Anti-racism in postgraduate medical curricula: A review of curricula.

Abstract

Objectives: To assess how UK postgraduate medical organisations have responded to calls for action on structural racism, and to examine the extent to which anti-racism is embedded in postgraduate medical curricula and learning outcomes.

Design: We conducted a review of publicly available statements and commitments from organisations responsible for postgraduate medical education, and a content analysis of all General Medical Council (GMC)-approved postgraduate curricula. Search terms related to racism, ethnicity, religion and discrimination were used, with double-coding of extracted data and inductive thematic analysis of relevant learning outcomes.

Settings: United Kingdom.

Participants: Twenty-one organisations responsible for postgraduate medical training and all 102 GMC-approved postgraduate medical curricula.

Main outcome measures: Presence of explicit anti-racism commitments, inclusion of education-related actions and accountability mechanisms, and representation of racism and its impacts on health within assessed curricular competencies.

Results: Sixteen organisations (76%) had public commitments addressing racism or related issues, with ten (48%) including education-related measures and five (24%) specifying accountability mechanisms. Across 102 curricula, only 11 (11%) mentioned racism, and just 10 included it in learning outcomes, largely confined to three specialities. Mentions of race, ethnicity and religion were more common but often lacked reference to structural drivers of health inequalities. No curricula addressed xenophobia, Islamophobia, antisemitism or decolonisation.

Conclusions: Despite widespread institutional commitments, anti-racism is minimally represented in UK postgraduate medical curricula. There is an urgent need to integrate explicit anti-racism competencies into training to equip doctors with the knowledge and skills required to address structural determinants of health and reduce inequalities.