Tuskegee as a History Lesson, Tuskegee as Metaphor: Addressing Discrimination as a Social Determinant of Health in the Classroom

Tara Vijayan; Nicolás Cortés-Penfield; Christina Harris

doi:10.1093/ofid/ofaa458

Tuskegee as a History Lesson, Tuskegee as Metaphor: Addressing Discrimination as a Social Determinant of Health in the Classroom

Open Forum Infect Dis. 2020 Sep 28;7(10):ofaa458. doi: 10.1093/ofid/ofaa458. eCollection 2020 Oct.

Authors

Tara Vijayan¹, Nicolás Cortés-Penfield², Christina Harris³

Affiliations

¹ Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
² Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
³ Department of Internal Medicine, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.

Abstract

While basic science and social medicine are fundamental to the practice of medicine, the former is often prioritized in preclinical medical education at the expense of the latter. In this perspective, we discuss ways to introduce the concept of interpersonal, institutional, and structural discrimination as social determinants of health (SDOH) into a preclinical microbiology and infectious diseases medical course. We offer 5 specific steps to creating a comprehensive curriculum on discrimination as a social determinant of health: define and use standardized terminology; integrate the concept of SDOH throughout the course; encourage critical appraisal of lay and medical resources; encourage student feedback; and provide faculty development supported by key faculty stakeholders that focuses on increasing comfort and facility with teaching such concepts. This approach offers a template for ongoing discussion in the setting of curricular reform.

Keywords: discrimination; social determinants of health; undergraduate medical education.