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Viewpoint: Physician, Know Thyself: The Professional Culture of Medicine as a Framework for Teaching Cultural Competence

Boutin-Foster, Carla MD, MS; Foster, Jordan C. MD, MS; Konopasek, Lyuba MD

Academic Medicine:
doi: 10.1097/ACM.0b013e31815c6753
Cultural Competence
Abstract

The need for physicians who are well equipped to treat patients of diverse social and cultural backgrounds is evident. To this end, cultural competence education programs in medical schools have proliferated. Although these programs differ in duration, setting, and content, their intentions are the same: to bolster knowledge, promote positive attitudes, and teach appropriate skills in cultural competence. However, to advance the current state of cultural competence curricula, a number of challenges have to be addressed. One challenge is overcoming learner resistance, a problem that is encountered when attempting to convey the importance of cultural competence to students who view it as a “soft science.” There is also the challenge of avoiding the perpetuation of stereotypes and labeling groups as “others” in the process of teaching cultural competence. An additional challenge is that few cultural competence curricula are specifically designed to foster an awareness of the student’s own cultural background. The authors propose the professional culture of medicine as a framework to cultural competence education that may help mitigate these challenges. Rather than focusing on patients as the “other” group, this framework explores the customs, languages, and beliefs systems that are shared by physicians, thus defining medicine as a culture. Focusing on the physician’s culture may help to broaden students’ concept of culture and may sensitize them to the importance of cultural competence. The authors conclude with suggestions on how students can explore the professional culture of medicine through the exploration of films, role-playing, and the use of written narratives.

Author Information

Dr. Boutin-Foster is associate director, Center for Multicultural and Minority Health, New York–Presbyterian Hospital, and assistant professor of medicine, Department of Medicine, Weill Cornell Medical College, New York, New York.

Dr. Foster is site director, Adult Emergency Medicine Department, and clinical assistant professor of medicine, Columbia University Medical College, New York, New York.

Dr. Konopasek is director of undergraduate medical education in pediatrics, course director of the Medicine, Patients, and Society 1 course, and associate professor of pediatrics (education), Weill Cornell Medical College, New York, New York.

Correspondence should be addressed to Dr. Boutin-Foster, Weill Cornell Medical College, 525 East 68th St., Box #46, Room F1421, New York, NY 10021; telephone: (212) 746-1607; fax: (212) 288-5015; e-mail: (cboutin@med.cornell.edu).

© 2008 Association of American Medical Colleges