 4 month cohort
Shareable Certificate
Earn a Certificate upon completion
100% online
Start instantly and learn at your own schedule.
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Dr Rafaqat Rashid
Co-Founder : Al-Balagh Academy UK
Imam Musha Azam
Director of Development : SoundVision Foundation
Sadaf Popal
Student Intern
ADEL SYED
CEO : UMMA Community Clinic
Dr. Obadah Ghannam
Academic Clinical Fellow in Genral Practice,
University of Birmingham, Trustee, Center for Islam
and Medicine
Dr Rafaqat Rashid
Co-Founder : Al-Balagh Academy UK
Imam Musha Azam
Director of Development : SoundVision Foundation
Sadaf Popal
Student Intern
ADEL SYED
CEO : UMMA Community Clinic
Dr. Obadah Ghannam
Academic Clinical Fellow in Genral Practice,University of Birmingham, Trustee, Center for Islam and Medicine
Flexible deadlines
Reset deadlines in accordance to your schedule.
Self paced
Progress through the course at your own pace within the 4 month cohort
Shareable Certificate
Earn a Certificate upon completion
100% online
Start instantly and learn at your own schedule.
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