On Sept. 4, 2020, the Executive Office of the President of the United States issued a memorandum to US government agencies to cease and desist any funding of employee training related to critical race theory or "White privilege" or both, deeming these to be "anti-American" and "divisive." (1) Ironically, this pushed critical race theory into public discourse--it was even a point of discussion in the first US presidential debate, where education based on critical race theory was described as a "radical revolution." (1)
As Black and Brown women in medicine, we have found in critical race theory a language with which we can better understand our experiences. Critical race theory gave me (R.Z.) the tools to found Black Physicians of British Columbia (www.blackphysiciansofbc.ca) and to work toward change in my own institution. It helped me (M.S.) "unlearn" some of the ways in which I was taught about race during medical training, where race was understood as a biological fact rather than as a social construct that maintains long-standing power relations. Medical education certainly did not offer me the conceptual tools to approach racism.
Critical race theory emanated from years of advocacy by Black and Brown lawyers in the US faced with racist law-school hiring practices and curricula. (2,3) Deeply rooted in theory-informed action, critical race theory can be used to understand the structural forces that drive racial inequities in society, and to work toward their dismantling. (2) Studying race and racism, even structurally, is insufficient and must be coupled with tangible action at multiple levels. (4)
Critical race theory is organized around 4 main ideas, referred to by the terms "race consciousness," "contemporary orientation," "centring the margins" and "praxis." (2)
Race consciousness refers to an understanding of racialization, or the creation of "race" as a social process that assigns meaning and value to physical and cultural differences between people. Race consciousness requires us to examine what we take for granted about race and racism, asking ourselves how they have shaped individual and interpersonal interactions, and our institutions and societies. (4) In medicine, it means thinking critically about what makes it possible to perceive race as a biological fact, and why it is so easy to use race as an explanation for health differences between people while overlooking the effects of political and social forces. Racism has been integrated into medicine through the apparent objectivity of numbers (like "race corrections" for physiologic measures), and through the things we overlook...