Exploring the Complexity of Considering Race in the Practice of Medicine

In recent years, educators and clinicians have advocated moving away from race-based medicine toward race-conscious medicine. Yet, few studies have evaluated the impact of teaching preclerkship medical students skills to critically evaluate various frameworks for understanding the role of race in clinical decision-making. This educational innovation was designed to review various frameworks, prompt clinical evaluation, and evaluate how student perspectives were shaped by their learning.

We delivered a 90-minute interactive session focused on recognizing, appraising, and considering alternatives to the framework of race-based medicine. Ninety-two first-year medical students attended this mandatory session. Student opinions on how race should be used in medicine were measured via pre- and postsession Likert-style surveys (response rates 57% and 48%).

While most students initially thought race was a helpful marker of genetically associated disease risk, postsession responses shifted significantly (p = .039) toward neutrality or disagreement with this perspective. The presession survey showed varying perspectives on the use of race-based calculators and treatment guidelines. Postsession, the cohort shifted toward seeing these uses of race as more harmful than beneficial, with statistically significant perspective shifts on the use of race in estimated glomerular filtration rate calculation (p = .009), atherosclerotic cardiovascular disease risk calculation (p = .011), and treatment guidelines for hypertension and heart failure (p = .010).

This single session presentation led to increased concern regarding the use of race-based tools and guidelines in medicine. It supports the value of clinically relevant discussions of race and medicine with preclerkship medical students.