Conscientious consumers of preventative care might want to go ahead and schedule that check-up now before the fashionable racial essentialism that seems to be overtaking almost every American institution succeeds in capturing the medical establishment. A paper published last week in the New England Journal of Medicine suggests that your practitioner may soon be less interested in your wellness than in decolonizing your colon.
The paper authored by seven physicians meditates on how “racial affinity groups” in medical education can advance “anti-racism curricula,” and it posits the dissonant idea that combatting racism in health care can be achieved through racial segregation. The study does not read like the work of clinicians. It reads like a Diversity, Equity, and Inclusion seminar. The authors’ foremost concern seems to have been displaying the ability to employ the jargon native to identity-studies departments in undergraduate campuses rather than lingua franca of, you know, medical professionals.
The paper begins its opening sentence with the dubious supposition that “racially disparate health outcomes” are attributable to racism. It posits that “traditional approaches to medical education” are “founded in inequitable systems.” To remedy this shortcoming, the physicians recommend “racial affinity group caucuses,” in which participants are “grouped according to self-identified racial or ethnic identity,” to integrate “antiracism curricula into clinical practice.”
The paper’s first paragraph continues along these incomprehensible lines:
Used as part of a broader antiracism and antioppression [sic] curriculum, racial affinity group caucusing engages participants in critical introspection through the lens of their own racialized experience and enhances learning by building community and encouraging praxis, the integration of theory, self-reflection, and action. Such caucusing, which some Indigenous scholars believe derives from an Algonquin term meaning a group gathering for wise counsel, involves a thoughtful and purposeful approach to dialogue.
You don’t need a medical degree to evaluate this initial supposition because it has nothing to do with medical expertise. Its authors certainly don’t rely on clinical evidence to buttress their arguments. Of the five references in the article, the opening paragraph cites three – two of which link to the work of social scientists laboring in pedagogical academia.
“Founded on legacies of colonialism and racism,” the paper continues credulously, “medical education has historically centered White learners and continues to perpetuate structural racism.” Educators may not know they’re universally guilty of ignoring the “differential impact” of medical education on those with “personal experiences of racism,” but they are.
For minority students, in particular, immersive study can be “retraumatizing, resulting in imposter syndrome, heightened anxiety, or a reduced sense of belonging.” Indeed, studying any subject at a depth sufficient to achieve expertise could make any student of any ethnicity feel inadequate at times. That’s not a problem to be solved. It’s an inducement to commit further to one’s own education. Prospective medical professionals might feel better about themselves if they cloistered themselves alongside their similarly untrained peers, all of whom shared their accidents of birth. But I wouldn’t want the overconfident products of that sort of “education” to remove my spleen.
The paper makes one tendentious assertion after another without consideration for the falsifiability of its pronouncements. It posits that American minorities “have been socialized to care for the egos of White people” and to “tread lightly around ‘White Fragility,’” which limits their professional ambitions. It describes the outcome of experiments in which racially distinct affinity-group participants expressed “a full range of emotions,” which sounds cathartic but is also irrelevant. It sings the praises of how these groups buffer “participants from (often daily) experiences of micro- and macroaggressions” in the “isolating silos” of “predominantly White institutions.” Lastly, it concludes with a recommendation that tends to accompany so many DEI initiatives: the hiring and promotion of “facilitators” with a “keen awareness of how racism operates at all levels.”
In sum, racially segregated medical education in antiracist curricula may or may not produce better outcomes for patients, but it definitely makes students feel better about themselves. “In a space without White people,” the paper concludes, “BIPOC participants can bring their whole selves, heal from racial trauma together, and identify strategies for addressing structural racism.”
From a historical perspective, this sort of “science” is familiar. It’s of a piece with the Victorian “moral science” that Yale College president Noah Porter popularized, which presupposed that the instruments of vice undermine “a wholesome and most necessary discipline to the duties of good citizenship and of personal responsibility.” In its racialist elements, it harkens back to eugenicist philosophies and the art of phrenology. As special pleading on behalf of anti-racism consultants, it is something between emotional manipulation and an extortion racket. This paper is many things. What is not, and what it doesn’t even claim to be, is a contribution to the medical sciences. What it’s doing in the New England Journal of Medicine is anyone’s guess.