Commentary

AAMC Unveils DEI Manifesto for Medical Students

  • By Do No Harm Staff
  • March 7, 2024

The Association of American Medical Colleges (AAMC) unveiled a new ‘Advocacy Toolkit for Physicians in Training’ in a recent webinar, “Developing the Next Generation of Physicians as Policy Advocates to Advance Health Equity.” The webinar is an installment of the AAMC’s Inclusion, Diversity, Equity, and Anti-racism Learning Series (IDEAS), which aims to equip politically progressive members of the medical community with concrete strategies to inculcate ideology into their professional and academic institutions, as well as the medical field more broadly.

The webinar brought together a panel of physicians, residents, medical students, and community advocates to discuss the importance of political activism in the medical field and offer insight into how the AAMC’s new advocacy toolkit can be used in practice. The scope of both the panel and the toolkit is sweeping—according to the AAMC’s own description, “all policy is health policy.” While this perspective might be dismissed as a vague platitude, its implications are more insidious. Through this lens, racial and ethnic disparities in any segment of society translate into health inequities that can be framed with the unique urgency that policymakers and the public associate with public health crises. This kind of alarmism is misguided, as it delegitimizes genuine public health issues and distracts from the central mission of the medical community to provide high quality health care.

The panelists of AAMC’s IDEAS Learning Series, of course, disagree. According to one panelist, the physicians should leverage the respect they get from policymakers to advocate for broad policy change. Indeed, the panel discussion framed a doctor’s decision to deploy the social capital of their position for political purpose as a professional obligation, rather than a matter of personal and reputational discernment that should be used sparingly. The panelists failed to consider how over-politicizing the medical field could erode the confidence of policymakers and the public and prove short-sighted.

A key emphasis of AAMC is widespread and constant training for physicians and medical students to be effective advocates. This training takes many different forms. One panelist noted the importance of exposing medical students to legal studies. So-called ‘medical-legal partnerships’ offer students law clinics during their rotations.

Extracurricular trainings in political activism present little to worry about, but another panelist did not see trainings as optional. According to Dr. Olanrewaju Falusi, Children’s National Hospital includes advocacy as part of its written mission. The leadership of hospital mandates political advocacy from the top management down through the hospital’s residents. Activism is embedded into the curriculum of the residents, the priorities of faculty, the mentorship of fellows, and even bedside care. Politics encompasses every aspect of the hospital’s work.

The AAMC’s new advocacy toolkit is central to the organization’s vision for expanding curricula in political activism throughout the medical field. One panelist explored its potential impact in the classroom or during residency by offering an example from the toolkit that outlined a sample advocacy plan for a physician or resident working with the homeless population. Notably, the scenario did not offer a process by which the reader could create a plan that reflects their own beliefs; instead, the toolkit outlines specific policy positions that the individual should adopt and pursue advocacy toward. The toolkit fails to mention any of the research upon which its policy recommendations are based, relying on an understood acceptance of broad progressive policy frameworks. Consistent with the rest of the panel discussion, there was no mention of the potential for physicians promoting uninformed policy positions to jeopardize the reputation of the medical field.

Figure 1, From the AAMC’s “Advocacy Toolkit for Physicians in Training” (pg. 21).

The latest installment of the AAMC’s IDEAS Learning Series is a testament to the arrogance of their ideological position. Even discounting legitimate questions about the place of politics in the medical field in the first place, the AAMC further failed to offer a nuanced discussion free from political presumptions. Moreover, the AAMC’s advocacy toolkit serves more as a manifesto than as a resource guide.