Like many others, I have felt immense frustration in the past couple of weeks. The news surrounding the Black Lives Matter movement, compounded by many other incidents of injustice against minorities, has made me feel constant rage at the society we live in.
I’ve tried to channel my anger into as much activism as I can think of, and I’m looking for more opportunities every day. Beyond donating, protesting, petitioning, and engaging in conversation, I have predominantly focused on educating myself, especially in my home territory.
As a current student in a BS/MD program, I am proud to call the health care industry my home. For several years, I have dreamt about the day I would wear a white coat and begin saving lives. That dream will soon be a reality.
But, the dream no longer seems perfect. From reading books like Black Man in a White Coat and Unmasking Racism in Healthcare: Alive and Well to conducting literature reviews on racial, class, and gender disparities in health care, a gnawing realization has come upon me.
Treatment regimens can only go so far, as, at some point, a patient’s history, living circumstances, socioeconomic status, race, and much more will play a larger role in how well the patient fares.
Coping with this realization after reading testimonial after testimonial was harder than I expected. I was always aware of the disparities, but reading stories of patients who died due to cultural incompetence on the physician’s part invoked a stronger emotion. I couldn’t sit still anymore.
I will prepare myself for what is to come. I now have three years before I enter medical school to try and do my part in learning about cultural differences in health care, understanding how to be cautious of such barriers when treating patients, and joining activist groups to make systemic changes to address the limitations patients face.
Unfortunately, I cannot say the same for my peers. There is no guarantee that my fellow pre-meds at college, much less the other students in the BS/MD program who are already guaranteed to become doctors, will be doing the same.
Cultural competency courses exist in medical school right now, but multiple studies have reported how these courses are not enough. 20 to 25 percent of medical school graduates do not feel prepared to provide effective cross-cultural care, despite the integration of cultural competency courses in their curriculum.
While the cultural competency courses themselves could be altered in the medical school curriculum, that change is not enough. Students need to be aware of these issues early on, meaning during their pre-med requisites.
Professionals who encounter and interact with individuals from diverse cultural backgrounds early in their training are better equipped to serve the nation’s multicultural society. Perspectives are broadened over time, and the more time we can give students to learn about the racial, ethnic, and cultural differences that they will be dealing with as medical professionals, the better the quality of care patients will receive.
The purpose of premedical requisites is to prepare students for the content which they will face as doctors in medical school and beyond; understanding and addressing the culture of a patient is a huge component of practicing medicine, meaning curriculum focusing on the basics of cultural competency should be incorporated at the pre-med stage, ensuring that students are better prepared to handle the more specifics of cross-cultural care during medical school and beyond.
Waiting until medical school for cultural competency training is simply not an option anymore. Not when thousands of patients are in danger of being treated by doctors who do not understand their life.
The four years of schooling at an undergraduate university are critical for shaping an individual’s perspective. Students develop their own values and beliefs through the classes they take, the faculty that mentor them, and the conversations they engage in with their peers.
Changing these perspectives in medical school is far more difficult than cultivating them during the pre-med years. Pre-med students will shadow and volunteer in preparation for their medical school applications. During these experiences, if they have learned about cultural competency, they can see their learning manifest itself in real life, a valuable moment to remember as they continue their journey into medicine.
While doctors cannot change the circumstances of a patient, by learning how to take into account the patient’s cultural and circumstantial differences, a doctor can create more effective treatment regimens to save the patient’s life. Moreover, by learning about how cultural differences result in symptoms presenting themselves in varying manners, doctors are less likely to miss important diagnoses.
Doctors are people, and people are capable of prejudice and discrimination. But, in medicine, there is no place for prejudice and discrimination because a patient’s life is at stake. Stereotyping a customer and assuming that they cannot afford a certain product is emotionally hurtful, but it is far less dangerous than stereotyping a patient and misdiagnosing a life-threatening condition.
The nature of the medical profession is handling a patient’s life; doctors are the last line of defense between life and death.
As such, doctors have to balance every aspect of the patient when choosing the right treatment, and ample evidence suggests that a patient’s culture, including race, ethnicity, and class, is an important factor in determining a health outcome.
With the stakes this high, it is vital that doctors understand the intersection of culture and medicine, and they understand it as soon as their journey into medicine begins.
Shvetali Thatte is a premedical student.
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