Sunday, December 4, 2022
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Time to decolonise the curriculum for med students

Black second year medical student at St George’s University of London Malone Mukwende realised there was a gap in information when he was being taught how to diagnose skin conditions. It was a matter of black and white.

He felt alienated and worried that people with darker skin would not be diagnosed as a result of doctors failing to spot the signs of diseases on their bodies as they had not been trained to do so.

“On arrival at medical school I noticed a lack of teaching about darker skin. We were often taught to look for symptoms, such as rashes, in a way that I knew wouldn’t appear on my own skin,” he told the British Medical Journal.

St George’s University of London is recognised for medical and health sciences education, training and research. Mukwende is working with senior lecturer in Diversity and Medical Education Margot Turner and clinical lecturer in Clinical Skills Peter Tamony on a student-staff partnership project looking at clinical teaching on black and brown skins.

The project inspired Mukwende, in collaboration with Turner and Tamony, to write a handbook for doctors on how to diagnose potentially life-threatening diseases on black, Asian and minority ethnic people.

The university “agreed that this was a very important issue and an essential part of decolonizing the curriculum. They designed a booklet to raise awareness of how symptoms and signs can present differently on darker skin as well as highlighting the different language that needs to be used in descriptors.”

Entitled ‘Mind the Gap’, the aim of the publication is to “educate students and essential allied health care professionals on the importance of recognising that certain clinical signs do not present the same on darker skin. This is something which is not commonly practiced in medical textbooks as there is a ‘white skin bias’. It is important that we as future healthcare professionals are aware of these differences so that we don’t compromise our care for certain groups,” he said.

The book features side-by-side images that show how illnesses appear on light and dark skin, as well as information about which language is appropriate to use with patients.                         

“The booklet addresses many issues that have been further exacerbated during the COVID-19 pandemic, such as families being asked if potential COVID patients are ‘pale’ or if their lips ‘turned blue’. These are not useful descriptors for a black patient and, as a result, their care is compromised from the first point of contact. It is essential we begin to educate others so they are aware of such differences and the power of the clinical language we currently use,” Mukwende said.

With the support of St George’s ‘Mind the Gap’ will be released in the coming months.

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