Medical Education and Racism: Where Have We Been and Where Might We Go?
The majority of approaches used in medical education to teach about health disparities and racism have been applied at the level of undergraduate medical education and taught through the lens of cultural competence. The dearth of curricula that directly address the experience of racism and its impact on access to health care, diagnosis, and treatment is notable. In this chapter, the limitations of using cultural competence training as a proxy for teaching about racism and the surprisingly few efforts to teach about health inequities and racism at the residency level are reviewed and discussed. With this background, the authors describe a recently developed psychiatry residency–level, racism-focused curriculum and propose broader training efforts that are needed. Finally, a more robust approach to teaching race equity than has been systematically implemented at either the undergraduate or residency level of medical education is proposed.
KeywordsMedical education racism Race equity teaching Racism pedagogy Health disparities Faculty development racism
- 2.Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care; Smedley BD, Stith AY, Nelson AR, editors. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press; 2003. http://www.nationalacademies.org/hmd/Reports/2002/Unequal-Treatment-Confronting-Racial-and-Ethnic-Disparities-in-Health-Care.aspx.
- 6.Department of Health and Human Services, Health Resources and Services Administration. Cultural competence in medical education. 2004.Google Scholar
- 10.Cross TL, Bazron BJ, Dennis KW, Isaacs MR. Towards a culturally competent system of care: a monograph on effective services for minority children who are severely emotionally disturbed. Washington, DC: CASSP Technical Assistance Center, Georgetown University Child Development Center; 1989.Google Scholar
- 18.Brooks KC, Rougas S, George P. When race matters on the wards: talking about racial health disparities and racism in the clinical setting. MedEdPORTAL Publ. 2016:2374–8265. https://doi.org/10.15766/mep_2374-8265.10523.
- 23.United States Census Bureau. QuickFacts, United States. Washington, DC: United States Census Bureau, 2018. https://www.census.gov/quickfacts/table/PST045216/0017.20.
- 24.Office of Community Planning and Development. The 2016 annual homeless assessment report (AHAR) to Congress. Washington, DC: US Department of Housing and Urban Development, 2016. https://www.hudexchange.info/resources/documents/2016-AHAR-Part-1.pdf.
- 26.Alexander M. The new Jim Crow: mass incarceration in the age of colorblindness. New York: The New Press; 2010.Google Scholar
- 27.Medlock M, Weissman A, Wong SS, Carlo A, Zeng M, Borba C, Curry M, Shtasel D. Racism as a unique social determinant of mental health: development of a didactic curriculum for psychiatry residents. MedEdPORTAL Publ. 2017;13:10618. https://doi.org/10.15766/mep_2374-8265.10618PubMedPubMedCentralGoogle Scholar
- 29.Singleton GE. Courageous conversations about race: a field guide for achieving equity in schools. 2nd ed. Thousand Oaks: Corwin; 2015.Google Scholar
- 33.Okwerekwu JA. The patient called me ‘colored girl.’ The senior doctor training me said nothing. Stat. April 11, 2016. https://www.statnews.com/2016/04/11/racism-medical-education/.