Racism in Medical Education: What it is, why it matters, and what we can do

Our thanks to the Antiracism in Medical Education Working Group for developing this resource.

Racism refers to systemic biases, discrimination, and prejudices based on race or ethnicity. It has no inherent physical or biological meaning, since race is an identity assigned based on rules made by society.

In medical education and across health care, racism affects educational processes, curriculum, policies, and social/clinical/teaching interactions. Racism can affect quality of care for patients and perpetuate disparities among groups of people. It affects health outcomes and patient/caregiver/community experiences. The impact of racism is compounded when it intersects with other identities, such as gender or disability.

Being antiracist in medical education means actively challenging and dismantling racial prejudice, discrimination, and systemic inequities. To do this, we need to acknowledge the historical roots of racism and how it currently affects medical education, health care and society.

What we mean when we talk about racism in medical education

Here are some examples of racism in medical education:

1. Lack of representation of minoritized or systemically oppressed groups among faculty, staff, and learners. This can perpetuate racial biases and inequities, create barriers to access, and prevent opportunities to participate. It is most apparent when looking at the leadership around us.
2. Curriculum bias: Medical curricula that do not adequately cover issues related to race, ethnicity, and ensure cultural safety can perpetuate stereotypes and biases. As a result, learners may not adequately understand the health care needs of diverse populations. Biases can also negatively impact learning, work, and care environments.
3. Stereotyping of some racial and ethnic groups influences how clinicians perceive medical conditions and symptoms. This can lead to misdiagnosis or inappropriate medical decisions.
4. Micro-aggressions, which are comments or behaviors (even subtle or unintentional) that communicate derogatory messages between individuals. Micro-aggressions can create a hostile learning and work environment for learners, faculty, and staff with marginalized identities and affect patient care.
5. Inequitable opportunities: When minoritized learners, staff and faculty have different opportunities for learning, research, leadership, or specialty choices because of their race or ethnicity, their growth and success may be limited.
6. Disparities in patient care: Biases learned during medical education can translate into inequitable treatment of patients based on ethnicity/race and other marginalized identities, affecting health outcomes and patient experience.
7. Implicit bias—which most people are unaware of—is held by educators, learners, staff, and institutions. Implicit bias can influence decision making, judgments and interactions and affect work, learning and other opportunities, assessments, feedback, and recommendations for letters of reference.
8. Socioeconomic factors: Minoritized populations often face the social and economic challenges that impact their health directly or indirectly.

How can we eliminate racism in medical education?

1. Build awareness by addressing the manifestations of racism and other forms of oppression in medical education.
2. Promote cultural safety through understanding and respect for diverse identities and cultures.
3. Create equity in access by ensuring opportunities and resources for all learners, staff and faculty based on their needs.
4. Advocate for policies that combat racism within educational institutions and health care settings.
5. Ensure medical curricula reflect diverse experiences and perspectives.
6. Apply a social justice lens to all that we do in medical education and health care.

For further tips, use this resource when you are developing educational materials, programs, or events for the CPS. It could also be useful for educational contexts outside the CPS.