Medical schools must include BAME representation in clinical teaching

The Issue

We call on the GMC to pass guidance requiring that course material in all medical schools must include ethnically diverse examples of case presentations - especially in clinically relevant instances where disease presentation differs between white and black and minority ethnic (BAME) patients. Clinical descriptions such as erythematous, pallor and rubor are not typical of all patients and students are often not taught otherwise. This is just one example.

Medical teaching should be representative of the society we live in. The duty to deliver the highest quality of care extends to all members of the public and if medical education does not actively prepare students for this, this is inconsistent with such values. It is important that BAME patients are acknowledged consistently throughout teaching and not just in highly specific case studies.

White normativity in medical teaching means that medical students are often unprepared in recognising signs of certain diseases in BAME patients that do not present in the same way as white patients and/or are not as clinically obvious. It also means that BAME students do not feel represented and included in their studies. Given that most medical schools only have a small proportion of BAME students (especially black students,) the lack of recognition of BAME patients in medical studies can feel increasingly isolating.

A pertinent example is the rash in children with meningococcemia, which is usually less visible in dark-skinned people. The teaching of the importance of - and often reliance on - this sign as a diagnostic indicator of meningitis can lead to delays in diagnosis in dark-skinned people, with often fatal consequences.

There are countless other examples, such as in haematology, cardiology and many other aspects of medical care which all need to see an improvement in representation in teaching. We must be taught presentation and normality in all patients.

Representation is important in all fields and it is vital in medicine, so that future doctors can provide the same high level of care to all patients and in doing so, work to bridge racial disparities in the medical field. Representation can quite literally save lives.

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The Issue

We call on the GMC to pass guidance requiring that course material in all medical schools must include ethnically diverse examples of case presentations - especially in clinically relevant instances where disease presentation differs between white and black and minority ethnic (BAME) patients. Clinical descriptions such as erythematous, pallor and rubor are not typical of all patients and students are often not taught otherwise. This is just one example.

Medical teaching should be representative of the society we live in. The duty to deliver the highest quality of care extends to all members of the public and if medical education does not actively prepare students for this, this is inconsistent with such values. It is important that BAME patients are acknowledged consistently throughout teaching and not just in highly specific case studies.

White normativity in medical teaching means that medical students are often unprepared in recognising signs of certain diseases in BAME patients that do not present in the same way as white patients and/or are not as clinically obvious. It also means that BAME students do not feel represented and included in their studies. Given that most medical schools only have a small proportion of BAME students (especially black students,) the lack of recognition of BAME patients in medical studies can feel increasingly isolating.

A pertinent example is the rash in children with meningococcemia, which is usually less visible in dark-skinned people. The teaching of the importance of - and often reliance on - this sign as a diagnostic indicator of meningitis can lead to delays in diagnosis in dark-skinned people, with often fatal consequences.

There are countless other examples, such as in haematology, cardiology and many other aspects of medical care which all need to see an improvement in representation in teaching. We must be taught presentation and normality in all patients.

Representation is important in all fields and it is vital in medicine, so that future doctors can provide the same high level of care to all patients and in doing so, work to bridge racial disparities in the medical field. Representation can quite literally save lives.

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The Decision Makers

General Medical Council
General Medical Council
Responded
“We are grateful for the widespread and vocal public support for this cause. Like you, we want doctors to be equipped with the essential knowledge and skills to provide the best possible care to all patients. It’s very important that teaching materials including course content and medical textbooks include examples of how diseases and health conditions present in people from different ethnicities and diverse groups. Medical schools design and deliver their own course content for students but we determine the outcomes that must be achieved by the end of the course. This petition has sparked important conversations about how to achieve our existing requirement that students should learn about the needs of patients from different social, cultural and ethnic backgrounds. Many medical schools have already done great work to address these issues and share their knowledge with each other. We are now working with schools to explore how to include new and more varied examples so that our future doctors see and learn about all people in their training. Recent events are an important reminder of health inequalities in the UK and it is unacceptable that Black, Asian and minority ethnic patients have, at times, had different experiences and outcomes in healthcare. We want to encourage more BME representation from the outset in medical teaching and training to support black and minority ethnic students, trainees, doctors and patients in the UK. - Prof Colin Melville, Medical Director and Director, Education and Standards at the General Medical Council”
Medical Schools Council
Medical Schools Council
Responded
“The Medical Schools Council is grateful for the issues this petition has raised about the importance of representation in healthcare. Medical schools must play a key role in reducing health disparities by equipping our future doctors with the knowledge and skills they need to provide the best possible care to all patients. Medical schools have been working on diversifying curricula on an individual level for some time. However, until recently, there was not a national forum to share best practice in this area. The Medical Schools Council has therefore set up an Equality, Diversity and Inclusion Alliance with representation from UK medical schools and students. The first piece of guidance to be produced by the Alliance will provide an overview of the current situation and give suggestions on how medical schools can address EDI issues across a range of different areas. Part of this work will include developing recommendations on diversifying curricula by ensuring that representation of diverse patient and student groups, as well as challenging stereotypes, are covered. This petition has also rightly highlighted that it is essential that all medical students feel represented and included. We believe that it is important to provide a space in which student voices can be heard. The Medical Schools Council will facilitate this by holding engagement events with medical students from across the UK to gather their views on a number of EDI issues, including how curricula can be diversified.”
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Petition created on 4 June 2020