Anti-Black racism and medical education: a curricular framework for acknowledging and learning from past mistakes.

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Date: Oct. 24, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 41)
Publisher: CMA Impact Inc.
Document Type: Viewpoint essay
Length: 1,988 words
Lexile Measure: 1540L

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Although increased physician diversity has been shown to improve patient care and reduce health care disparities, (1,2) the current demographics of the profession do not reflect the population of Canada as a whole, including the proportion of Black Canadians. (3,4) The racial homogeneity of the medical profession did not occur by chance; rather, it is the product of discriminatory policies that have systematically prevented Black and other racialized students from pursuing medical training. Historians have shown that discriminatory admission policies were common in North American medical schools well into the middle of the twentieth century, and these continue to have a measurable impact on the number of Black medical school graduates in the present day. (5,6)

Argueza and colleagues (7) argued that medical training institutions that want to address the crisis of representation must first turn their attention inwards and "thoroughly investigate how systemic racism is built into their walls." After a reckoning with its own history of anti-Black admissions policies, the School of Medicine at Queen's University chose to make this history a permanent fixture of its undergraduate curriculum. We discuss the development of this antiracist curriculum that uses local history as a lens for examining how institutional racism has shaped the history of the medical profession.

Anti-Black admissions policies at Queen's School of Medicine

In 1918, Queen's University instituted a ban on Black medical students, pressuring its 15 Black students to leave the program and barring future admissions (Figure 1). At that time, the university pointed the finger at residents of Kingston, who allegedly refused to be treated by Black students, which led to insufficient clinical training opportunities for them. However, recent research by Edward Thomas, a PhD candidate at Queen's, uncovered a different motivation for the ban. Archival documents suggest that Queen's University expelled its Black students in hopes of currying favour with the American Medical Association, an organization that publicly supported segregated medical education. Although the ban has not been officially enforced at Queen's since 1965, the university senate's motion to ban Black medical students remained on the books until 2018, when it was formally repealed. (8)

The curriculum

After the ban was officially repealed, the Commission on Black Medical Students was tasked with properly acknowledging the historic injustices perpetuated by the School of Medicine. One of the commission's goals was to develop curricular content about the ban, both as a form of ongoing remembrance and as an introduction to the topic of anti-Black racism in medicine. The new session, "Who gets to be a doctor?," was designed to complement the existing history of medicine program at Queen's. Historians have made many arguments about the importance of history for medical education, including that history "offers essential perspective about the causes of persistent inequalities and possible solutions." (9) Since students are most engaged when the relevance of history to contemporary social problems is made explicit, the curriculum links the history of the ban directly to the profession's lack of diversity in the present. Students...

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Gale Document Number: GALE|A723284562