Ethics in Medicine, Carl von Ossietzky University of Oldenburg, Ammerländer Heerstraße 114-118, 26111, Oldenburg, Germany.
BMC Med Educ. 2023 Jun 2;23(1):399. doi: 10.1186/s12909-023-04386-y.
Racism in medicine represents a global problem. It takes place on the individual, institutional and structural level. Especially structural racism can have serious effects on the health of individual people. Furthermore, racist discrimination is not always based on race solemnly but frequently intersects with other social categories such as gender, class or religion. To describe this multidimensional form of discrimination the term intersectionality has been coined. However, the understanding of structural intersectional racism in medicine is still fragmented, especially in the German context. Yet, medical students need to be trained in understanding structural and intersectional racism to see the impact of racist structures on the patient's health.
We conducted a qualitative study to explore the knowledge, awareness and perception of racism in medicine and health care of medical students in Germany. Our research questions are how do medical student understand structural racism and its effects on health in Germany? Do students see interrelations with other forms of discrimination and in this context to what extent are they familiar with the concept of intersectionality? Which categories intersect from their point of views with race in context of medicine and health care? We conducted focus groups with medical students (n = 32) in Germany.
Our results demonstrate that students have a wide spectrum of knowledge, awareness and perceptions about racism from being rather elaborate to very little knowledge about it. The students have particular problems to understand and situate structural racism in Germany. Some raised doubts about the relevance. Yet, other students are aware of the concept of intersectionality and are convinced that racism must be looked at from an intersectional perspective.
The diverse knowledge, awareness and perceptions of medical students about structural racism and intersectionality hints to a lack of systematic education of medical students about these issues in Germany. Yet, in context of diversifying societies an understanding about racism and its impact on health is imminent for future medical doctors to provide good care for their patients. Therefore, this knowledge gap must be systematically filled by the medical education.
医学领域的种族主义是一个全球性问题。它存在于个人、机构和结构层面。特别是结构性种族主义会对个人的健康产生严重影响。此外，种族主义歧视并不总是基于种族，而是经常与性别、阶级或宗教等其他社会类别交织在一起。为了描述这种多维形式的歧视，术语“交叉性”应运而生。然而，医学领域结构性交叉种族主义的理解仍然支离破碎，尤其是在德国语境下。然而，医学生需要接受培训，以了解结构性和交叉性种族主义，从而认识到种族主义结构对患者健康的影响。
我们开展了一项定性研究，以探讨德国医学生对医学和医疗保健中种族主义的知识、意识和看法。我们的研究问题是：医学生如何理解德国的结构性种族主义及其对健康的影响？学生是否看到与其他形式歧视的相互关系，在这种情况下，他们对交叉性概念的熟悉程度如何？从他们的角度来看，在医学和医疗保健背景下，哪些类别与种族交叉？我们在德国进行了医学生（n=32）的焦点小组讨论。
我们的研究结果表明，学生对种族主义的了解、认识和看法从相当详细到几乎一无所知，范围广泛。学生在理解和定位德国结构性种族主义方面存在一些问题。一些人对相关性表示怀疑。然而，其他学生意识到交叉性概念，并坚信必须从交叉性视角看待种族主义。
医学生对结构性种族主义和交叉性的多样性知识、意识和看法表明，德国医学生在这些问题上缺乏系统的教育。然而，在多元化社会背景下，未来的医生要为患者提供良好的护理，就必须了解种族主义及其对健康的影响。因此，医学教育必须系统地填补这一知识空白。
