1/ BREAKING from #AMAmtg: AMA HOD just adopted a report by the @AmerMedicalAssn's Council on Medical Education which aims to begin redressing the harms of the #FlexnerReport.
As a Councilor on CME who is invested in health justice, this is a report I am jazzed about. 🧵
2/ I learned about CME's role as a sponsor of the Flexner Report well before joining the Council, bc the downstream consequences have been huge.
The Report closed 5/7 Black medical colleges, diminishing the projected # of Black docs today by >35k 👇🏽 jamanetwork.com/journals/jaman…
4/ CME's report has a number of important recommendations:
✅Advocate for HBCU, HSI, TCU funding with goal of achieving population parity in the health workforce
✅Create a commission to guide AMA's work on truth, reconciliation, & healing in medicine + MedEd
5/ ✅Recognize how systems of oppression contribute to underrepresention/exclusion/marginalization in #MedEd by race, ethnicity, sexual orientation, disability status, and gender identify
✅Recognize the harm of the Flexner Report on physicians, HBCUs, and patients
6/ ✅Commission & enact a new, forward-looking, cross-continuum study of #MedEd focused on racial justice, workforce diversity, and ameliorating inequitable outcomes
✅Study interventions to improve equity in residency selection (eg, address AOA/GHHS disparity, ATLAS tool, etc.)
7/ Let's be clear: this report is not a standalone end-game.
But, by redirecting resources of AMA & others in #MedEd, I hope we can make a dent in the "wicked problems" of improving workforce diversity & mitigating health inequities. medscape.com/viewarticle/95…
• • •
Missing some Tweet in this thread? You can try to
force a refresh
For the first time in AMA history, we have policy to explicitly & actionably fight for #antiracism in #MedEd, health care delivery, research, & practice.
3/ By telling the truth & reconciling harms, and by advocating for actionable paths forward, these new policies will foster a brighter future of robust AMA advocacy for #HealthEquity and #Antiracism.
The adopted Resolved clauses (our resolutions are 005 & 010) are as follows:
2/ #Redlining in the 1930s involved racialized federal mapping of housing "desirability" (L) --> ⬆️💰 into White/affluent areas + systematic disinvestment in "undesirable" areas.
To this day, HOLC maps of urban areas like Omaha STILL align w/deprivation & racial segregation (R).
3/ Omaha is among the most segregated U.S. cities. Our HIV clinic serves ~50% Black and Latinx pts, who disproportionately live in deprived neighborhoods.
We assessed neighborhood disadvantage using the ADI, outlined by @amyjhkind et al. in @NEJM.
2/ @AmerMedicalAssn's Center for Health Equity has followed state demographic reporting. 46 states currently report race/ethnicity, 49 report age, and 48 report gender.
This is a map on which #GoBigRed#GBR has a less than ideal meaning for Nebraska.
3/ Being a flyover state doesn't render us immune to inequity. Data from Douglas County (includes most of Omaha) shows disproportionate case incidence among Hispanic, Black, and Asian patients despite our county being ~70% non-Hispanic & White...
1/ So, today was a big day for @DrJRMarcelin and I. We've been developing curricula on "Structural Challenges & Inequities in Healthcare Delivery" for the @UNMCCOM M1 students as part of the Health Systems Science coil.
Thread on this #MedEd project + today's capstone 👇🏾
2/ With inspiration from @JonathanMetzl & Dr. Helena Hanson's work on #StructuralCompetency, we wanted to assemble a pilot set of experiences that would give @UNMC students a glimpse into local health inequities, from historical & community perspectives:
3/ We gave the M1s several introductory lectures & assignments focused on big-picture issues like #SDoH & disparities, creating a "structural DDx" for patients, unconscious #bias & #microaggressions, developing structural humility, and #racism in medicine...