Each month, Social Mission Alliance (SMA) highlights important work done by our allies.
This month, we spoke with third-year medical students from the Icahn School of Medicine at Mount Sinai in New York City, Adriana Pero and Emily Xu. They recently authored an article published in the AMA Journal of Ethics, called Is It Reasonable to Expect Students and Trainees to Internalize Equity as a Core Professional Value When Teaching and Learning Occurs in Segregated Settings?
Their article talks about segregation in healthcare, and how it is perpetuated through medical professions education.
We asked Pero and Xu to tell us more about their article, how to balance service-learning in medical education, their experience with activism, and how other students can get involved in the movement to desegregate healthcare.
Q: What inspired you to write your article on segregated settings in medical education?
“We felt like this was the area we had the most direct experience with and were best able to comment on as preclinical medical students. As students, we are often made to feel like we have the least amount of power and are at the bottom of the medical hierarchy, and we wanted to draw attention to the power we do have to push for change. We targeted segregated care in medical education because what we learn at the beginning of our training will shape us as the next generation of physicians, and we wanted to draw attention to the way education replicates bias.”
In their article, Pero and Xu highlighted how the segregated environments in medical education can appear, and how this contributes to the formation of bias in the minds of medical professionals:
“The assumption of ‘separate-but-equal’ treatment is ubiquitous in medical training. For example, some medical schools continue to attract applicants with opportunities to participate in student-run free clinics that primarily rely on Black and Brown bodies for student learning.”(Excerpt from article)
Q: How can schools balance service-learning opportunities, while also ensuring they are not adding to the segregation of health care?
“The problematic aspects of student-run free clinics revolve around treating the clinic as a learning opportunity for students and treating patients as learning objects. Encouraging these clinics as early clinical exposure normalizes the problematic notion that Black and Brown patients are for student learning.
The ways to balance service-learning with mitigating negative aspects involves centering patient care and well-being above all else, including and especially student learning. Students should never be able to do things beyond their training, including physical exam maneuvers, blood draws, and specialty care. Instead of medical care, the clinic could focus more on providing social support, which often has a huge impact on patient health. Student-run clinics can help patients access and navigate the healthcare system that otherwise would have been entirely excluded. Patient feedback can also be incorporated into the clinic to make it more of a partnership as opposed to students imposing what they think patients need. It is important to recognize that the patients seen at student-clinics are there because they are intentionally excluded from the traditional healthcare system. Student-run clinics should incorporate advocacy for policies to desegregate care and include their patients in the larger healthcare system.”
As activists working to fight against segregation in medical professions education, Pero and Xu helped found a coalition of medical trainees called New York City Against Segregated Healthcare.
Q: Tell us about New York City Against Segregated Healthcare. How did it get started, what are some highlights from your experiences, and how can others get involved?
“We began in 2021 as a group of medical students addressing segregated healthcare at our individual institutions. We acknowledged that segregated care cannot be fixed by an individual approach and that we could create stronger actions and have a larger impact as a coalition. As we started connecting with other trainees at academic medical centers across NYC, we found that a lot of our experiences were very similar and realized that we could learn from and support each other.
Our work centers around activism to end segregated healthcare in New York. Our activism has taken the form of teach-ins, phone banks, twitter storms, and petitions. The goal of our actions is to confront the systemic racism ingrained in our healthcare system leading to segregated care. We advocate for the desegregation of healthcare at the hospital level as well as the city and state level. Although our main goal is tackling segregated care in academic medical centers, this issue is interconnected with other forms of systemic racism in healthcare, such as unjust hospital closures.
We welcome all new voices and ideas of how we can get closer to achieving our goal of a desegregated, equitable, and just healthcare system. Learn more about our work on our website https://www.nycsegcare.com/ and get in touch email@example.com.
Q: What advice do you have for other student activists wanting to desegregate the healthcare system?
“Our biggest piece of advice is to build coalitions with other trainees and find solidarity with other healthcare workers, patients, and grassroots organizers. It is important to share experiences to affirm that when we as trainees observe patient and team actions that don’t feel right, it probably isn’t right.”
SMA would like to thank Adriana Pero and Emily Xu for taking the time to talk with us, and for their commitment to social mission.