Can US Medical Schools Teach About Structural Racism?

Abstract

Policy Points There need to be sweeping changes to medical school curricula that addresses structural racism in medicine and how to attend to this in medical practice. The Liaison Committee on Medical Education should develop and promulgate specific learning objectives and curricular offerings that require medical schools to teach about structural racism and antiracist medical practice in ways that are robust and standardized. The federal government, through the Health Resources and Services Administration, should prioritize support for antiracism education in medical schools, residency, and continuing medical education in similar ways and with similar effort in scale and scope to its support for primary care, providing technical assistance and grants for programs across the educational spectrum that provide antiracist training. State governments should mandate, as part of continuing education requirements for physicians, 2 or more hours per recertification cycle of antiracist training.

Context: Since the beginning of COVID-19 and the rise of social justice movements sparked by the murders of George Floyd and Breonna Taylor in the summer of 2020, many medical schools have made public statements committing themselves to become antiracist institutions. The notions that US society generally, and medicine, are rife with structural racism no longer seems as controversial in the academic community. Challenges remain, however, in how this basic understanding gets translated into medical education practice. Understanding where the profession must go should start with understanding where we currently are.

Methods: Prior to the events of 2020, in the spring of 2018, we conducted nine key informant interviews to learn about the challenges and best practices from schools deemed to be positive deviants in teaching about structural racism.

Findings: Our interviews showed that even those schools deemed positive deviants in the amount of teaching done about structural racism faced significant barriers in providing a robust education.

Conclusions: Significant structural change, perhaps far beyond what most schools consider themselves willing and able to engage in, will be necessary if future US physicians are to fully understand and address structural racism as it affects their profession, their practice, and their patients.