Medlock Morgan, Weissman Anna, Wong Shane Shucheng, Carlo Andrew, Zeng Mary, Borba Christina, Curry Michael, Shtasel Derri
Fourth-year Psychiatry Resident, Massachusetts General Hospital.
Fourth-year Child Psychiatry Resident, Massachusetts General Hospital.
MedEdPORTAL. 2017;13. doi: 10.15766/mep_2374-8265.10618.
Mental health disparities based on minority racial status are well characterized, including inequities in access, symptom severity, diagnosis, and treatment. For African Americans, racism may affect mental health through factors such as poverty and segregation, which have operated since slavery. While the need to address racism in medical training has been recognized, there are few examples of formal didactic curricula in the psychiatric literature. Antiracism didactics during psychiatry residency provide a unique opportunity to equip physicians to address bias and racism in mental health care.
With advocacy by residents in the Massachusetts General Hospital/McLean Psychiatry residency program, the Division of Public and Community Psychiatry developed a curriculum addressing racial inequities in mental health, particularly those experienced by African Americans. Four 50-minute interactive didactic lectures were integrated into the required didactic curriculum (one lecture per postgraduate training class) during the 2015-2016 academic year.
Of residents who attended lectures and provided anonymous feedback, 97% agreed that discussing racism in formal didactics was at least "somewhat" positive, and 92% agreed that it should "probably" or "definitely" remain in the curriculum. Qualitative feedback centered on a need for more time to discuss racism as well as a desire to learn more about minority mental health advocacy in general.
Teaching about racism as part of required training conveys the explicit message that this is core curricular material and critical knowledge for all physicians. These lectures can serve as a springboard for dissemination and provide scaffolding for similar curriculum development in medical residency programs.
基于少数族裔种族地位的心理健康差异已得到充分描述，包括在获得医疗服务、症状严重程度、诊断和治疗方面的不平等。对于非裔美国人来说，种族主义可能通过贫困和隔离等因素影响心理健康，这些因素自奴隶制以来就一直存在。虽然人们已经认识到在医学培训中解决种族主义问题的必要性，但在精神病学文献中，很少有正式教学课程的实例。精神病学住院医师培训期间的反种族主义教学为医生提供了一个独特的机会，使他们能够在精神卫生保健中应对偏见和种族主义。
在马萨诸塞州总医院/麦克莱恩精神病学住院医师培训项目住院医师的倡导下，公共与社区精神病学部门开发了一门课程，以解决心理健康方面的种族不平等问题，特别是非裔美国人所经历的问题。在2015-2016学年，四门50分钟的互动式教学讲座被纳入必修教学课程（每个研究生培训班级一场讲座）。
参加讲座并提供匿名反馈的住院医师中，97%的人认为在正式教学中讨论种族主义至少“有点”积极意义，92%的人认为它“可能”或“肯定”应该保留在课程中。定性反馈集中在需要更多时间讨论种族主义以及普遍希望更多地了解少数族裔心理健康倡导方面。
将关于种族主义的教学作为必修培训的一部分传达了一个明确的信息，即这是所有医生的核心课程材料和关键知识。这些讲座可以作为传播的跳板，并为医学住院医师培训项目中类似课程的开发提供框架。
