Inclusive curriculum FAQs

What do you mean by diversity?

The below is an extract from Dogra et al’s (2016) paper on ‘Teaching Diversity to Medical Undergraduates’:

'Consensus on definitions in this field can be difficult to achieve. In this Guide, diversity is not limited to viewing individuals as only being defined by a particular ethnic or racial group. The term diversity is not synonymous with “multicultural”; we extend diversity to include all facets that define the way individuals perceive themselves us (sic), so that there is no requirement to have ethnic diversity for cultural diversity to be present. This Guide views any difference as diversity. It does not make judgments about different groups but accepts that there is diversity within society and that future doctors need to be able to deal with diversity.'

What do you mean by inclusivity?

In essence, this is simply ensuring that we are all doing what we can to ensure that everyone feels included within their learning environment, having a sense of belonging and feeling that the learning environment is a safe space for them and conducive to their learning and development as future clinicians.

The Medical School Council’s recent framework (Dec 2021) on ‘Active Inclusion: Challenging Exclusions in Medical Education’ (see pg. 6-7 in particular) extends this understanding of inclusion to ensure this is not simply a passive process, but something that we are all working towards at an individual and institutional level.

What do you mean by decolonising (the curriculum)?

There is a lot of literature on this beyond medicine, and our resources include references decolonisation of medical curricula; Mbaki et all (2021), for example provides a definition of decolonisation from the perspective of students and staff at Nottingham Medical School. A general definition from a locally developed University of Leicester toolkit (itself drawn from the Keele Decolonising the Curriculum Network) is as follows:

'Decolonisation involves identifying colonial systems, structures and relationships, and working to challenge those systems. It is not ‘integration’ or simply the token inclusion of the intellectual achievements of non-white cultures. Rather, it involves a paradigm shift from a culture of exclusion and denial to the making of space for other political philosophies and knowledge systems. It’s a culture shift to think more widely about why common knowledge is what it is, and in so doing adjusting cultural perceptions and power relations in real and significant ways.'

UCL have also produced a guide (‘So you want to decolonise your medical school?’) which includes an introduction titled ‘What actually is decolonising the medical curriculum?’

Given the objectivity inherent within the scientific method, why is there a need for such decolonising of our curriculum?

There are clear strengths in our (rather than ‘the’) scientific method(s). But it is this self-same scientific method, and many within the scientific community, that supported and gave rise to the now discredited pseudoscientific belief of ‘scientific racism’ (and the idea of distinct races) which was of course used to justify the horrors of slavery.

One of the strengths of our scientific method is of course the ongoing exploration that ensures we are constantly striving for the truth and thus the ability to correct inaccuracies in our worldview, but both history and logic suggest that it would be fallacious to assume that ‘the’ scientific method means we are immune to the dogma and grave errors made by scientists in the past, and the very real impact this has had, and continues to have, on individuals and societies.

What is anti-racism?

Anti-racism is an active commitment to working against racial injustice and discrimination. The BMA Charter to prevent and address racial harassment is one example of this. It involves making conscious and thoughtful decisions regarding our own (interpersonal) behaviours and our institution’s processes and how they can/might negatively influence and impact stereotypes, biases and discriminatory actions. As expressed in this piece from the BMJ – ‘health disparities are documented but not contested, and multi-culturalism and diversity training are confused with anti-racist pedagogy. Truly anti-racist teaching confronts prejudice through the discussion of racism, stereotyping and discrimination in society. It teaches the economic, structural and historical roots of inequality.’

Similarly, an excellent piece in the Lancet by Cerdena et al (2020) also proposes a move towards a race-conscious (rather than race-based) approach in medicine. In their introduction, they write:

'Although clinicians often imagine themselves as beneficent caregivers, it is increasingly clear that medicine is not a stand-alone institution immune to racial inequities, but rather is an institution of structural racism. A pervasive example of this participation is race-based medicine, the system by which research characterising race as an essential, biological variable, translates into clinical practice, leading to inequitable care. In this Viewpoint, we discuss examples of race-based medicine, how it is learned, and how it perpetuates health-care disparities. We introduce race-conscious medicine as an alternative approach that emphasises racism, rather than race, as a key determinant of illness and health, encouraging providers to focus only on the most relevant data to mitigate health inequities'

For anyone interested in a more general (sociological) introduction to the different types of racism, Steve Garner's book, Racisms: an introduction, is a very good resource.

What do you mean by race not having any biological basis?

There are lots of good articles and summary pieces on this linked to below:

• How Science and Genetics are Reshaping the Race Debate of the 21st Century
• What Happens When Geneticists Talk Sloppily About Race
• Race Is a Social Construct, Scientists Argue
• Race is Real, but it’s not Genetic
  
  

Why are you only talking about racial inclusion and not considering other protected characteristics?

Although this work grew out of the BMA Charter’s focus on prevention of racial harassment and discrimination, it would clearly be antithetical to be working towards racial inclusion whilst excluding other aspects of diversity! Thus, MedRACE’s work – and racially inclusive principles, and this toolkit – apply not just to the nine legally protected characteristics but to a consideration, inclusion and celebration of cultural diversity more generally.