Published research has shown that resident physicians believe training on the ways racism and bias affect medical care would help improve their preparation to excel as physicians. Furthermore, the institutions that oversee medical training also have shown the necessity of training on these topics. Namely, the Accreditation Council for Graduate Medical Education (ACGME) and the Association of American Medical Colleges have created competencies for training related to diversity, equity and inclusion.
While residents, faculty and administrators may understand how such training can help increase physician workforce diversity, build safe and inclusive learning environments and promote health equity, getting that content to busy residents remains a challenge. Enter the AMA GME Competency Education Program, which offers a series of health equity educational courses and curriculum.
The AMA GME Competency Education Program delivers education to help institutions more easily meet Accreditation Council for Graduate Medical Education common program requirements. Modules cover five of the six topics—patient care, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice—within the core competency requirements. The sixth requirement, medical knowledge, is one that is typically addressed during clinical education.
Among the program’s experts are several who contributed to the AMA’s Health Systems Science textbook, which draws insights from faculty at medical schools that are part of the Association’s ChangeMedEd initiative.
Current program subscribers have access to award-winning online education designed for residents on the go. It’s easy to use and saves time with simple tracking and reporting tools for administrators. Learn more.
Lessons that reshape health care
The aim of the health equity curriculum is to ensure that resident physicians are equipped to understand and address the root causes of health inequities, including racism and other structural determinants of health. To that end, courses include case scenarios and quizzes tailored for resident and fellow learners.
“The goal of creating this content is to fill what we believe is a gap in available content for residents,” said Emily Cleveland Manchanda, MD, MPH, director of social justice education and implementation at the AMA Center for Health Equity. “From wherever they are when they enter a residency program, we are trying to get them up to speed to the level we think is necessary—an understanding of the skills to advance equity in medicine—before they take on independent practice.”
The curriculum includes:
- “Basics of Health Equity for GME,” an introductory course that grounds learners in common definitions, concepts and frameworks of health equity and encourages further investigation, engagement and reflection.
- “Racism in Medicine: An Introduction,” an interactive course that takes learners though the historical social construction of race and the obstacles racism poses for the attainment of health and wellness.
- “Social Determinants of Health,” which helps build a foundation for recognizing and addressing the structural drivers and social determinants of health during a clinical encounter in order to improve outcomes and health equity.
- “Improving Population Health,” a course that introduces learners to population and public health and explains recent changes in health care delivery to improve U.S. health.
- “Racism in Medicine: Distrust and Mistrust,” which explores the distinctions between medical distrust and mistrust and how, for patients from historically marginalized racial and ethnic groups, contemporary engagement with the health system is often influenced by the history of medical experimentation and substandard care.
- “Racism in Medicine: Race and Pain,” which details the history of racist beliefs about pain tolerance in people of color, specifically in Black people, and how implicit, unconscious bias can affect patient care.
Dive deeper:
- New AMA resource helps overstretched GME program directors
- Health equity demands rethink on education, professionalism
- Why coordinated action is needed to advance health equity
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Filling gaps
The uses for these courses are many, Dr. Cleveland Manchanda said. One key gap of some residency programs is the lack of a faculty member with specific health equity expertise. These modules can help.
“If you're in a training institution or a program where you don't have a dedicated faculty member with expertise in teaching about health equity, racism in medicine and other core topics, then these modules can help support programs and ensure that their trainees are able to meet those competencies,” she said. “We hope that the modules are also useful for faculty who are looking to advance their own understanding.”
The work to achieve health equity across the U.S. health system is vast. Ultimately, Dr. Cleveland Manchanda said, these modules help empower residents to improve health care for every patient they serve.
“Diversity trainings or implicit-bias trainings don’t really get to some of the root causes of health inequities,” she said. “We’ve created content that helps doctors develop an understanding of structural forces that create inequities. From there we can develop, identify and change policy that perpetuates inequity. We can identify the ways in which it shows up in our institutions and create pathways for redress and restoring trust with the communities that have been harmed. It’s also important to recognize that this work to address inequities helps improve the overall system and raises the quality of care for every patient—not only the individuals and communities who are being harmed by our current ways of practicing. That's what I'm hoping that folks will take away from this.”
Easy to track progress
Residency program directors have access to dashboards and reports that provide a view of progress at the program and institution levels. In addition, customizable reports make it easy to track learner performance and demonstrate compliance for accreditation.
The AMA GME Competency Education Program covers topics including well-being, QI and patient safety, residents as teachers, navigating health systems, health equity, professionalism and faculty development. Schedule a meeting to discuss your organization’s needs.
