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I’m a Black Physician, and I’m Appalled by Mandated Implicit Bias Training – Commentary

By Marilyn Singleton, M.D., J.D.

I’ll never forget my parents’ reaction when I was accepted to the University of California at San Francisco’s medical school. Having attended segregated schools, my mother and father were thrilled their daughter would attend a fully integrated, top-tier institution.

When I graduated with a medical degree in 1973, a Black woman in a class of mostly White men, there was a real sense the days of obsessing over skin color and making race-based assumptions about our fellow human beings was finally fading—and, hopefully, soon gone for good.

Apparently not. That racial obsession has come rushing back—in academia, politics, business, and even in my beloved medical profession. But now it’s coming from the opposite direction. The malignant, false assumption Black people are inherently inferior intellectually has been traded in for the malignant false assumption White people are inherently racist.

Required for License Renewal

That is the basic message conveyed by “implicit bias training,” which a California law requires state-based providers of continuing medical education to include in courses involving direct patient care. It is a message I believe is harmful both to physicians and patients. There is a sad irony in all this because the misguided focus on racism is specifically intended to improve the health and well-being of Black patients.

The law, which took effect last year, has other bias targets, such as gender identity, age, and disability. But, in practice, such training—a mainstay of the diversity and inclusion industry, worth an estimated $3.4 billion in 2020—is overwhelmingly about race.

In California, where I’ve been licensed since 1974, every physician receiving continuing medical education from state-based providers of courses involving direct patient care must participate in this racially regressive practice. The law does not apply to courses unrelated to direct medical care or to out-of-state providers. Continuing medical education, for at least 50 hours every two years is required for renewal of a California medical license.

Many of my friends and colleagues ask why I’m so upset by the law. Clearly, implicit bias training isn’t meant for me. It’s aimed at White people, who are far and away the biggest share of the medical profession.

My answer is simple. I reject the unscientific accusation that people are defined by their race, not by their individual beliefs and choices. It is little consolation that studies find implicit bias training has no effect on its intended targets, and might even make matters worse.

Mandate Targets Collegiality

Think about the message this mandate sends to Black physicians. It suggests I should be wary of my White colleagues because, after all, they’re biased against people like me. Sure, they can undergo frequent training, but their bias is always going to be there, beneath the surface, threatening to rear its ugly, racist head. Collegiality and collaboration—two essential components of high-quality medical care—are targeted by this mandate.

Call that an implicit bias.

Undermines Patients’ Trust

Since I became a physician, I have seen exactly one instance of racism in health care—and it was from a patient, not a fellow physician. As for my colleagues, I have been consistently impressed with the conscientious, individualized care they provide to patients of every race and culture.

When we all took our oath to “first, do no harm,” we meant it, and we live it. I can’t imagine spending my entire career thinking my peers can’t uphold their oath without constant racial re-education.

The message to physicians is bad enough, but the message to patients is much worse. Black people are, in effect, being told White physicians are likely to quite literally damage our health. If that’s the case, why on earth would you seek medical care, unless you could be absolutely certain of not being treated by a White physician? And if you do seek medical care, why wouldn’t you doubt every word from a White doctor who is inherently prejudiced against you?

Marilyn Singleton, M.D., J.D. (marilynsingletonmd1@gmail.com) is a board-certified anesthesiologist and a visiting fellow at the medical advocacy organization Do No Harm. A version of this article appeared in The Washington Post on February 22, 2023. Reprinted with permission.

For a related article, see Five States Mandate ‘Implicit Bias Training’ for Professionals

Marilyn Singleton
Marilyn Singleton
Dr. Singleton is a board-certified anesthesiologist.


  1. Good on Dr. Singleton for speaking out. As a residency-trained, board-certified ER doctor for over 25 years, I left medicine, in part, because of this type of nonsense. I got tired of being told that I am the problem for being a straight, white, male. For kicks I once took the Harvard Implicit Association Test. It concluded that I have a moderate preference for people like me. Oddly, my wife of 30 years is Japanese.

  2. Wow, and more and more people are leaving medical schools when they find out, in reality, the pharma stuff is slow poison. Congrats to you for standing up. Im pretty sure they have lowered doctor salary enough to not bother as well, making it a nominal wage like they do to most things. Smart people can make a lot better living elsewhere and not help poison others under the guise of Rockefeller take over of medical.

    You and others quitting out are the shining stars… Soon, nutrition will return. Most of the companies that make the shelved foods that are ridden with toxins are heavily invested into Pharma, why? Because they make more money there, then off the lousy stuff they label as edible. We need to change the FDA, the bydol act? Much more… Judy Mikovits, Karen Kingston, Truth tellers of the world that are silenced. We the people need to stand up like you have!

  3. A note…. Seems like all the meds they are wanting to give me…. have ED as a side effect… Like, at least 6 of them… Hmmmmmm, yea…. strange or not?

    They want to lower population at all costs….

    I am working on nutrition to get all this nonsense fixed. Years of toxic food though, its gonna take some time to get all that out.

    Check your meds people, if you have and sexual issues, its IN THE MEDS>……

    • Let me note, i am getting back to normal, Ozempic was the worst for libido, absolutely killed libido and I finally figured that out. Thank God for the Internet and people who care.


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