Background Reducing ethnic inequalities in health care is a worldwide priority. General practice is no exception to this, as studies pointed to ethnic discrimination in diagnosis, referral and treatment of racial minorities patients by General Practitioners (GPs). However, it is unclear whether these discriminations are due to implicit bias or by the lack of explicit cultural competences, two explanations demanding different intervention. Implicit biases are a human trait which can influence stereotypes and care behaviour whereas cultural competence is ‘the ability to work and communicate effectively and appropriately with people from culturally different backgrounds’.

Methods This mixed-method study investigates the existence of implicit biases and the level of cultural competences among GPs trainees. Data collection among GPs trainees (2021) was used and analysed in SAS Enterprise Guide. The 170 respondents took an Implicit Association Test, a validated tool measuring attitudes and beliefs that people are not conscious of. They also completed the Hudelson scale assessing the relative responsibility to adapt to migrants. These quantitative results were then discussed as a group with the respondents.

Results The results suggested that more than 80% (95% CI: 0.71–0.85) of GPs in training have implicit preferences for their ingroup to the detriment of the exogroup of migrants. Also, 60% (95% IC: 0.52–0.67) of respondents placed the responsibility to adapt on migrant patients when their values and habits differ from those of the host country.Qualitative data indicate trainees were not aware of these biases.

Conclusion This study shows that GPs trainees have implicit and explicit bias detrimental to ethnic minority groups, of which they are not aware of.