II.  Medical School Accreditation: Purpose and Vision


. .[T]he scientific blindspot to ethical issues that was responsible for the Tuskegee Study--what the [Atlanta] Constitution called “a moral astigmatism that saw these black sufferers simply as ‘subjects' in a study, not as human beings.”

Medical schools and graduate residency programs must meet minimum accreditation requirements including a cultural competency component. *167 Champaneria and Axtell note that:

Cultural perceptions of illness have been reported to influence health-seeking behaviors, patient-physician communication, and health outcomes. Recent changes in US demographics have underscored the demand for cultural awareness in clinical settings, as the current minority population in the United States is projected to exceed 50% by 2056. The percentage of minority physicians and medical students, however, has not been increasing proportionately. Medical schools have responded in part with 2 broad strategies: cultural immersion programs and cultural competence curricula. The former typically include either a clinical rotation in another country or a more local experience with native communities. In 2002, 38% of US medical students participated in international electives, compared with 6% in 1982. By contrast, cultural competence curricula use case-based, small-group formats to explore the core cultural issues and health beliefs of various ethnic groups, complementary and alternative medicine, language barriers, substance abuse, racism, and cross-cultural interviewing skills. Such curricula also include role play, panel discussions with patient advocates and interpreters, and simulated encounters.

Focus should be drawn to the significance of contextualizing the cultural competence curricula in order to satisfy accreditation mandates. Medical accreditation standards can serve as a tool to ensure that undergraduate and graduate medical education addresses salient issues surrounding the intersection of gender and race in the Tuskegee Syphilis Study, specifically via cultural competence curriculum content. William C. McGaghie notes that, “[t]he sad history of medicine's contribution to the legacy of racism in America from ignoring slavery to exclusionary medical school admission policies to the Tuskegee syphilis study scandal and beyond [is well documented].

*168 Medical education's failure to teach about the biomedical significance of the Tuskegee Syphilis Study as it relates to the historical omission of women impacted by the study inherently impairs its ability to satisfy current cultural competence accreditation standards. The fact is, “[k]nowing the truth about our history will help to free us from the beliefs and attitudes about human differences that were deeply embedded in our culture with the invention of ‘race’ and ‘races.” ‘ The process of accreditation is designed to promote quality assurance in postsecondary education. It fosters institutional and program improvement. The improvement of medical education through cultural competency mandates the acknowledgement of “the point of view of women of color bodies and experiences with interfacing with the healthcare system of the past and present.”