As Equity and Justice Fellows, VP&S Students Work Toward Anti-Racist Medical Curriculum

The VP&S Equity and Justice Fellowship, now in its second year, supports students to participate in medical school efforts to counter systemic racism and promote inclusive programming.

“In 2020, the combination of the COVID-19 pandemic and the Black Lives Matter movement helped bring new awareness to anti-racism work, particularly in health care settings,” says Hetty Cunningham, MD, associate professor of pediatrics and director of equity and justice in curricular affairs at the Vagelos College of Physicians and Surgeons. “At the same time, many students were asking for more anti-racism programming in the curriculum.”

The fellowship grew out of work students were already doing to support anti-racist curricula and was endorsed by students and faculty of the medical center and VP&S task forces, which were established to recommend ways to build a more inclusive learning, research, and patient care environment at the medical center.

The goal of the VP&S Equity and Justice Fellowship is to improve curricular programming by considering how anti-racism is embedded in the curriculum. One fellow in the first class, Laura Benoît, an MD/PhD student, was already familiar with curricular changes.

In 2015, Benoît and other first-year students raised some issues with the curriculum. “As first-years, we were often confused or frustrated by some of the content in our classes,” she recalls. One example: In the first-year anatomy course, lecture materials about the oral cavity described healthy gums as coral pink. “Some of us in the class heard that and started looking around at each other, thinking, ‘That’s not true for everybody. Something is missing here.’”

The students brought the issue to the instructor’s attention, citing that a person of color’s healthy gums may not be pink at all. The professor was receptive to their feedback, revised the materials, and encouraged the students to use the example in discussions with faculty about revisions to the curriculum.

Conversations among Benoît and other students led to the creation of the VP&S Task Force for a Bias-Free Curriculum, which produced the VP&S Guidelines for Promoting a Bias-Free Curriculum. The guidelines were adopted by the Committee on Education Policy and Curriculum in 2017. The guidelines provide educators with a toolkit for combating systemic racism and weeding out bias in the curriculum. A feedback portal allows students to provide additional feedback to faculty. 

“Bias in the curriculum may not always be caused by overt racism, but it can still result in ill-taught physicians,” Benoît says. When she was selected in 2020 to be one of the first Equity and Justice Fellows, Benoît was able to continue work on the guidelines by collecting student feedback and considering ways to refine the guidelines.

Through the equity and justice fellowship, students work with Cunningham on shared and individual projects. Fellows in the second class have begun work on developing longitudinal anti-racism threads for the Foundations of Clinical Medicine pre-clinical course. They also assisted with the inaugural Anti-Racism Curriculum Summit and collaborated with faculty to evaluate equity in medical student grading.  

Individual projects include creating an oral history of race and racism at VP&S. “I am trying to document this narrative from the school's founding to the present day,” says Ahmed Owda, fourth-year student and current equity and justice fellow. “A fair amount of people here now know the history of Dr. Samuel Bard, a founding member of the medical school, George Washington's physician, and a slave owner. But between the school’s founding and the last 20 to 30 years of progress, there's a very long history there that needs to be explored.

“For much of American history, medicine in general has been, overall, a very racist institution. Columbia is a preeminent leader in medicine, and we need to acknowledge its place in that history.”

As an equity and justice fellow, Owda has discovered a greater appreciation for what it takes to effect change at the institutional level, and he hopes that the fellowship’s work will inspire lasting growth at VP&S and beyond.

“It's great that we're doing this work as students, but we can only do so much. I hope this fellowship will create the next generation of medical school faculty who will continue that work. The fellowship has inspired me to potentially pursue a more academic path, because I see real change happening in medical education. There’s real power among medical faculty, especially in making change and dictating what medicine is and how it serves people.”

That is an aspiration shared by Cunningham, who has been working on issues of health equity for her 22 years at VP&S: “I would like to help create the next generation of leaders in this space. I'd like to train these fellows to be leaders in this work in medical education. I’d also like to broaden the fellowship to serve more students, to really bring a wider group of students together around this cause.”