Bridging The Gap: Demanding 1-1 Representation of Dark-Light Skin Tones Within Medical Lectures/Resources

Abstract

Being a good physician means having the ability to recognize diseases in all kinds of individuals. This is especially true for skin lesions (e.g., acne, cancer), which present differently based on skin color and tone. Developing skin-tone-dependent diagnosing skills depends on the medical education (e.g., lectures, medical textbooks, and online board certification prep resources) and hands-on clinical experiences doctors receive. We find it alarming that medical students' gold standard resources overrepresent light skin and underrepresent dark skin to the point where many medical students can recognize a lesion on white skin but fail to recognize a similar lesion on dark skin. This lack of representation perpetuates race as a social determinant of health, leading to missed diagnoses and diagnosis at a later/worse stage in people of color. To combat this underrepresentation within medical education, we propose the Liaison Committee on Medical Education (LCME) amend Accreditation Standard 7: Curricular Content, Subsection 7.6: Cultural Competence and Health Care Disparities. The amendment is to include 1 of the 2 following policy changes, with preference for the top-down mandate: 1) Top-down Mandate: An objective measure and subsequent goal (1:1 representation) for the representation of skin of color within a school's medical lectures, which is evaluated by an LCME-approved curriculum committee and mandated for schools wishing to continue to be LCME accredited. 2) Bottom-up Individualized Institutional Goals: A requirement for schools to choose their own goal, create their committee, and evaluate their progress. These progress reports will be submitted to the LCME annually.