To support the demands of this petition, please add your signature through THIS FORM.

(please don’t write your name directly on this; when you fill out the form, your name will appear in the list at the bottom)

 

Reforming Antiracist Education at Yale School of Medicine

Dear Director of Admissions Ayaska Fernando, Dean Nancy Brown, and Dean Richard Belitsky, 

The Yale School of Medicine must make a working knowledge of structural racism in the United States a competency required for matriculation. The current unrest across the country in response to unconscionable murders of Black people at the hands of those called to serve and project lays bare the failure of American institutions to value Black lives. Medicine is no exception and the countless ways the actions of those in the healthcare field have caused Black communities to disproportionately suffer and die from disease is unacceptable.  

The widespread impacts of racism on healthcare have been known and studied for decades. From ignoring Black communities during the past and present HIV/AIDS epidemic, to the disproportionate burden of the COVID-19 pandemic on the Black community, race defines the quality and quantity of healthcare in the United States. The disparities in healthcare aren’t only apparent in national and global crises: racial inequalities are apparent in chronic situations as well. From the Black maternal mortality crisis, racialization of addiction, and disparities in pain management of Black children, to implicit bias in clinical decision making, and lack of access to health care, race is undoubtedly a significant determinant of health. Racism has real and direct impacts on individuals, and must be addressed in healthcare. 

The Yale School of Medicine plays a crucial role in educating doctors and researchers who go on to lead across this nation and beyond. YSM therefore has the responsibility to do all within its power to actively work against the effects of anti-Black racism and white supremacy in the field of medicine. We join in solidarity with the YSM students calling on Yale to use its ample academic, political and financial resources to combat systems of oppression.

There is a growing body of work indicating that shortcomings in medical education play a significant role in perpetuating racial disparities in health as harmful racist ideas and actions among American medical school students and faculty are prevalent. Yale researchers have highlighted patterns of racial bias in evaluations that negatively impact underrepresented minority medical school students. Medical students have false beliefs about biological differences between Black and white bodies and those with negative racial attitudes have decreased intention to practice in minority and high-need communities which impairs their ability to treat minority patients. 

We believe that educating students on the history of medical racism is paramount in preventing future health practitioners from following in the bloodied footsteps of their predecessors. Students must be made aware of how the medical field in its current state was built at the expense of communities of colour who were made to suffer in both purposeful and inexcusably negligent ways. This education should not begin only in medical school, but rather YSM must make it a priority for successful applicants to demonstrate they have already begun critical engagement with this history and the present reality of medical racism and health inequity. Current Yale faculty recently published research supporting the reform of medical school admissions as a key mechanism by which we can fight racial prejudice in medicine. Participants in a day-long structural competency training all agreed that while the lessons were beneficial earlier, continuous training was necessary for the development of the skills needed to recognize and properly address the effects of structural inequality. 

YSM should ensure that students can build on this learning during their four years of medical school. Negative racial attitudes are often learned and maintained not only through the absence of anti-racist and structurally competent curricula but also through informal lessons given as medical students observe how physicians and professors interact with patients and medical staff. Therefore, it is essential for medical school curricula to become actively anti-racist and, as theorized in a framework by a YSM graduate, to ensure students are structurally competent. Coursework in anti-racism and structural competency must be placed at the forefront of medical education as opposed to simply supplementing the traditional curriculum. It is not sufficient for YSM to only make such relevant courses available, since this education is crucial for all medical students and doctors and can mean life-or-death for many patients, it must be mandatory. As peer medical schools have recognized, there is an immediate need to address medical education’s shortcomings and train future doctors to be active participants in deconstructing systems of discrimination and inequality. 

 

We, the undersigned, are calling on YSM to take action now:

Position #1: We believe YSM must require applicants to demonstrate competency on the structural factors that produce health disparities. This should be demonstrated through application essays, interview questions, MMI scenarios or another significant mode of assessment.

  • This requirement can be met by taking a course that deals significantly with medical racism, health equity, history of medicine, medical sociology, etc.
  • This requirement can also be met through lived experience and extracurricular involvement, or by engaging with freely available resources on this topic. In order to make this education equitably accessible, Yale should support students in fulfilling this competency by prominently featuring such resources on the admissions website. These resources should include those compiled by Yale’s Medical Historians on Race and Racism and by Yale student groups.

Position #2: In solidarity with YSM Demands, we believe YSM must meaningfully incorporate anti-oppressive and anti-racist education into existing course frameworks in order to appropriately address the historical and present racial inequalities that exist in medicine. Yale has demonstrated its ability to do this in the reform of the “Introduction to the Profession Course” and should build on this success by reforming all other courses. 

  • This position can be satisfied by making the anti-racism thread currently under development a requirement for all Yale medical students. 
  • This position can also be satisfied by meaningfully integrating an anti-racism and anti-oppression lens into the curriculum of every available course at YSM. A task force or consortium of medical students, graduate students from multiple Yale Schools and faculty trained in anti-racism ought to be given the opportunity to consult and hold accountable lecturers as they faithfully integrate this lens. 

In solidarity,

STEM & Health Equity Advocates (SHEA) at Yale

 

 

 

Racism In Healthcare 

(in order of appearance as well as additional resources)

 

 

Addressing Racism in Medical School 

(in order of appearance as well as additional resources)

 

To see signatories go to this link: https://docs.google.com/document/d/1uBnCdSR6WmhYUF6c8pueKyY3vFMjMePx9vZNa3o16EQ/edit