More than 100 years since the historic Flexner report highlighting the systemic challenges of American medical schools, we continue to face challenges in the process and climate of medical education. A recent revelation of an American medical college yearbook containing a horrific and derogatory photo associated with a historical demeaning portrayal of Black people and a domestic terrorist organization has left many of us pondering, how this could happen? Similar occurrences have since been reported around the nation. The emergence of these images is reflective of the racist systematic imagery that is pervasive in much of American culture, including higher and graduate education.
These occurrences strike a chord of anger and outrage from students, faculty and staff, and allies alike, and provide an opportunity for systematic dismantling of institutional racism in medical colleges and beyond. The harsh reality is that these images are not novel. In fact a deeper review will demonstrate the presence of these images in photos across institutions. Though, there is no such standard space or avenue for processing these events and their full impact. The emotional, psychological, and visceral reaction that images such as these photos as well as other depictions of oppression and racism evoke must have a place for dialogue that translates to action. As an organization, Community-Campus Partnerships for Health (CCPH) has a track record of creating these areas designed for dialogue, through an evidence based scholarly framework, rooted in lived experiences of communities and stakeholders. CCPH has worked in partnership with multiple medical colleges to facilitate efforts that target increasing diversity and addressing health equity. Specifically, these recent revelations are unsettling and propel CCPH into action.
These moments should not be dismissed as something of the past, as the past often shapes the present and the future. These moments highlight and confirm the need to understand implicit beliefs, and institutional and systemic norms. These incidences create the necessity for systematic dismantling of institutional racism in medical colleges and beyond. Institutions charged with educating medical professionals must understand how these events manifest and what cultural attitudes contribute to the occurrences. In her book, Medical Apartheid, Harriett Washington illuminates with painstaking detail the history of medical education and the atrocities associated with the abuses inflicted upon people of color and other marginalized people. Against this backdrop we must question the internalized biases that medical students hold against the diverse patient populations they serve, and how these beliefs manifest in their delivery of care.
Central to this conversation is the reality of the pervasive health disparities that have created a marked difference in health outcomes between communities of color and whites in the US. Over time we have attributed this difference to a myriad of factors including access, costs and individual preferences. Lead by public health practitioners we now know that racism – including implicit bias and structural inequalities – contribute to poor health outcomes.
Filling the gap for resources needed to unpack these occurrences, and catalyzing the road to change, CCPH is an agent for transformation. The experience in partnering with and providing training for medical schools positions our 5 pillars as effective strategies in this seminal moment:
- Leading the discussion of what is needed in community-academic partnerships to address issues of implicit bias and structural inequality.
- Convening and facilitating conversations between community and academic leaders with the intent to define actionable steps.
- Partnering with key stakeholder groups
- Training in implicit bias and structural inequality
- Disseminating the work to local leaders and creating a depositary of best practices in unpacking the impact of racism and working towards collective healing.
We cannot move forward until we are willing to address the past and how it continues to loom over everything that we do. Each instance of hatred only serves to re-traumatize those who continue to seek healing from the past.
Dr. Karriem S. Watson, DHSc, MS, MPH
Chair CCPH Board of Directors
Alan N. Richmond MSW