E. Nieblas-Bedolla is a second-year student, University of Washington School of Medicine, Seattle, Washington; ORCID: http://orcid.org/0000-0001-5879-1800.
B. Christophers is a second-year MD-PhD student, Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York; ORCID: http://orcid.org/0000-0001-5248-069X.
Acad Med. 2020 Dec;95(12):1802-1806. doi: 10.1097/ACM.0000000000003496.
The medical community has been complicit in legitimizing claims of racial difference throughout the history of the United States. Unfortunately, a rigorous examination of the role medicine plays in perpetuating inequity across racial lines is often missing in medical school curricula due to time constraints and other challenges inherent to medical education. The imprecise use of race-a social construct-as a proxy for pathology in medical education is a vestige of institutionalized racism. Recent examples are presented that illustrate how attributing outcomes to race may contribute to bias and unequal care. This paper proposes the following recommendations for guiding efforts to mitigate the adverse effects associated with the use of race in medical education: emphasize the need for incoming students to be familiar with how race can influence health outcomes; provide opportunities to hold open conversations about race in medicine among medical school faculty, students, and staff; craft and implement protocols that address and correct the inappropriate use of race in medical school classes and course materials; and encourage a large cultural shift within the field of medicine. Adoption of an interdisciplinary approach that taps into many fields, including ethics, history, sociology, evolutionary genetics, and public health is a necessary step for cultivating more thoughtful physicians who will be better prepared to care for patients of all racial and ethnic backgrounds.
医学界在美国历史上一直默许将种族差异合理化的说法。不幸的是，由于时间限制和医学教育固有的其他挑战，医学课程中通常缺乏对医学在跨种族不平等中所起作用的严格审查。在医学教育中，不精确地将种族（一种社会建构）用作病理学的替代物是制度化种族主义的遗留问题。本文提出了以下建议，以指导努力减轻在医学教育中使用种族相关的负面影响：强调入学新生需要熟悉种族如何影响健康结果；为医学院教师、学生和工作人员提供在医学领域进行关于种族的公开对话的机会；制定并实施解决和纠正医学学校课程和课程材料中不当使用种族的方案；鼓励医学领域内的文化大转变。采用跨学科方法，利用包括伦理学、历史学、社会学、进化遗传学和公共卫生学等多个领域，是培养更有思想的医生的必要步骤，这些医生将更好地准备为所有种族和族裔背景的患者提供护理。
