New England Journal of Medicine Perspective: How Medical Education Is Missing the Bull’s-Eye

LaShyra Nolen, B,S. (JUNE 25, 2020)

Moving through the world as a black woman, I am accustomed to not being represented as “the norm.” Everything from the hue of the Band-Aids that cover my wounds to the heroes in the movies I watch makes me acutely aware of my deviation from what is typical and expected: I am black and female, whereas the world represented around me is often white and male. For me and for many members of minority groups in the United States, this realization does not come as an epiphany but is instead an essential fact that we must come to understand to navigate the world in which we live. It was not until I started medical school, however, that I realized the ways in which the standard representation of white and male might affect medical education – and consequently the quality of care that my peers and I will provide to our future patients.

As a first year medical student, I have considered steps we can take to address these inequities during the early stages of medical education. First, it’s essential that medical schools obtain female-bodied mannequins so that students can comfortably learn about the nuances of performing CPR on patients with breasts. Schools could also develop a complementary curriculum addressing common misconceptions about female bodies, appropriate touching, and follow-up conversations about consent. Second, medical educators should strive to include images of more than one skin type in their learning material. Reference photos of patients with nonwhite skin have already begun to be collected on online platforms such as Brown Skin Matters and VisualDx; such collections could be used as a starting point for developing new material. Finally, these reforms cannot be merely isolated changes, but should be part of broader policy changes and ongoing requirements implemented at all medical institutions. This approach will ensure that these changes are lasting and become ingrained in competencies for medical practice.

Read Nolen’s full article in NEJM here.