With a unique lens and growing knowledge base, resident physicians can be empowered to create a more equitable system of care.
An e-learning course entitled “Basics of Health Equity for GME” is a tool that aims to help residents grow their knowledge base and encourages further investigation of how systemic racism impacts health care. The course is part of the AMA GME Competency Education Program, which delivers education to help subscribing residency institutions effectively meet ACGME requirements. The program provides an award-winning virtual experience, with quality education designed for residents on the go. It saves time and cuts administrative burdens with simple reporting tools. Request a demo.
The course gives residents context on how systems of care can be rife with bias, from interpersonal interactions through structural inequities. It also offers comprehensive terminology to aid understanding and effect change.
“In order to advance equity, and health equity specifically, it’s critical that we begin with a shared understanding of the foundational concepts and terms,” said Emily Cleveland Manchanda, MD, MPH, an emergency physician who directs social justice education and implementation at the AMA.
“Otherwise, we end up with people misconstruing, misunderstanding and getting defensive about issues that are raised to advance equity. If someone is trying to improve health outcomes by addressing racial inequities, and if the issue is framed as structural racism, folks may not have a grasp of that concept,” added Dr. Cleveland Manchanda, who is an assistant professor of emergency medicine at Boston University Chobanian & Avedisian School of Medicine and associate program director for the Boston Medical Center Executive Fellowship in Health Equity.
“If they don’t understand what structural racism means, some people may think they’re being called a racist, rather than talking about systemic issues that shape differential opportunities for health.” The module uses a fictional family from Flint, Michigan, to exemplify barriers people from marginalized communities experience in the health care system. With its yearslong water crisis, Flint is a glaring example of the impact structural racism can have on an entire population.
Flint is an example that resonates, but it’s far from alone. As an emergency physician at Boston Medical Center, a safety net hospital, Dr. Cleveland Manchanda works with residents who are often on the front lines confronting inequities. These lessons, she said, can take a toll. Having an understanding of what causes systems-level failures and working to address them can have value beyond one-on-one patient interactions.
“Every physician has to decide for themselves what role they want to play in the health system,” she said. “It’s certainly an individual decision how and where you will use your power, but if you are proximate to the harms that are experienced by so many in our country, working to address those harms and advance health justice is incredibly gratifying, and can be lifesaving for us as physicians, too. ”
Learn more about the AMA Center for Health Equity and the AMA’s strategic plan to embed racial justice and advance health equity.
The “Basics of Health Equity for GME” course covers several foundational topics, including the contrast between equity and equality, the four levels of racism, and the relationship between moving upstream and health equity.
“If residents can learn from this module, can internalize and understand at a more intuitive level the terminology that we are using to describe the ways racism and other systems of oppression operate—that is the goal of this course,” Dr. Cleveland Manchanda said.
“It’s important for us to give residents the tools to name the problems they see around them,” she added. “In the same way we give them the tools to name health conditions, we need to give them the tools to identify—and then address—systems that create inequities and the systems of suffering our patients face.”