Fall 2023 (Volume 33, Number 3)
Creating Equitable Medical Education
By Mala Joneja, MEd, MD
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For many years now, there has been a call for more
equitable and inclusive medical education as well
as appeals to address racism and discrimination in
both medical education and patient care. Medical educators
have urged medical schools to produce physicians
who not only represent the communities they serve, but
who are also trained to address racism and health inequity.
Despite these calls and appeals, we witness persisting
inequities in health care and persisting harm to learners
due to racism and discrimination in the learning environment.
To create equitable medical education, a profound
and authentic change is needed, and the efforts to create
this change must come from all of us.
Profound change can start with institutions and
groups examining themselves closely. It is now clear that
medical education and the health care system are not
neutral. There is a long history of racism and discrimination
embedded in these important institutions. To generate
change, under these conditions, it is essential that
organizations take an anti-racist stance toward medical
education and clinical care. Leaders in medical education
need to listen closely to students, faculty and the communities
they serve to understand what truly has been
the lived experience of those who are Indigenous, Black,
or people of colour. Whatever is found in this self-examination
needs to be acknowledged and dealt with so the
institution or group can move forward or improve.
With the task of self-examination, there must follow intentional
efforts to create a learning and practice environment
that is anti-racist. As rheumatologists, we can work
within our sphere of influence to work against racism and
discrimination. We should not underestimate our own abilities
to influence change as we are physicians, educators,
researchers and leaders within our clinical and academic
communities across the country. All rheumatologists can
participate in the efforts to create change by first acknowledging
the reality of racism and discrimination and then
taking action. Physicians can address bias and discrimination
when they witness them, engage in equitable hiring
initiatives, and help colleagues from underrepresented
groups achieve success. Educators can create targeted mentorship
initiatives for students and trainees. Researchers
can ensure their scientific endeavours are inclusive in nature
and designed to promote health equity. Finally, leaders
can model authentic actions for change by speaking
out against racism and discriminatory practices and holding
individuals accountable for exclusionary behavior.
The Canadian Rheumatology Association has an
Equity Diversity and Inclusion Task Force chaired by
Dr. Nicole Johnson, and this group has created a workshop
on how to incorporate equity, diversity and inclusion into
medical education. The workshop was presented during
the 2023 Annual Scientific Meeting and will be housed
on the CRA website as an educational resource for CRA
members. This task force can offer guidance and direction
for the CRA; however, making an organization truly
inclusive and equitable is up to all members and requires
action from everyone.
Acknowledgement: Special thanks to Dr. Nicole Johnson for
her insights
Mala Joneja, MEd, MD
Professor,
Division Chair,
Division of Rheumatology
EDI Lead for the Department of Medicine,
Queen’s University
Kingston, Ontario
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