The death of George Floyd at the hands of police in 2020 sparked a national reckoning on the devastating toll of systemic racism in America. For students and faculty at Wake Forest School of Medicine, the events of that year were a call to action – to do more to embed justice into how we teach and practice medicine.
The drive to bring equity, advocacy, law, policy and honor more fully into the medical education experience grew into a multifaceted effort known as the justice thread. Today, the justice thread is delivering on this vision with initiatives that are helping students and the broader School of Medicine community integrate awareness of racial disparities into how we approach health and healing.
Agents of Change
In March of 1966, Rev. Martin Luther King Jr. proclaimed, “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.” It’s a sentiment that rings all too true more than half a century later, as racial minorities continue to suffer worse health outcomes and reduced access to care compared to white populations.
“Everyone deserves equitable care, and we need to be properly equipped to take care of all patients, no matter what their identity or background is,” said Amber Brooks, MD, associate professor of Anesthesiology and faculty co-director for the justice thread. “We have to prepare our next generation of physicians to be not only good physicians but agents of change within their community.”
Like the rest of the nation, the community served by Atrium Health Wake Forest Baptist is growing increasingly diverse in terms of race and ethnicity, gender, nationality and other factors. To address the needs of a more diverse population, it’s vital to understand how disparities, barriers to care, and history and attitudes may influence a person’s health and the relationship between doctor and patient.
"We have to prepare our next generation of physicians to be not only good physicians but agents of change within their community.” - Amber Brooks, MD
“As a physician, you are seeing the patient who is right in front of you, and you’re not always aware of the broader issues that are going on,” said Nancy Denizard-Thompson, MD, associate professor of General Internal Medicine, who co-leads the justice thread with Brooks. “Bringing these issues to light really helps us to improve our practice patterns to help different patient populations thrive.”
Focusing on justice, early and often
The justice thread complements and builds upon the School’s Longitudinal Health Equity Program, which partners with community organizations to help students examine how poverty and other social factors play into health. While that program starts in the third year of medical school, when students begin seeing patients, the justice thread aims to incorporate issues of equity into all four years of medical school.
“It is important to weave these topics into medical education early, to marry basic science with the realities of the lives of our patients,” said Denizard-Thompson, who directs the Longitudinal Health Equity Program. In its first two years, the justice thread’s five student designers worked with Brooks and Denizard-Thompson to host a lecture series on race in medicine and review course curricula with a goal of reducing bias and increasing awareness of health disparities.
“The ideas come directly from the students. They’re so knowledgeable in this area, and they’re the ones who are guiding the future directions for their medical education. I see my role as being a liaison to help catalyze action and turn their ideas into reality,” Brooks said.
The initiative’s four lectures held throughout 2020 and 2021 were well received and brought attention to how issues such as increased maternal mortality among Black women are impacting communities at the local and national scale. In the course reviews, the team identified opportunities to improve curricular materials, for example, by adding an example case for the Medicine and Patients in Society (MAPS) Course that emphasizes the intersectionality of racial injustice, social injustice and health inequity.
Student leaders also shared lessons from these efforts at a regional medical education conference last year. Looking ahead, Brooks says the team is working on developing a workshop on diversity, equity and inclusion and collaborating with colleagues at the University of South Florida to expand the race in medicine lecture series.
“For our learners, this is something that’s really part of their fabric. It’s been inspiring to see how they advocate and challenge the status quo and make us rethink how we need to practice medicine,” said Brooks. This student-driven advocacy has led more medical schools to approach issues around equity and justice as a required, integral part of medical education, rather than seeing these issues as “extras” or electives. As this evolution continues, Brooks adds, “My hope is that eventually we won’t need a justice thread, because this will become part of the way we think and practice in general.”