The Medical School Curriculum Initiative
Description of the Initiative
The Medical School Curriculum Initiative (curriculum) enhances medical school instruction by helping medical students and health professionals appreciate their role in reducing health disparities in American communities. The curriculum is based on Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, and national origin.
The curriculum teaches future practitioners about the legal obligation recipients of federal financial assistance have to provide service to persons without regard to their race, color, or national origin, and how doing so reduces health disparities that disproportionately affect various communities. The curriculum also ensures that medical students and other health care professionals understand that some aspects of “culturally competent” care, including access for limited English proficient persons, are crucial in providing equitable, accessible, and optimal quality health care services.
The curriculum initiative began in 2004, when the National Institute of Health’s National Heart, Lung and Blood Institute awarded a five-year grant to a consortium of 18 medical schools across the country to develop cultural competency curricula for medical schools. The medical school grantees then formed the National Consortium for Multicultural Education for Health Professionals (NCMEHP). Subsequently, OCR provided the framework for developing the Medical School Curriculum and partnered with the NCMEHP and the HHS Office of General Counsel to develop it.
The curriculum was piloted at Wake Forest University School of Medicine’s Maya Angelou Center on Health Equity in 2008. The resulting curriculum was then published in the Association of American Medical Colleges’ (AAMC) MedEdPORTAL – the leading web-based tool that facilitates the exchange of high-quality, peer-reviewed educational materials to medical schools nationwide.
Currently, three medical schools have incorporated the curriculum into their programs: Emory University School of Medicine, University of Colorado School of Medicine, and the University of Kansas Medical School. To date, nearly 1,200 3rd and 4th year medical students have taken the curriculum. Because of widespread interest in the curriculum, in 2014 OCR renewed its partnership with AAMC to reach new audiences through webinars and university-based presentations to undergraduate students. This renewed partnership has resulted in: jointly conducted webinars marketing the curriculum to the AAMC’s network of schools of medicine, medical students, faculty, and administration officials; and presentations by OCR to participants in AAMC’s Summer Medical and Dental Education Program (SMDEP). A statement from the AAMC about its partnership with OCR can be found here.
The primary goal of the Medical School Curriculum is to train medical students and physicians on how to provide culturally competent, equitable, accessible, and high quality care to patients in compliance with Title VI (see: https://www.mededportal.org/publication/7740).
The objectives of the curriculum are to:
- Discuss the application of federal civil rights laws – specifically Title VI – in health care practice;
- Describe the current extent of racial and ethnic disparities in health care;
- Utilizing hypothetical health care scenarios that highlight civil rights compliance concerns; and
- Illustrate how OCR enforces Title VI through investigations and technical assistance to health care providers and covered entities.
The curriculum includes lectures, videos, case scenarios, group discussions, and power-point presentations. Instructors are supported by a comprehensive facilitator’s guide and a hypothetical case that illustrates how ineffective care contributes to health disparities. The curriculum is presented in medical schools by at least one physician and one attorney and can be delivered over a three-hour period, with 45 minutes allocated for discussion of a health disparities hypothetical case. The “Stopping Discrimination Before It Starts: The Impact of Civil Rights Laws on Health Care Disparities” curriculum covers the following topic areas:
- The history of Title VI, how it is enforced, and how it applies to the health care practice;
- Why physicians must be concerned about Title VI;
- Why health disparities exist;
- How physicians contribute to health disparities;
- When racial bias amounts to a civil rights violation;
- Analysis of a hypothetical case to identify health disparities and potential Title VI violations; and
- A comparison of disparate treatment vs. disparate impact.
The Summer Medical and Dental Education Program
Through the Medical School Curriculum, OCR is collaborating with the AAMC to introduce nearly 1,000 aspiring medical and dental school students to their obligations under Title VI once they become doctors and dentists. Through this collaboration, OCR staff is scheduled to give 90 minute presentations from June 2014-August 2014 to college students studying medicine and dentistry at 12 university campuses across the country. These presentations are condensed versions of the presentations given to medical students and also cover racial and ethnic health disparities, cultural and linguistic competence in health care, and compliance with Title VI.