— LETTERS TO THE EDITOR —

Racism Education is Needed at All Levels of Training

Judy C. Washington, MD | José E. Rodríguez

Fam Med. 2018;50(9):711-712.

DOI: 10.22454/FamMed.2018.424750

To the Editor:

The article “Addressing Racism in Medical Education: An Interactive Training Module”1 describes an innovative way to tackle a very old view: racism. The authors should be applauded for their scholarship and use of this method to address this difficult, emotionally charged issue. Participants in the training were like-minded family medicine faculty who participated in the authors’ workshop by choice. Participants were open to discussion and eager to learn new teaching strategies. Even so, the authors facilitated change in participants’ attitudes about their ability to teach about racism. Participants in the training set a goal to combat racism and identified specific actions they could take when they returned to their home institution.

The authors’ work on racism can be transferred to other aspects of health care beyond the preparation of physicians to care for minority patients. Racism education is needed at every level of academic medicine—from premedical student training to the highest levels of leadership in academic medicine. Racism affects everything from acceptance to medical school,2 performance on United States Medical Licensing Examinations, residency match results, to promotion in academic departments.3 It is also a primary driver of underrepresented in medicine faculty from their academic jobs.4 Indeed, no one is spared from the effects of racism, regardless of their individual racial or ethnic background. We, as medical professionals, have allowed racism to continue to have an influence in virtually every aspect of a medical career.

Recognizing this, Dr White-Davis et al have prepared a toolkit to provide faculty with resources to address racism in their institutions at the curricular level. The toolkit began as a Society of Teachers of Family Medicine Annual Spring Conference workshop constructed and implemented by a multiracial, multidisciplinary team from the Minority and Multicultural Health Collaborative. The toolkit is available for use by all, and can be downloaded at: https://tinyurl.com/y7yel8k4.

Combating the negative effects of racism requires more than a commitment to a goal. It requires the deliberate use of innovative and impactful curricula1 to facilitate change. Recent political rhetoric in the United States suggests that racism is almost acceptable (again). In this climate, family medicine must identify racism as it is experienced, and actively choose words and actions that foster inclusivity and collaboration. Racism education should be included in faculty development programs to address inequities in faculty. Faculty should welcome and encourage African American, Latino, and Native American youth in our offices, so that when they are old enough to make career choices, they have been inspired to become physicians, scientists, and medical educators. Family medicine leaders in academic medicine have the opportunity to hold deans, department chairs, hospital administrators and other decision makers to a higher standard.

For decades, family medicine has led other medical specialties in the areas of diversity and inclusion.5 Both in academia and in clinical practice, family medicine is by far the most diverse group. Addressing racism head-on and providing tools for our colleagues in other disciplines will take this leadership role to the next level. Family medicine has always been inclusive, and now we must use our voices to point out and eliminate racism in all its forms.

References

  1. White-Davis T, Edgoose J, Brown Speights JS, et al. Addressing racism in medical education: an interactive training module. Fam Med. 2018;50(5):364-368. https://doi.org/10.22454/FamMed.2018.875510
  2. Rodriguez JE, Campbell KM, Adelson WJ. Poor representation of Blacks, Latinos, and Native Americans in medicine. Fam Med. 2015;47(4):259-263.
  3. Rodríguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: what of the minority tax? BMC Med Educ. 2015;15(1):6. https://doi.org/10.1186/s12909-015-0290-9
  4. Cropsey KL, Masho SW, Shiang R, Sikka V, Kornstein SG, Hampton CL; Committee on the Status of Women and Minorities, Virginia Commonwealth University School of Medicine, Medical College of Virginia Campus. Why do faculty leave? Reasons for attrition of women and minority faculty from a medical school: four-year results. J Womens Health (Larchmt). 2008;17(7):1111-1118. https://doi.org/10.1089/jwh.2007.0582
  5. Xierali IM, Nivet MA, Gaglioti AH, Liaw WR, Bazemore AW. Increasing family medicine faculty diversity still lags population trends. J Am Board Fam Med. 2017;30(1):100-103. https://doi.org/10.3122/jabfm.2017.01.160211

Lead Author

Judy C. Washington, MD

Affiliations: Overlook Family Medicine Residency, Summit, NJ

Co-Authors

José E. Rodríguez - Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT

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