Integration of anti-racist aspects in medical education in German speaking countries - initial results from a position paper

Background
Sex/gender, cultural backgrounds, and ethnicity influence the quality of healthcare. Black, Indigenous und People of color (BIPOC) often receive delayed diagnoses and have a higher mortality rate for diseases such as skin cancer and chronic renal failure compared to white patients. It is therefore necessary that healthcare professionals and medical students have adequate knowledge and are aware of the influence of racism in healthcare to be able to provide adequate care for all patients.

Summary of Work
In 2021, an interprofessional and international working group has been assigned by the DACH Association for Medical Education (GMA) to work on a position paper on ‘racism in medical education’. The authors defined key terms, discussed historical contexts, conducted a literature review of currently existing teaching courses and searched national learning catalogues. From March until May 2022, the authors launched an online survey to assess the extent of curricular integration of anti-racist courses or awareness building in Germany, Austria and Switzerland. The survey was sent to all GMA members, national student representatives and the deans' offices of medical faculties.

Summary of Results
Literature on racism in medical education is scarce in German-speaking countries. A total of n=19 submissions from n=10 institutions were received with n=26 courses. N=12 courses explicitly referred to the topic, two of which were mandatory. In 7 other courses, an implicit reference was conceivable, as related topics (e.g. discrimination, diversity, stigmatization) were listed as learning objectives.

Discussion and Conclusion
In German-speaking countries, there is currently only little research available on racism in medical education. However, aspects of racism in medicine are integrated into mandatory courses at few medical schools. Explicit learning objectives in this field are scarce. Faculty development courses on racial and ethnic disparities in healthcare and awareness building should be developed and learning objectives integrated into national learning objectives catalogues.

Take-home Message
In German-speaking countries, critical reflection on how to include anti-racist teaching content into medical education is needed. This requires more research, the development of mandatory courses on anti-racist aspects, the integration into the assessment and a longitudinal integration into healthcare professions curricula.