DIVERSITY AND INCLUSION
(Un)Learning What Matters: Dismantling and Restructuring Antiracism Curricula Into an Integrated Framework SAEM PULSE | JANUARY-FEBRUARY 2021
By Michelle Suh, MD; Daniela Ortiz, MD, MPH; and Anisha Turner, MD on behalf of the SAEM Academy for Diversity and Inclusion in Emergency Medicine
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Recent events regarding systemic racism have led to the promotion of “antiracism” curricula and statements within resident programs. While residencies develop and refine their diversity, equity, and inclusion (DEI) pedagogy, it is important that careful consideration of these efforts don’t reinforce the marginalization of racial minorities. Clear examples of marginalization include unequal representation of racial groups in lecture slides and the inclusion of racial stereotypes with diagnoses in case vignettes. Instead of focusing solely on introducing competency-based learning information, we must continuously (un)learn and assess existing curricula
for inaccuracies in concepts of race and diversity. DEI should be promoted and integrated into each aspect of patient-based or case-based learning in order to assure an inclusive and biasfree curriculum. Here we identify and challenge common pitfalls of medical curricula, propose practices for DEI integration, and review existing tools for curriculum evaluation.
Pitfalls and Practices Avoid discussion of race as a pathology. Since the 19th century, medical education has pathologized and insinuated a scientific foundation for
ideas of hierarchy based on race. Today, many conditions such as sickle cell disease, sarcoidosis and cystic fibrosis, are linked to biological differences among racial groups without consideration of environmental factors, social inequalities, genetics, and ancestry. Medical education also perpetuates institutionalized racism by encouraging trainees to identify race as risk factors for several medical conditions such as hypertension, kidney disease, stroke, and glaucoma, when the relationship between disease and race is confounded by multiple factors. Students are commonly rewarded by adopting race as a heuristic throughout standardized exams that inculcates