The awakened dominance of American higher education can seem tragically comical when confined to the English department. But when you delve into the hard sciences, more is at stake. Read on and wonder how awake politics is about to infect medical education.
The Association of American Medical Colleges (AAMC) is a non-profit organization based in Washington, D.C., that represents and advises medical schools. It also has influence with the Liaison Committee for Medical Education, the national accrediting body that sets middle school standards. So when the AAMC asks schools to review its teaching method, America’s future doctors will have an obligation to listen.
The AAMC recently released a report describing the new “Diversity, Equity, and Inclusion competencies” that medical students and residents are expected to master. Medical practitioners who work in teaching hospitals may also soon be required to undergo this type of political re-education.
As a starting point, aspiring clinicians will have to master such awakening concepts as “intersectionality,” which the AAMC defines as “the overlapping systems of oppression and discrimination that societies face on the basis of race, gender, ethnicity, ability, etc.” Med students who managed to avoid learning critical race theory in college will now take an immersive course.
They are also expected to demonstrate “knowledge of the intersection of a patient’s multiple identities” – not to be confused with personality disorders – and “how each identity can lead to various and diverse forms of oppression or privilege related to clinical decisions and practices.” This seems as though every medical diagnosis It must be done with an accompanying political and social analysis.
Aspiring clinicians will have to learn that race is “a social construct that is a cause of inequality in health and health care, not a risk factor for disease.” However, racial or ethnic groups sometimes have a greater tendency to have certain health problems. For example, black women are more likely to have a type of breast cancer known as triple negative, and women of Ashkenazi Jewish heritage are more likely to have a BRCA gene mutation.
Relationships between race and disease are not always well understood, but knowing they exist can improve outcomes for minority patients. The doctor does not help patients with urgent needs by assuming that their condition is really related to the “systems of power, privilege, and oppression” in society.
Med students are also expected to demonstrate how their “identities, power, and privileges (eg, occupational hierarchy, culture, class, gender) influence interactions with patients” as well as “the impact of various systems of oppression on health and health care (eg colonialism, white supremacy) acculturation, assimilation).
Most young people who pursue a career in medicine want to help patients. Now they will be taught that “a complex web of social, behavioural, economic, and environmental factors, including access to quality education and housing, has a greater impact on patients’ health than physicians,” AAMC leaders wrote in an editorial for StatNews outperforming their new curriculum. The implicit message is that the best way to help patients is to expand the size and reach of government.
It is clear that social and economic conditions can influence individual health behaviour. But the hyper-awareness and racial awareness that the AAMC wants to instill in physicians may lead to worse care for minorities. ‘Systems of oppression’ can easily become a criterion for medical estimation analysis.
AAMC leaders write at StatNews more “We believe this topic deserves as much attention from learners and educators at every stage of their careers as the latest scientific breakthroughs.” This sounds dangerous. Will learning about mRNA technology or the latest skin cancer treatment hold back new cultural personalization theories?
America faces a looming and severe shortage of doctors as the baby-boom generation retires. It wouldn’t help entice would-be doctors to tell top students that they must take care of their guilt as racial and political persecutors before they can be diagnosed with cancer.
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appeared July 27, 2022, print edition.