What Changes Can Medical Schools Make to Create a More Informative and Inclusive Learning Environment?

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First, is this even an issue?

The answer is obvious. A medical education without an emphasis on social and racial justice can have detrimental effects on the future healthcare of minorities. There are many specific steps that medical schools across the world can take to ensure a more equitable future for all people.

I interviewed Dr. Alfred Sipols, a Clinical Professor at the University of Washington Medical School in Seattle. I got his take on inclusivity in the curriculum he teaches to future doctors. The UW Medical School prides itself on its racial and social diversity, and medical institutions globally should definitely model some of its tactics. “We now have courses that emphasize social equity, racial equity, economic equity, understanding the kinds of hurdles that our patients have undergone in the past, and trying to treat everybody equally and with as much sensitivity as possible,” explains Dr. Sipols. He adds, “this is certainly in the racial justice field and also in the gender justice field.” 

Although a few institutions are leading in diversity and inclusion, most are not up to par. Nisha Dogra’s “Twelve tips for teaching diversity and embedding it in the medical curriculum” shows what some institutions have already implemented. Sabine Ludwig’s 2020 study titled “Diversity in Medical Education” emphasizes that many institutions are using various methods to go about promoting equity. “According to the General Equal Treatment Act (AGG), diversity comprises six categories: age, gender, ethnicity, physical impairment, sexual orientation, and religion” (Ludwig). All of these categories must be represented and included in the medical education environment. 

What follows is a list of proposals that medical schools worldwide should implement to create a more productive and inclusive learning environment.

Suggestion #1 – Encourage minorities to pursue health professions

It seems natural for medical school faculty to create a curriculum that they believe fits their audience. By increasing racial and ethnic diversity in the classroom, professors will be encouraged to recognize and educate on the experiences of minorities in healthcare. The addition of minority doctors in healthcare will also encourage minority populations to seek treatment because their care will be provided by someone who looks more familiar and approachable. A study conducted as far back as 1990 found that “Black physicians cared for significantly more Black patients and Hispanic physicians for significantly more Hispanic patients than did other physicians” (Komaromy). This makes it all the more important to diversify the future doctors that will spearhead our healthcare system. Since 1990, other studies have emerged demonstrating the positive effects that race-concordance in patient-physician interactions can have on healthcare (Saha).

Percentage of US Medical School Graduates by Race, 2019 (“Figure 13”)

Suggestion #2 – Include rotations in underserved populations

Working at free clinics for houseless folks, working in clinics that serve minority populations, joining the Peace Corps, and working in a more impoverished country. In doing these things, future doctors would be exposed to the full consequences of lack of resources and how they affect health outcomes. These health outcomes are predominantly apparent in disadvantaged groups of people that, as a result, are underserved in terms of healthcare. Medical schools should push their students even further to participate in these opportunities. In doing so, they will create a doctor sensitive to the different population groups that their patients come from. Dr. Sipols says, “Not every one of your patients will be a middle-aged white male.”

Suggestion #3 – Focus on teaching to treat patients holistically

According to Dr. Sipols, “UW, at least, is very concerned with making sure that we treat a patient as much as we can holistically. Understanding their background and being sensitive to their concerns, their ethnic background, their financial background, and trying to be as inclusive as possible.” By pushing students to see their patient as a whole person, not just a body with specific symptoms, they will have increased empathy and relate to their patients better.

Suggestion #4 – Educate students on the past faults of medical science

Dr. Sipols explains that at UW, “we’re very good at understanding the shortcomings of medical science in the past. For example, where we haven’t included people like pregnant individuals or minorities, there may be differences in terms of how people respond based on those conditions.” Because of these shortcomings, “it is all the more important to teach about the limitations of medical science. Oftentimes studies were done on males 35 to 55 years of age, excluding females, excluding pregnant individuals, excluding young people, and so on.” A 2016 study revealed that “these deficiencies, have hindered the progress of understanding women’s response to medication” (Liu). Educating students on these shortcomings will teach them to recognize that a particular drug may affect different groups differently. This will push them away from just prescribing medications blindly because they affect a specific group the correct way.

Works Cited and Consulted

Feedback

Thank you for taking the time to read through my proposals. Had you heard about this issue prior to reading this page? What do you think it will take to spark structural change? Will we ever be able to attain a fully inclusive curriculum? I would deeply appreciate it if you could leave your comments/thoughts below. Thanks again!

2 Comments

2 comments

  1. Sophia_64

    Hi Darta, amazing project! I love how you were able to interview a medical school professor about their social justice curriculum and gain a professional’s viewpoint on the importance of social justice in medical education. As someone who has a parent who does a lot of global health work and public health work with low-income and unhoused populations, I definitely agree that these experiences give a more holistic view of equitable and unbiased healthcare and are important in medical training. I do hope that one day we can achieve a fully inclusive curriculum in all medical schools, but wonder if this would require a larger national response as opposed to individual medical schools working on this initiative.

  2. Avatar

    Hi Darta. So wonderful to see that you are still a part of GOA. I enjoyed learning about your project and considering the important questions you are asking. I am not sure that I thought about the role of medical school education in this topic, but I did know that women of color are 3 to 4x more likely to die of a pregnancy-related complication here in the US. As a white woman, dying of childbirth was not something that I worried about, so I have been deeply troubled that this is not the same for women of color. I am hopeful that med schools can improve curriculum and representation as a way to amplify and support the voices of communities of color.

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