To the Editor:
As COVID-19 cases surged across the United States, xenophobia, racism, and the unjust inadequacies in health care faced by vulnerable populations became more evident. The COVID-19 pandemic also demonstrated how disparities in outcomes result from neglecting the social determinants of health (SDoH) (e.g., food insecurity, economic instability, housing insecurity). However, some medical leaders publicly lamented the lack of teaching about public health disasters in medical school in favor of an overemphasis on the SDoH and injustice.1 This false equivalency has deleterious implications. Instead, those redesigning undergraduate medical education must consider it an imperative to incorporate public health and health justice into the curriculum. Despite experts arguing to limit the promotion of social justice in medical schools, this pandemic offers a compelling counterpoint to prioritize teaching about the SDoH and health equity.
Medical schools have adapted and overhauled learning environments in response to the pandemic. However, no standards exist for teaching students about incorporating the SDoH into patient care. Some medical students have compensated by obtaining a master’s in public health or public policy. Others have participated in student-led advocacy organizations or sought out community-focused experiences.
A robust medical education curriculum should allow for the comprehension of scientific concepts, the attainment of clinical acumen, and the understanding of public health. Specifically, students should learn about frameworks that outline epidemiological principles and expose the harmful health effects of structural racism. An integrative curriculum can equip students with the tools necessary to advocate effectively for patients in a culturally responsive, patient-centered manner. I recently worked on a project addressing maternal mental health and birth equity for Black women—issues exacerbated by the pandemic. The experience enriched my studies and broadened my perspective on what it means to provide culturally responsible care.
Although we each live a life of unique experiences, physicians take an oath to provide competent and compassionate care to all their patients. As a Black medical student experiencing this pandemic, I need to make sense of the disproportionate suffering and death of people who look like me. I want to learn how to do more. I believe my educational experience must undergo a transformation that prioritizes health equity. More importantly, the medical profession must view this type of education as a required duty and responsibility to its students.
The author would like to thank Valencia P. Walker, MD, MPH, and Soban Umar, MD, PhD, for their support and mentorship.
1. Goldfarb S. Med school needs an overhaul; Doctors should learn to fight pandemics, not injustice. Wall Street Journal. https://www.wsj.com/articles/med-school-needs-an-overhaul-11586818394
. Published April 13,2020 Accessed July 12, 2020