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The issue of race and ethnicity within obstetrics and gynecology has come to the forefront in the current social and political climate. Understanding the ill effects of racism within the clinical space requires an acknowledgment of both the ongoing problem and current limitations in the state of knowledge and praxis among clinicians, trainees, and educators alike. In this commentary, the issue of race and racism within obstetrics and gynecology is discussed through a case of discrimination experienced by an intern working in an urban, academic hospital. By attending to the different layers of hierarchy within medical education and care as well as the multitude of silences from potential allies, we demonstrate a critical need to understand racism and inequality in the clinical and educational space. We deconstruct the issue of race and racism by contextualizing it with ongoing discussions in the social sciences and public health as well as wider discussions of the relationship of race with professional training and employment in biomedical fields. Finally, we offer both action items and calls for future educational and practice-based solutions to affect change in the way obstetrics and gynecology is taught and practiced.