Health Justice Standards in Graduate Medical Education: Moving from Performative to Concrete Change

Abstract

Background: Inadequate support for underrepresented-in-medicine physicians, lack of physician knowledge about structural drivers of health, and biased patient care and research widen US health disparities. Despite stating the importance of health equity and diversity, national physician education organizations have not yet prioritized these goals.

Aim: To develop a comprehensive set of Health Justice Standards within our residency program to address structural drivers of inequity.

Setting: The J. Willis Hurst Internal Medicine Residency Program of Emory University is an academic internal medicine residency program located in Atlanta, Georgia.

Participants: This initiative was led by the resident-founded Churchwell Diversity and Inclusion Collective, modified by Emory IM leadership, and presented to Emory IM residents.

Program description: We used an iterative process to develop and implement these Standards and shared our progress with our coresidents to evaluate impact.

Program evaluation: In the year since their development, we have made demonstrable progress in each domain. Presentation of our work significantly correlated with increased resident interest in advocacy (p<0.001).

Discussion: A visionary, actionable health justice framework can be used to generate changes in residency programs' policies and should be developed on a national level.

Keywords: health equity; medical education; racism in medicine.