A.K. Blanchard is retired professor, Department of Obstetrics & Gynecology, and former associate dean for graduate medical education and designated institutional official, University of Chicago Medicine, Chicago, Illinois; ORCID: https://orcid.org/0000-0001-8904-8518 .
J.C. Blanchard is professor, Department of Emergency Medicine, George Washington University, Washington, DC; ORCID: https://orcid.org/0000-0001-7230-2583 .
Acad Med. 2022 Jul 1;97(7):967-972. doi: 10.1097/ACM.0000000000004664. Epub 2022 Jun 23.
The COVID-19 pandemic highlighted the great achievements that the biomedical community can accomplish, but raised the question: Can the same medical community that developed a complex vaccine in less than a year during a pandemic help to defeat social injustice and ameliorate the epidemic of health inequity? In this article, the authors, a group of Black academics, call on the graduate medical education (GME) community to reset its trajectory toward solutions for achieving diversity, improving inclusion, and combating racism using education as the new vector. Sponsoring institutions, which include universities, academic medical centers, teaching hospitals, and teaching health centers, are the center of the creation and dissemination of scholarship. They are often the main sources of care for many historically marginalized communities. The GME learning environment must provide the next generation of medical professionals with an understanding of how racism continues to have a destructive influence on health care professionals and their patients. Residents have the practical experience of longitudinal patient care, and a significant portion of an individual's professional identity is formed during GME; therefore, this is a key time to address explicit stereotyping and to identify implicit bias at the individual level. The authors propose 3 main reset strategies for GME-incorporating inclusive pedagogy and structural competency into education, building a diverse and inclusive learning environment, and activating community engagement-as well as tactics that sponsoring institutions can adapt to address racism at the individual learner, medical education program, and institutional levels. Sustained, comprehensive, and systematic implementation of multiple tactics could make a significant impact. It is an academic and moral imperative for the medical community to contribute to the design and implementation of solutions that directly address racism, shifting how resident physicians are educated and modeling just and inclusive behaviors for the next generation of medical leaders.
COVID-19 大流行凸显了生物医药界所能取得的巨大成就,但也提出了一个问题:在大流行期间,医学界能否在不到一年的时间内研制出一种复杂的疫苗,同时帮助消除社会不公正现象,改善健康不平等的流行状况?在本文中,一群黑人学者呼吁研究生医学教育(GME)界重新调整其轨迹,通过教育作为新的载体,为实现多样性、改善包容性和打击种族主义寻找解决方案。赞助机构包括大学、学术医疗中心、教学医院和教学保健中心,它们是学术研究的创造和传播中心。它们通常是许多历史上处于边缘地位的社区的主要医疗服务来源。GME 学习环境必须让下一代医疗专业人员了解种族主义如何继续对医疗保健专业人员及其患者产生破坏性影响。住院医师有长期的患者护理经验,个人的职业身份很大一部分是在 GME 期间形成的;因此,这是解决明确的刻板印象和识别个人层面的隐性偏见的关键时期。作者提出了 3 项 GME 的重置策略,即将包容性教学法和结构能力纳入教育、建立多元化和包容性的学习环境,以及激活社区参与,以及赞助机构可以采用的策略,以解决个人学习者、医学教育项目和机构层面的种族主义问题。持续、全面和系统地实施多种策略可能会产生重大影响。医学界有责任为直接解决种族主义问题的解决方案的设计和实施做出贡献,转变住院医师的教育方式,为下一代医学领袖树立公正和包容的行为榜样。