South Alabama OB-GYN Residency’s Implicit Bias, Microaggression Training Draws Questions Under Alabama’s DEI Law

MOBILE, Ala. — The University of South Alabama’s obstetrics and gynecology residency program says on its website that it trains faculty and residents in “implicit bias” and “microaggressions,” a description that critics argue could run afoul of Alabama’s 2024 law restricting diversity, equity and inclusion programs at public universities.

The questions were raised in a report published Monday, Oct. 26, which examined the program’s public web page and the materials it describes. The report contends the training could potentially violate the state law. It was not immediately clear whether the university has reviewed the program’s materials in light of the law or whether any complaint has been filed.

What the residency’s website says

The university describes its OB-GYN residency online as a “remarkable experience for our residents.”

“Our residents receive education and training in patient care, surgery, including robotic training, and inpatient and outpatient management of acute obstetric and gynecologic conditions,” the site reads. “Didactics include weekly grand rounds, monthly morbidity and mortality conference, and weekly didactic presentations resulting in well-trained and well-prepared OB-GYN specialists.”

A section of the page labeled “Health Determinants” describes in-house training and community health experiences. In addition to a health clinic experience, the page says the program:

• Trains faculty and residents in implicit bias as well as microaggression through the College of Medicine’s Office of Health Advancement.
• Conducts research that focuses on health disparities and social determinants of health in the community.

The page also says the program partners with the College of Medicine’s OB/GYN Interest Group on a quarterly book club focusing on a “variety of health issues.” Titles the group has discussed include:

• “Half the Sky: Turning Oppression into Opportunity for Women Worldwide”
• “The Remedy: Queer and Trans Voices on Health and Health Care”
• “The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having—or Being Denied—an Abortion”
• “Pregnant While Black: Advancing Justice for Maternal Health in America”

What Alabama’s DEI law says

In 2024, the Alabama Legislature passed and Gov. Kay Ivey signed a law, known during the session as Senate Bill 129, that restricts diversity, equity and inclusion programs at state agencies, public schools and public colleges and universities. Among other things, the law bars those institutions from maintaining DEI offices and from requiring students, employees or contractors to attend training or classes that promote a list of what the law calls “divisive concepts.”

One of those concepts is described in the law as: “That, by virtue of an individual’s race, color, religion, sex, ethnicity, or national origin, the individual is inherently racist, sexist, or oppressive, whether consciously or subconsciously.”

The law also includes language intended to protect academic instruction and research, and supporters and critics have debated how those provisions apply to specific courses and programs since it took effect.

The argument over implicit bias training

Implicit bias training generally teaches that people can hold unconscious attitudes or associations, including ones linked to race, sex and other characteristics, that may influence their decisions without their awareness. Microaggression training typically focuses on identifying everyday comments or behaviors that may be perceived as slights based on identity.

Critics of these trainings, including the authors of Monday’s report, argue they attribute bias or fault to people based on characteristics such as race or sex, which they say mirrors the “divisive concepts” the Alabama law prohibits in required training.

Supporters of such training in medicine take a different view. Medical schools and professional organizations have increasingly included training on bias and communication, arguing it can help doctors recognize assumptions that may affect patient care. That argument has been especially prominent in obstetrics, where national data have long shown differences in maternal health outcomes among racial and ethnic groups, a topic addressed in one of the books on the program’s reading list.

The disagreement reflects a broader national debate over whether bias training improves care or promotes contested ideas, and over how far state DEI laws reach into graduate medical education, which is also governed by national accreditation standards for residency programs.

The book club titles

Monday’s report also criticized several titles on the book club list, describing “The Remedy,” an anthology of essays by transgender and queer writers about their experiences with health care, as promoting ideas about privilege and oppression. The report quoted passages from the book in which contributors discussed race, privilege and identity.

The report also noted that feminist activist Gloria Steinem praised “The Turnaway Study,” a book based on a long-term research project that followed women who sought abortions, comparing those who received them with those who were turned away. The report argued that the book is frequently cited by abortion rights advocates despite what it described as limitations in the study’s design. Researchers involved in the project have defended its methods, and the study has been widely cited in both academic and policy discussions.

The book club is described on the residency’s page as a partnership with a student interest group. It was not clear from the website whether participation is required for residents.

Context: abortion and residency training in Alabama

Alabama has one of the nation’s strictest abortion laws, which took effect after the U.S. Supreme Court overturned Roe v. Wade in 2022. OB-GYN residency programs in states with abortion bans have faced questions nationally about how they provide the full range of training required by accrediting bodies, sometimes by arranging rotations in other states.

Those broader issues were not the focus of Monday’s report, but they form part of the backdrop for debates over medical education in Alabama.

What happens next

It is not yet known whether the university will review the residency’s training descriptions or book club materials, or whether state officials will take up the questions raised in the report. Public universities in Alabama have adjusted a range of programs, offices and web pages since the DEI law took effect.

South Alabama News will update this story if the university responds to the questions raised about the program.

Key facts

• Program: University of South Alabama obstetrics and gynecology residency, College of Medicine
• At issue: Website language describing faculty and resident training in implicit bias and microaggressions
• Law cited: Alabama’s 2024 law restricting DEI programs and required “divisive concepts” training at public institutions
• Also cited: A quarterly book club with the College of Medicine’s OB/GYN Interest Group
• University response: Not immediately available