Betial Asmerom, a fourth grader at the University of San Diego (UCSD) medical school in Oakland-California, California, showed no interest in becoming a doctor.
As a teenager, she helped her parents, immigrants from Eritrea who speak little English, navigate the healthcare system in Oakland, California.
She saw a doctor who was rude to her family and not interested in her mother’s treatment for cirrhosis, high blood pressure, and diabetes.
All those experiences made me not like a doctor. “Asmerom said,” in our community they always said: ‘Go to the doctor only when you die.’
However, it changed when he took a college course on the health gap. He realized that other ethnic communities of color were suffering the same as Eritrea family and friends. Asmerom, as a doctor, thought he could change the situation.
Teachers and student activists across the country have long called on medical schools to increase the number of students and practitioners in marginalized communities, improve care, and promote inclusion.
But to understand the roots of racism and its impact on the healthcare system, they say, fundamental changes must be made to the curriculum.
Asmerom is one of many voices calling for a strong anti-racist education. It requires schools to eliminate the use of race as a diagnostic tool, recognize how systematic racism harms patients, and talk about racism in medical history.
This behaviorism is nothing new. The White Coats for Black Lives (WC4BL), a student-led organization that fights medical racism, emerged after the 2014 Black Lives Matter protests.
But after George Floyd’s murder in Minneapolis in May, medical schools and medical institutions are under pressure to take concrete steps.
Don’t use race as a diagnostic tool.
Over the years, medical students have been taught that genetic differences between races affect their health. However, studies in recent years have found that the variety does not reflect it reliably.
The National Institute of Human Genomes observes few genetic variations between races and more differences between people within the same race. For this reason, more doctors accept that race is not an inherent biological difference, but a social makeup.
But Dr. Brook Cunningham, a doctor and sociologist at the University of Minnesota School of Medicine, says it is difficult to give up. This is part of how doctors diagnose and measure disease, he explains.
Some doctors say it helps to consider race when treating patients. Others argue that it leads to prejudice and poor care.
This view has led to various misconceptions that blacks have thicker skin, blood clots are faster or less painful than whites.
When race plays a role in medical calculations, it can lead to less effective treatment and perpetuate racial inequality.
In the light of this study, medical students are asking schools to rethink their curriculum that treats race as a risk factor for disease.
Briana Christophers, a sophomore at Weill Cornell Medical School in New York, said it makes no sense for race to make people prone to disease, even if economic and social factors come into play.
Naomi Nkinsi, a senior at UW Medicine in Seattle, recalled at a medical conference that he had been told that blacks were more susceptible to disease.
“It felt very personal,” said Nkinsi. “That’s my body, my parents, they’re my brothers and sisters. Now every time I go to the office they’ll feel that they don’t see me as a whole person, but I’m physically different from all other patients just because I have .More melanin in the skin.”
Recognizing the adverse health effects of racism
The Medical Education Liaison Committee (LCME), the official accreditation body for medical schools in the United States and Canada, says that students “must learn to be aware of prejudices in the process of themselves and others.” Providing medical services”.
However, LCME does not explicitly require accredited institutions to teach about systematic racism in medicine.
This is what students and some teachers want to change.
Dr. David Acosta, Director of Diversity and Inclusion at the American Association of Medical Schools (AAMC), reported that about 80% of colleges offer mandatory or elective courses on the health gap. However, he explained that there is little data on how many schools teach students to recognize and fight racism.
Anti-racist curriculum should look for ways to mitigate or eliminate the damage of racial discrimination, said Rachel Hardeman, professor of health policy at the University of Minnesota.
“You have to think about how this penetrates the learning of medical education,” he said. Hardeman added that a process of exploring systematic racism is needed.
Edwin Lindo, a professor at the University of Washington School of Medicine, said the interdisciplinary model should be adopted so that sociologists and historians can lect on how racism harms health.
Acosta said AAMC has formed a committee of experts to develop an anti-racist curriculum for each medical education level. They look forward to releasing their work this month and talking to LCME about the development and implementation of the standard.
Recognizing racism in medical education
Activists want their institutions to admit to racism that has accompanied their mistakes and past medical outcomes.
University of California-San Francisco medical student Derek Paul says he wants all faculty to include lectures on people like Henrietta Lax, a black woman who dies of cancer when cells are removed without consent. They have been used to develop important cell lines in medical research.
Asmerom pointed out that the faculty wants to recognize the past of racist medicine in their classes. He cited an introductory anatomy course at his school where scientists in the past failed to point out that blacks and other groups were abused when trying to study the human body.
“Okay, but why don’t you tell me you took the blackbody out of the grave for use in the dissection lab?” I ask
Asmerom is pleased to see the faculty listen to the needs of the students, but I think the manager should admit to the mistakes of the recent past.
Asmerom said, “Someone has to admit how anti-black racism persisted in this institution.”
Asmerom, one of the leaders of the UCSD anti-racism coalition, said the administration has so far responded favorably to the coalition’s call to invest time and money in anti-racism initiatives. And she carefully feels hope.
“I dare not hold my breath until I see real change,” he concluded.
Kaiser Health News (KHN) is a non-profit news service covering health-related topics. It is an editorial independent program of the Kaiser Family Foundation (KFF) that is not affiliated with Kaiser Permanente.