In 2020 Dr Gozie Offiah, Director of Curriculum at RCSI, organised a student symposium with medical students from the USA, UK and Ireland, at the International Conference on Communication in Healthcare. Here, Dr Offiah outlines what she learned from the meeting.
The meeting was held in the aftermath of the murder of George Floyd amid really heightened tensions and a focus on the Black Lives Matter movement. It aimed to address how issues related to race equality should be addressed in future healthcare education curricula.
The students – from different ethnic backgrounds, medical schools and training levels – presented their specific experiences of racism during medical training to an international audience of communication teachers and researchers. The group then took part in a discussion on how teaching could effectively tackle racism within medical education.
Institutional bias and racism
Institutional racism, which is the collective failure of an organisation to provide appropriate and professional service to people because of their colour, culture or ethnic origin, had been witnessed in some form by each of the students. It manifested as a gap in achievement between white and Black, Asian or other Minority Ethnic (BAME) medical students.
The students also reported a lack of minoritised ethnic groups representation in assessment situations, for example role plays involving patients and a lack of BAME representation in those teaching about diversity.
Experiencing racism during medical training
Participants shared either first-hand experiences of racism, classmates’ experiences of racism or witnessed racism towards others during medical training.
This correlates with previous research from the US in 2020, which found that underrepresented minorities or multiracial students reported experiencing mistreatment at a higher rate than their white classmates.
Both overt and covert racism was discussed with covert racism being more subtle and more difficult to identify and address. Covert racism was referred to by students as seemingly innocuous comments that can negatively affect recipients.
Recommendations for curricula change
The meeting recommended that issues relating to race and racism could be incorporated early and continually throughout medical education to ensure deeper learning is achieved.
They recommended the inclusion of patients from minoritized ethnic backgrounds as standard across teaching methods and tools such as simulations and the teaching of specific communication skills to challenge racism in a range of settings.
They also called for a greater focus on the development of communications skills amongst students to enable them to effectively interact with patients of different ethnic backgrounds.
The participants recommended that changes to the curricula should be undertaken in a collaborative way involving students and faculty and a tokenistic approach should be avoided.
The outcomes from the meeting can guide educators in the development of best practice to tackle racism early and continuously in medical training. Here at RCSI, it will inform how we progress with our efforts to ensure that we are equipping our students for practice in diverse communities and complex healthcare settings across the world.
In 2021 RCSI became the first higher education institution in Ireland to publish a Race Equality Action Plan. As one of the country’s most internationally diverse universities, the plan reinforces our commitment to ensuring that the experience of our students, trainees and staff is defined by respect, equality and inclusion.
Dr Gozie Offiah is a Senior Lecturer and Director of Curriculum at RCSI and the National Clinical Lead for Intern Training for the Medical Intern Unit, HSE.
RCSI is committed to achieving a better and more sustainable future through the UN Sustainable Development Goals.
