Lack of diversity in the medical curriculum as a cause of worse heath outcomes for BME patients

https://www.bbc.co.uk/news/av/world-africa-60330395 https://www.england.nhs.uk/2021/07/nhs-workforce-more-diverse-than-any-point-in-its-history-as-health-service-commits-to-more-action-on-representation/#:~:text=New%20data%20published%20as%20part,rise%20of%20around%20one%2Dfifth%2C https://www.bmj.com/content/369/bmj.m2303/rr-1 https://www.sgul.ac.uk/news/mind-the-gap-a-handbook-of-clinical-signs-on-black-and-brown-skin

The NHS is more diverse than any other point in history with 42% of medical staff working in the NHS being from a BME background (2021), yet the medical school curriculum has not followed a similar trend. When looking at the deaths caused by COVID-19, BME communities have been disproportionately affected when compared to white suffers of the disease, with many attributing it to the lack of diversity in teaching within UK medical schools, which propagates racial inequality within healthcare provision. This month’s behind the headlines addresses BME representation in medical school and textbooks. This issue that has been resurfaced by recent headlines has in fact been raised decades prior, yet nothing has really been done to implement change. An American study has shown that skin tones represented in medical textbooks were 74.5% light, 21% medium and 4.5% dark, which does not reflect the American population where 62.5% are white and 37.5% are people of colour. The medical system has failed to educate medical students therefore on clinical signs and presentations seen in all ethnicities, which is particularly problematic in specialities such as dermatology. Lack of representation and diversity in medical textbooks is an issue recognised by both Nigerian Medical illustrator Chidiebere Ibe, whose drawing of a black fetus went viral online after teaching himself over lockdown how to draw the anatomy of darker skin tones, and Malone Mukwende, a medical student at St George’s medical school in London, who authored the book ‘Mind the Gap’ which acts as a handbook illustrating clinical signs on black and brown skin. Both understand that these are very important steps in the decolonisation of the medical curriculum and to address health care disparities within the UK and the wider medical field exacerbated during the COVID-19 pandemic seen when potential patients are asked whether they are ‘pale’ or have ‘blue’ lips, which do not act as useful descriptors on darker-skinned patients, leading to a compromise in their care from the first point of contact. Whilst the actions of these individuals is a step towards a more diverse medical school curriculum until universities act on this and together make this a standardisation across all medical schools within the UK as well as diversifying the teaching staff and doing more to widen access in medical school to those of varied backgrounds, doctors that go on to work for the NHS will lack the skills required to provide adequate care to the diverse population it serves.