Medical Education Should Focus on Solutions to Health Inequity
The isolating nature of the pandemic provided an opportunity for introspection on the privilege that we have to study medicine during a time when students and faculty members challenge the paternalistic principles of this field. This has led to the movement of patient-centered care in which we must consider all aspects of the social determinants of health to improve the quality of care. After sitting through lectures on health inequities, students often feel discouraged because we do not receive solutions to addressing the problems we learn about. Medical education should move beyond acknowledging the institutional basis of health inequities. Students should be empowered to apply their knowledge of these inequities to develop community-based projects and learn how to collaborate with policymakers.
This is happening in some places. One such example is the National Institutes of Health (NIH) Academy, led by Dr. Shauna Clarke, which educates future scientists and clinicians about the social determinants of health. Unlike traditional courses that only teach students about health disparities, the NIH Academy trains students to engage in the community actively. It encourages students to create projects that improve quality of life and increase the accessibility of care.
As an NIH Academy fellow, I co-founded a collaborative initiative with five other NIH Academy fellows to address incarcerated persons’ social and health inequities and evaluate interventions that support recidivism in the D.C. area. We also developed a podcast called, Let’s Talk Reform to elevate the discussion around social and mental health needs in the United States criminal justice system with community stakeholders, educators, physicians, lawyers, and professors. Being an NIH Academy fellow empowered me to stand in the gap and use my gained insight to develop interventions to improve health outcomes.
Root Causes, a student-run organization at Duke University, serves as another example demonstrates the impact that students can have on the community when they are educated on inequities and embolden to address the needs of the Durham community. Food insecurity is a significant issue in the United States, with more than 10% of the population being affected. Root Causes provides fresh produce and delivers nutritious food to Duke Health patients, helps people transition from homelessness through providing move-in support, and advocates for food policy initiatives with lawmakers.
Freedom Community Clinic, a student-run integrative medicine pop-up clinic, serves women, children, and families in the San Francisco Bay area. Bernadette Lim, a University of San Francisco medical student, founded this grassroots movement, opting to serve her community rather than applying to a medical residency after graduation by providing whole-person healing of Black, Brown, and Indigenous undocumented communities. This speaks to the fact that student advocates may feel the pressure of leaving academia to meet the needs of vulnerable and marginalized communities.
On March 1, 2021 Bernadette tweeted:
Instead of driving solution-based advocates outside of academic medicine, we should support innovators like Bernadette. Medical institutions should mirror programs like the NIH Academy by training students to be mission-driven physicians and provide students with the tools of advocacy and financial support to improve the greater community’s health. Medical students can serve as agents for change to improve the social determinants of health when given the necessary education, instruments, and support to succeed.
Antoinette Charles is a medical student at Duke University
