Community Perspectives in Medicine: Elective for First-Year Medical Students

Abstract

Introduction Recently, stories depicting social injustices and inequities have gripped the US, leading to protests and other demonstrations of student activism. In response to current events, students at Weill Cornell Medical College identified the need for more diversity inclusion components in the newly developed medical school curriculum. Thus, we developed a student-initiated, student-run elective, Community Perspectives in Medicine, which provides a forum for first-year medical students to interact, and have open discussions, with members of communities most impacted by social and health inequities. Methods During five weekly 2-hour sessions, representatives of different community-based organizations (CBOs) speak with 15 first-year medical students. Invited CBOs represent diverse populations, including LGBT, chronic illness, disabilities, religion, and immigrant health. For each session's first hour, a second-year student facilitates a semistructured interview of the CBO guests focusing on health disparities within their community, challenges experienced with the medical system, and what they wish doctors did differently. Students are encouraged to ask questions, often resulting in a rich dialogue. The session's second part is a debriefing by the student facilitator over a relaxed dinner (without CBO guests). Results Fourteen of the16 enrolled students attended all five sessions and completed the course evaluation. Satisfaction with the course was high, as 93% of students enrolled rated the course as excellent. The course format, content, and diversity of speakers were rated as excellent by 79%, 86%, and 93%, respectively. Similarly, 71% of students believed there to be excellent applicability to medical practice, and 100% of students thought the timing during first year was excellent. Discussion We emphasize the importance of a partnership between CBOs and medical students, thus increasing students’ cultural awareness as well as formally involving traditionally disenfranchised communities in medical education. Our project's unique format of safe-space discussion forums and session debriefings enhances critical thinking. Though used with multiple CBOs as an elective, our model can be easily adapted for one session on a specific health disparity.

Critical Consciousness as a Framework for Health Equity–Focused Peer Learning

“…Critical consciousness is a topic with limited discussion to date in MedEdPORTAL, with existing publications focusing on the application of critical consciousness to onetime educational activities related to faculty development on multicultural education, 5 community empowerment, 6 and responding to racism, discrimination, and microaggressions. 7 The educational content described here overlaps with that of other publications in MedEdPORTAL, including discussions of identity, 8-10 privilege, 8 microaggressions, 7,11,12 racism, 13,14 health disparities, 15,16 the social determinants of health, 15,17,18 and implicit bias. 19,20 However, CCM is unique in that it adopts critical consciousness as the unifying concept and approach for a series of studentled workshops spanning these topics for all first-year medical students at our institution.…”

How Diverse Is Your Universe? An Activity for Students to Reflect on Ethnoracial Diversity During Orientation

“…11 Although there are many well-designed published interventions targeting unconscious bias, most of them are too extensive to easily integrate into a curriculum. These interventions differ in duration, setting, and content 12,13 but typically rely on curricular interventions such as discussion cases 14 or lectures. 15 Curricular change of even this small scale may not be feasible for all institutions.…”