“The ultimate measure of a person is not where one stands in moments of comfort and convenience, but where one stands in times of challenge and controversy.” – Martin Luther King, Jr.
In response to the global outcry to tackle systemic racism in the summer of 2020, we decided to take action at our own institution, RCSI University of Medicine and Health Sciences. We formed a virtual reading group to engage students in a discussion about systemic racism, health inequality, and the importance of anti-racism in medicine – the legacies of which are likely to persist long after the last page is read.
RCSI has long championed issues of anti-racism and discrimination in medicine. During the apartheid era, RCSI gave disenfranchised South African citizens the opportunity to graduate in medicine – a move that was recognised in 1996, when Nelson Mandela accepted an honorary fellowship of RCSI to show his gratitude. RCSI has also, for decades, supported the training of surgeons in Africa through a partnership model with the College of Surgeons of East, Central and Southern Africa.
In 2016, RCSI established the International Citizenship Award, an extracurricular opportunity and two-year mentored programme that exposes students to different cultures and countries, encouraging them to reflect on their experiences and develop a more profound awareness of the world around them.
Our truly international student body allows students and faculty alike to learn from and develop a deeper awareness of various cultures. Equality, diversity and inclusion (EDI) is a foundational pillar of RCSI’s strategic plan and in 2018, we launched our Equality, Diversity and Inclusion Strategy and Action Plan, providing a framework to support race equality.
Reading between the lines
Even with RCSI’s history of work to promote diversity and inclusion, RCSI is not necessarily immune to issues of race inequality nor does our cultural diversity assume that the understanding of one another’s cultures is innate. Furthermore, the issue of racism in medicine is a global problem that affects patient care in many ways.
This is why, last year, we approached our faculty with the idea of piloting an anti-racism reading programme, allowing us to start important discussions about the danger of race-based medicine and systemic inequality, to foster meaningful conversations and to generate tangible actions.
The pilot, adopted from the University of Washington School of Medicine, aimed to facilitate a discussion about racism and the misuse of race as a biological category in medicine. Another key aim was to give medical students an introductory understanding of how racism underpins health inequities.
The reading project focused on a seminal text in anti-racism literature: Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century by Dorothy Roberts. In addition to providing the book electronically to the reading group, it was also made available to all students at RCSI through the library.
We opted to pilot the programme with a group of graduate entry medical students in the second year of their medical programme, and recruited almost half of the class on a voluntary basis. These students were instructed to read three chapters from Fatal Invention: “The Invention of Race,” “Medical Stereotyping” and “Embodying Race”. Following completion, four discussion groups were held virtually, facilitated by one RCSI faculty member and one student per group.
Moving on up
The feedback from the programme was overwhelmingly positive. Following completion of the project, the participants reported feeling more informed about the history of racism in modern society and medicine, and better able to discuss and challenge racism in their daily lives. When asked about their motivations for taking part in the programme, students expressed a strong desire to learn more about racism in order to make a change – be that in medical school, in clinical practice or in society as a whole.
Now, several initiatives are being taken forward by students and staff working in partnership at RCSI. We have established a staff/student Race Equality Forum as an ongoing positive action group for change through our EDI Department. We are reviewing our case-based teaching to ensure there is diversity in clinical cases and teaching images to improve student training and ultimately patient care.
We are undertaking collaborative efforts to promote an anti-racist mindset for staff and students with the goal of cultivating a truly inclusive community environment. Additionally, cultural competence training for students and mandatory annual unconscious bias training for staff is currently available online, with plans to expand these modules and supplement them with additional EDI-centred training.
These initiatives are being implemented to provide the best learning environment and to empower our graduating healthcare professionals to be leaders in championing equality, diversity and inclusion around the globe.
Racism persists when people stand silent. Taking active steps against discrimination is everyone’s responsibility.