Medical Education and the Challenge of Race

Medical curricula in the United States have never addressed the racial dimension of American medicine in an adequate, let alone systematic, way. Medical schools have instead marginalized race and ethnicity as unnecessary for medical education. This chapter argues that medical students should understand the breadth and depth of the health crises in American minority communities. Many medical schools have implemented so-called cultural competency courses that are supposed to improve the interracial and cross-cultural medical relationships future doctors will have with their patients. The consensus is that this type of instruction has proven to be inadequate to its task. In fact, much “cultural competency” instruction actually excludes the examination of black–white relationships and other cross-cultural encounters and the racial scenarios that arise in medical settings. Medical students should be informed about the ways in which cross-racial relationships (doctor–patient and doctor–doctor) can go wrong and have dysfunctional effects on medical treatment. In addition, these often superficial, episodic, and underfunded activities tend to focus on patient behaviors while leaving unexamined the racial belief systems of medical students and doctors. The chapter offers two strategies for pedagogy to address these issues: interpersonal relations within the medical culture and the racial dimension of diagnoses and treatments within the medical subdisciplines that medical students study. Medical students should be aware of these habits of thought and how they can affect the diagnosis and treatment of minority patients. The chapter ends by describing the author’s initial course offering on the topic.