Abstract
White Coats for Black Lives (WC4BL) is a national medical student movement that aims to affirm the role of medical professionals in combating racism and racial disparities in medicine. The WC4BL chapter at the University of California, San Francisco (UCSF), has focused its efforts on community engagement, local and national political activism, and medical education reform. As part of the inaugural class studying under the Bridges Curriculum at the UCSF School of Medicine, five UCSF WC4BL members provide perspectives on their first year of medical education, the integration of structural competency into the curriculum, and how their involvement with WC4BL has impacted and enriched their experiences. In addition, two faculty members from the UCSF Department of Anthropology, History, and Social Medicine who were involved in the introduction of structural competency and other content addressing racialized health and healthcare disparities describe the process of developing and implementing this new curriculum. Collectively, reflections of trainees and faculty offer a multi-perspectival understanding of the experiences and lessons learned from the introduction of structural competency curricula into medical education.
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Notes
- 1.
Eric Garner (1970–2014) was a husband and father of six children who was choked to death by officers of the New York Police Department. His last words, “I can’t breathe,” became a rallying cry for the Black Lives Matter Movement (http://www.blackpast.org/aah/garner-eric-1970-2014).
- 2.
Michael Brown (1996–2014) was a college-bound student shot by an officer of the Ferguson, Missouri Police Department. His body was left out on the street for 4 h. His death became the catalyst for the protests in Ferguson against police brutality.
- 3.
Alex Nieto (1986–2014) was a full-time scholarship student at Community College of San Francisco earning a criminal justice degree and applying to transfer to a 4-year college program. He was a practicing Buddhist pacifist, a youth mentor, and an active community member. He was shot by four officers of the San Francisco Police Department and inspired the “Frisco 5” Hunger Strike (https://justice4alexnieto.org/).
- 4.
Members of WC4BL have drafted more of the organization’s history in the following article: [1].
- 5.
“Police Violence IS a Public Health Issue” became the rallying cry after UCSF healthcare workers organized to provide medical care to the “Frisco 5” hunger strikes protesting police brutality in San Francisco (http://synapse.ucsf.edu/articles/2016/05/31/urging-police-do-no-harm).
- 6.
Structural competency aims to develop a language and set of interventions to reduce health inequalities at the level of neighborhoods, institutions, and policies. See more at: [2].
- 7.
- 8.
The UC Berkeley-UCSF Joint Medical Program (JMP) is a 5-year graduate/medical degree program. Students who are matriculating into the program and attend the same White Coat Ceremony that UCSF medical students attend at the beginning of their first year.
- 9.
The UCSF Bridges Curriculum – which launched in August 2016 – is a three-phase, fully integrated curriculum delivered over 4 years (http://meded.ucsf.edu/bridges).
- 10.
Medical education as is more than simple transmission of knowledge and skills; it is also a socialization process. Wittingly or unwittingly, norms and values transmitted to future physicians often undermine the formal messages of the declared curriculum [4].
- 11.
In Guatemala (1946–1948), the US government infected people with syphilis resulting in at least 83 deaths. In 2010 the United States formally apologized for these experiments. Read More: [5].
- 12.
In Tuskegee, Alabama (1932–1972), the US government followed the progression of syphilis in 399 black men with 40 wives contracting the disease and 19 children born with congenital syphilis despite the opportunity for treatment. Read More: [6].
- 13.
- 14.
Twelve FS Principles: anatomy, behavioral sciences, siostatistics and epidemology, microbiology, pathology, pharmacology, physiology, aging, immunology, molecular and cell biology, nutrition, and genetics
- 15.
In 1968, UCSF facilities were segregated, and people of color had to go to the basement to eat or use the bathroom. The “basement people,” as they were called, organized a meeting in Cole Hall that led to the birth of the Black Caucus and a transformation of the UCSF campus (https://www.ucsf.edu/news/2013/05/105576/beloved-ucsf-professor-dan-lowenstein-delivers-inspirational-last-lecture).
- 16.
Read More: [10].
- 17.
Read More: [11].
- 18.
The inquiry curriculum is a longitudinal component of Bridges that engages students in research appraisal and the generation of new knowledge (http://meded.ucsf.edu/bridges/inquiry-curriculum).
References
Charles D, et al. White coats for black lives: medical students responding to racism and police brutality. J Urban Health. 2015;92(6):1007–10.
Metzl JM, Hansen H. Structural competency: theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014;103:126–33.
Neff J, Knight KR, Satterwhite S, Nelson N, Matthews J, Holmes SM. Teaching structure: a qualitative evaluation of a structural competency training for resident physicians. J Gen Intern Med. 2016;32(4):430–3.
Mahood SC. Medical education. Can Fam Physician. 2011;57(9):983–5.
Rodriguez MA, García R. First, do no harm: the US sexually transmitted disease experiments in Guatemala. Am J Public Health. 2013;103(12):2122–6.
Gamble VN. Under the shadow of Tuskegee: African Americans and health care. Am J Public Health. 1997;87(11):1773–8.
Hadley J. Sicker and poorer – the consequences of being uninsured: a review of the research on the relationship between health insurance, medical care use, health, work, and income. Med Care Res Rev. 2003;60(2_suppl):3S–75S.
Pletcher MJ, et al. Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. JAMA. 2008;299(1):70–8.
Pérez-Stable EJ, Napoles-Springer A, Miramontes JM. The effects of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Med Care. 1997;35(12):1212–9.
Washington HA. Medical apartheid: the dark history of medical experimentation on Black Americans from colonial times to the present. New York: Doubleday Books; 2006.
Becker ER, Sloan FA, Steinwald B. Union activity in hospitals: past, present, and future. Health Care Financ Rev. 1982;3(4):1.
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Donald, C. et al. (2019). Reflections on the Intersection of Student Activism and Structural Competency Training in a New Medical School Curriculum. In: Hansen, H., Metzl, J. (eds) Structural Competency in Mental Health and Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-10525-9_4
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