The awakened dominance of American higher education can seem tragically comical when confined to the English department. But when it infiltrates the hard sciences, much more is at stake. Read and shudder at how politics is about to contaminate medical education.
The Association of American Medical Colleges (AAMC) is a nonprofit organization based in Washington, DC, that represents and advises medical schools. It also influences the Liaison Committee on Medical Education, the national accrediting agency that sets standards for medical schools. So if the AAMC tells schools to rethink their teaching methods, America’s future doctors will be obligated to listen.
The AAMC recently released a report detailing the new “diversity, equity and inclusion competencies” that medical students and residents are expected to master. Practicing physicians working in teaching hospitals may soon also have to undergo this form of, well, political re-education.
As a starting point, aspiring physicians will need to become fluent in waking concepts such as “intersectionality,” which the AAMC defines as “overlapping systems of oppression and discrimination facing communities based on race, gender, ethnicity, ability, etc.” Medical students who managed to avoid learning critical race theory in college are now getting an immersive course.
They are also expected to “demonstrate knowledge of the intersectionality of a patient’s multiple identities” – not to be confused with personality disorders – and “how each identity can result in varied and multiple forms of oppression or privilege regarding clinical decisions.” and practice.” This sounds like any medical diagnosis will have to be made with an accompanying political and sociological analysis.
Aspiring physicians will have to learn that race is a “social construct that is a cause of health and healthcare inequality, not a risk factor for disease.” Still, racial or ethnic groups sometimes have a greater propensity for certain health problems. For example, black women are at higher risk for a type of breast cancer known as triple-negative, and women of Ashkenazi Jewish descent are at greater risk for the BRCA gene mutation.
Race-disease relationships are not always well understood, but knowing they exist can improve outcomes for minority patients. It does not help patients in immediate need of a doctor to assume that their condition is really related to the “systems of power, privilege and oppression” in society.
Med students will also need to articulate how their own “identities, power, and privileges (e.g., professional hierarchy, culture, class, gender) influence interaction with patients,” as well as “the impact of different systems of oppression on health and health care ( e.g. colonization, white supremacy, acculturation, assimilation).”
Most young people pursuing a career in medicine want to help patients. Now they will learn that “an intricate web of social, behavioral, economic and environmental factors, including access to quality education and housing, has a greater impact on patients’ health than physicians,” AAMC leaders write in a StatNews op-ed. herald their new wake curriculum. The implicit message is that the best way to help patients is to expand the size and reach of government.
Social and economic conditions can clearly influence individual health behaviour. But the hyper-class and racial awareness that the AAMC wants to instill in doctors could lead to poorer care for minorities. “Systems of suppression” as a standard of analysis can easily become medical fatalism.
AAMC leaders further write in StatNews that “we believe this topic deserves as much attention from students and educators at every stage of their careers as the latest scientific breakthroughs.” That sounds dangerous. Will learning about mRNA technology or the latest treatment for melanoma take a back seat to new theories of cultural appropriation?
America faces a looming and serious medical shortage as baby boomers retire. It won’t help attract future doctors to tell top college students to address their guilt as racial and political oppressors before they can diagnose your cancer.
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Appeared in the print edition July 27, 2022.