Developing an Anti-Racism Tool Kit for Medical Education: A Pre-Clerkship Curriculum Audit

Racialized health inequities are poorly addressed in medical education, often presenting race without social context and perpetuating racialized biases. Reframing the understanding of race as a social construct and incorporating anti-racism education into medical curricula are essential to mitigate health inequities. Our study describes an anti-racism curriculum audit conducted for the University of Ottawa Undergraduate Medical Education pre-clerkship program. This audit informed the development of an anti-racism toolkit designed to serve as a systematic guide for medical schools undertaking curriculum reforms.

A comprehensive anti-racism curriculum audit was conducted on pre-clerkship curriculum content from May 2020 to August 2021. Content flagged for concern was categorized into 4 themes: insufficient representation of racialized populations, race-based generalizations, cultural insensitivities, and reinforcement of stereotypes.

The curriculum audit evaluated 772 course modules, completed by 18 medical students. A total of 224 (31.6%) modules contained one or more racial biases. The most prevalent concern was insufficient representation of racialized populations, identified in 145 flagged comments (55.1%). Curriculum content also perpetuated race-based generalizations (n = 75 flagged comments, 28.5%), racial stereotypes (n = 23 flagged comments, 8.8%), and cultural insensitivities (n = 20 flagged comments, 7.6%).

This anti-racism curriculum audit revealed a lack of diverse representation, alongside the persistence of race-based generalizations, stereotypes, and cultural insensitivities in a large proportion of the pre-clerkship curriculum. An anti-racist lens and curriculum are necessary to reduce bias in medical education and empower medical students to provide equitable care to the diverse Canadian patient population.