Cumming School of Medicine (Kalifa, Brown); Faculty of Science (Okuori, Abatan); Faculty of Nursing (Kamdem), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Yahya), McMaster University, Hamilton, Ont.
CMAJ. 2022 Oct 24;194(41):E1395-E1403. doi: 10.1503/cmaj.211746.
Protests against police brutality and anti-Black racism were catalyzed by the murder of George Floyd and other Black and racialized people in spring 2020. Addressing anti-Black racism had been historically minimized as an institutional priority across Canadian medical schools, but many swiftly released statements broadly condemning racism. Given that little has been documented about how institutions are responding with action, we sought to explore Black medical students' and senior faculty perspectives on Canadian medical schools' efforts to address anti-Black racism in 2020.
We conducted a qualitative, instrumental case study, grounded in critical race theory. We recruited Black medical students and deans (or delegated senior faculty administrators) and we conducted virtual, individual, semi-structured interviews with participants between Oct. 5, 2020, and Jan. 16, 2021. Interviews were transcribed and iteratively analyzed through inductive and deductive techniques.
We interviewed 19 participants, including 8 medical students (6 in pre-clerkship; all of whom identified as Black) and 11 senior faculty administrators (4 deans, 7 delegate faculty administrators; 3 racialized). We had at least 1 student or faculty participant from 13 medical schools, and no student or faculty participants from the 4 medical schools in Quebec. Nearly all represented medical schools were described as "starting from scratch" in their responses, having previously failed to acknowledge or address anti-Black racism. In the absence of diverse faculty leaders, participants indicated that medical schools primarily relied on Black medical students to drive institutional responses, unfairly burdening students during an already difficult period. At the time of the interviews, a range of initiatives were in the planning stages or underway, and were largely related to admissions and curriculum reform.
We found that medical schools relied heavily on Black medical students to inform and drive their institutional responses related to anti-Black racism in 2020, which these students found burdensome. Medical schools lacked intrinsic capacity because of the paucity of Black faculty - a direct result of historical and ongoing structural anti-Black racism in medicine. Institutional accountability remains critical, and further research is needed to show the extent to which medical schools in Canada are successfully addressing anti-Black racism.
2020 年春季，乔治·弗洛伊德（George Floyd）和其他非裔及少数族裔人士被谋杀，抗议警察暴力和反非裔种族主义的浪潮由此掀起。尽管加拿大各所医学院一直以来都将反非裔种族主义作为一个重要的机构优先事项，但历史上对其重视程度较低，但许多医学院很快发表了广泛谴责种族主义的声明。鉴于几乎没有记录机构采取了哪些行动来应对，我们试图探讨黑人医学生和资深教职员工对 2020 年加拿大医学院应对反非裔种族主义的看法。
我们进行了一项定性的、工具性的案例研究，以批判种族理论为基础。我们招募了黑人医学生和院长（或指定的资深教职员工管理人员），并于 2020 年 10 月 5 日至 2021 年 1 月 16 日期间对参与者进行了虚拟、单独的半结构化访谈。访谈记录被转录，并通过归纳和演绎技术进行迭代分析。
我们采访了 19 名参与者，包括 8 名医学生（6 名在预科阶段，均为黑人）和 11 名资深教职员工管理人员（4 名院长，7 名代理教职员工管理人员；3 名少数族裔）。我们至少有一名学生或教职员工来自 13 所医学院，而魁北克的 4 所医学院没有学生或教职员工。几乎所有接受采访的医学院都表示，在回应反非裔种族主义方面，他们“从零开始”，此前未能承认或解决这一问题。在缺乏多样化的教职员工领导的情况下，参与者表示，医学院主要依靠黑人医学生推动机构回应，这给学生带来了不必要的负担，而此时学生们正处于一个艰难的时期。在采访时，各种倡议正在规划阶段或正在进行中，主要与招生和课程改革有关。
我们发现，医学院在 2020 年严重依赖黑人医学生来告知和推动他们与反非裔种族主义有关的机构回应，而这些学生发现这是一种负担。由于缺乏黑人教职员工，医学院缺乏内在能力——这是医学领域历史上和持续存在的结构性反非裔种族主义的直接结果。机构问责制仍然至关重要，需要进一步研究以表明加拿大医学院在多大程度上成功地解决了反非裔种族主义问题。
