The purpose of this paper is to provide a perspective from New Zealand on the role of medical education in addressing racism in medicine. There is increasing recognition of racism in health care and its adverse effects on the health status of minority populations in many Western countries. New Zealand nursing curricula have introduced the concept of cultural safety as a means of conveying the idea that cultural factors critically influence the relationship between carer and patient. Cultural safety aims to minimize any assault on the patient's cultural identity. However, despite the work of various researchers and educators, there is little to suggest that undergraduate medical curricula pay much attention yet to the impact of racism on medical education and medical practice. The authors describe a cultural immersion program for third-year medical students in New Zealand and discuss some of the strengths and weaknesses of such an approach. The program is believed to have great potential as a method of consciousness raising among medical students to counter the insidious effects of non-conscious inherited racism. Apart from the educational benefits, the program has fostered a strong working relationship between an indigenous health care organization and the medical school. In general, it is hoped that such programs will help medical educators to engage more actively with the issue of racism and be prepared to experiment with novel approaches to teaching and learning. More specifically, the principles of cultural immersion, informed by the concept of cultural safety, could be adapted to indigenous and minority groups in urban settings to provide medical students with the foundations for a lifelong commitment to practicing medicine in a culturally safe manner.
Dr. Crampton is senior lecturer, Department of Public Health, and Dr. Dowell is professor and Mr. Parkin is senior teaching fellow, Department of General Practice, Wellington School of Medicine and Health Sciences, Wellington, New Zealand; Ms. Thompson is Kaitiaki/Manager Community Health Teams, Ngati Porou Hauora, East Cape, New Zealand.
Correspondence and requests for reprints should be addressed to Dr. Crampton, Department of Public Health, Wellington School of Medicine and Health Sciences, PO Box 7343, Wellington, New Zealand.
The authors thank Ngati Porou Hauora for organizing the cultural immersion program, Otago University for funding it, Denis Simpson for supporting it, and the students for immersing themselves in it.