Abstract
A professional and moral medical education should equip trainees with the knowledge and skills necessary to effectively advance health equity. In this Perspective, we argue that critical theoretical frameworks should be taught to physicians so they can interrogate structural sources of racial inequities and achieve this goal. We begin by elucidating the shortcomings in the pedagogic approaches contemporary Biomedical and Social Determinants of Health (SDOH) curricula use in their discussion of health disparities. In particular, current medical pedagogy lacks self-reflexivity; encodes social identities like race and gender as essential risk factors; neglects to examine root causes of health inequity; and fails to teach learners how to challenge injustice. In contrast, we argue that Critical Race Theory (CRT) is a theoretical framework uniquely adept at addressing these concerns. It offers needed interdisciplinary perspectives that teach learners how to abolish biological racism; leverage historical contexts of oppression to inform interventions; center the scholarship of the marginalized; and understand the institutional mechanisms and ubiquity of racism. In sum, CRT does what biomedical and SDOH curricula cannot: rigorously teach physician trainees how to combat health inequity. In this essay, we demonstrate how the theoretical paradigms operationalized in discussions of health injustice affect the ability of learners to confront health inequity. We expound on CRT tenets, discuss their application to medical pedagogy, and provide an in-depth case study to ground our major argument that theory matters. We introduce MedCRT: a CRT-based framework for medical education, and advocate for its implementation into physician training.
Highlights
As the healthcare system struggles to combat racial health injustices, it is important to interrogate how medical education may contribute by failing to address inequity on a pedagogical and rhetorical level [1, 2]
To ensure healthcare professionals are able to provide highquality patient care and advance health justice, medical education needs a robust approach to health inequity that can scrutinize racial injustices pertaining to clinical practice, physician training, and scientific knowledge production [3, 10,11,12]
By training learners to identify and oppose fundamental sources of patient marginalization and engage in self-critique of health services research, Critical Race Theory (CRT) does what biomedical and health disparities curricula cannot: rigorously prepare physician trainees to combat health inequity. In this Perspective, we review current pitfalls of Biomedical and Social Determinants of Health (SDOH) educational models, introduce medical CRT (MedCRT): A CRT-based framework for medical education, and advocate for its implementation in physician training
Summary
Many have expressed concern that current health disparities curricula—often referred to as “Social Determinants of Health” (SDOH) curricula—fail to engage with health inequity [6] These models merely name the existence of health differences and describe social determinants (such as access to food, educational attainment, income level) without relating them to power structures that marginalize different populations [6]. By training learners to identify and oppose fundamental sources of patient marginalization and engage in self-critique of health services research, CRT does what biomedical and health disparities curricula cannot: rigorously prepare physician trainees to combat health inequity In this Perspective, we review current pitfalls of Biomedical and SDOH educational models, introduce MedCRT: A CRT-based framework for medical education, and advocate for its implementation in physician training
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