Student-Led Efforts to Advance Anti-Racist Medical Education

Abstract

Over the past decade, medical schools across the United States have increasingly dedicated resources to advancing racial and social justice, such as by supporting diversity and inclusion efforts and by incorporating social medicine into the traditional medical curricula. While these changes are promising, the academic medicine community must apply an anti-racist lens to every aspect of medical education to equip trainees to recognize and address structural inequities. Notably, organizing and scholarly work led by medical students has been critical in advancing anti-racist curricula. In this article, the authors illustrate how student activism has reshaped medical education by highlighting examples of student-led efforts to advance anti-racist curricula at Harvard Medical School (HMS) and at the University of California, San Francisco (UCSF) School of Medicine. HMS students collaborated with faculty to address aspects of existing clinical practice that perpetuate racism, such as the racial correction factor in determining kidney function. They also responded to the existing curricula by noting missed opportunities to discuss structural racism, and they planned supplemental sessions to address these gaps. At UCSF, students identified specific avenues to improve the rigor of social medicine courses and developed new curricula to equip students with skills to confront and work to dismantle racism. The authors describe how HMS students, in an effort to improve the learning environment, developed a workshop to assist students in navigating microaggressions and discrimination in the clinical setting. At UCSF, students partnered with faculty and administration to advocate pass/fail grading for clerkships after university data revealed racial disparities in students' clerkship assessments. In reviewing these examples of students' advocacy to improve their own curricula and learning environments, the authors aim to provide support for students and faculty pursuing anti-racist curricular changes at their own institutions.

Deconstructing Racism, Hierarchy, and Power in Medical Education: Guiding Principles on Inclusive Curriculum Design

“…Lastly, there must be a conscious effort to enact change without adding an additional form of oppression through the “diversity tax” on vulnerable student and faculty groups. 38 We recommend that leadership provide protected time and compensation for faculty and students who choose to engage in this transformative work. By prioritizing and embracing this work, each academic medical institution has the opportunity to transform the practice of medicine and impact millions of patient outcomes through a commitment to equity and inclusion.…”

Future developments in training

“…Additionally, discrimination based on ethnicity and race poses a significant problem to CM and ID as well. BIPoC (Black, Indigenous, Persons of Colour) trainees are faced with structural racism and racist attitudes in various learning environments, which comprise their learning outcomes [ 50 ]. Structural racism is ‘not simply the result of private prejudices held by individuals, but is also produced and reproduced by laws, rules and practices, sanctioned and even implemented by various levels of government, and embedded in the economic system as well as in cultural and societal norms’ [ 51 ].…”

Addressing race and diversity in graduate education: Practices from student activism.

“…Previous work has demonstrated the value of student-led initiatives and activism in raising awareness, combating inequities, and effecting reform in higher education (Afolabi et al, 2021; Jacoby, 2017; Lantz et al, 2016). Students at all levels of postsecondary education have organized discussions about the importance of antiracist practices and the prevalence of racial discrimination on campus and have served as “political actors” by advocating for institutional change through collective action (e.g., through protests and demanding administrative and pedagogical reforms; Morgan et al, 2021).…”