In a November New England Journal of Medicine article titled “Health, Social Reform and Medical Schools – The Training of American Physicians and the Dissenting Tradition,” Dr. Merlin Chowkwanyun, Donald H. Gemson Assistant Professor of Sociomedical Sciences at Columbia University Mailman School of Public Health and Dr. Benjamin Howell, a Yale National Clinical Scholar, address the past history of American medical schools including some of the lingering ills of exclusion and elitism. They offer a perspective on what can be done to address the deficits especially as some of these injuries of the past continue to linger in our medical schools. For example, medical schools continue to admit low numbers of black and Hispanic students, and their commitment to a “social mission,” as measured by the numbers of doctors who choose primary care or work in medically underserved areas remains low.
The fight against racial exclusion, as well as curriculum reform, was led by two organizations: the Association of Internes and Medical Students (AIMS) and the Student Health Organizations (SHO). Both organizations were known for their trainee activism, Dr. Chowkwanyun and Dr. Howell note, in the 1940s and 1960s. On many campuses, curricular reform efforts led to the formation of permanent social medicine and community health programs.
Today, activism is clearly sanctioned by a number of academic medical institutions, yet inclusion and sanction does come with trade-offs. “Clearly, past activism has not consistently made as dramatic a dent as was hoped, particularly when it comes to racial exclusion,” observe the authors. “However, despite the tensions and unresolved contradictions of past activist efforts, they offer a rich legacy to build on in the ongoing fight for health equity.”
Dr. Benjamin Howell, a Yale National Clinical Scholar, is co-author of the article.Friday Letter Submission, Publish on November 29