The Importance of Discussing the History of Racism in Medical Student Education.

Racial health disparities are tightly linked to the longstanding and pervasive institution of racism. Efforts to reverse disparities begin with awareness and accountability through education. The health care workforce must be formally educated about racist practices, tools, and ideologies that perpetuate poor health outcomes. This article explores prior efforts to integrate race didactics into medical school education, addresses current legislation, and illuminates lessons learned from a single institution pilot curriculum exploring the history of racism in the field of obstetrics and gynecology. Educating medical school students about the history of racism is an important and necessary tool for positive change.

History of development of undergraduate public health education in Bulgaria.

OBJECTIVE: The study aims to present a historical review and analysis of the establishment and development of undergraduate public health (PH) education in Bulgaria from 1878 until 2019. METHODS: А search and selection of historical documents was performed, including laws, rules, regulations, government plans, programmes, scientific publications from periodical medical press, journals, specialized monographs, and books. A retrospective analysis of the normative documents related to the organization of the sanitation and public health activities, and to the provision of professional undergraduate education of the public health workforce in Bulgaria has been carried out. The required competences and tasks of the specialists exercising public health control services were extracted. RESULTS: The development in the public health educational activities were followed in three consecutive periods: the newly independent state (1878-1944); the socialist state (1945-1990); the democratizing state (1990-2019). The development of organized PH activities began after the liberation of Bulgaria in 1878. The historical analysis reveals a direct link between the major socioeconomic changes in the country and the organization of PH undergraduate education which passed through dynamic transformations. The professional education in the sphere of PH started with the training of feldshers, followed by sanitary feldsher and sanitary health inspectors performed in secondary vocational medical schools during the socialist period, reaching the stage of undergraduate university PH education provided by medical colleges associated with universities in the third period. CONCLUSION: Despite the continuous development in the organization of undergraduate PH education in Bulgaria, its content is still not fully compatible with the basic European PH services and actions. There is a growing need for wider standardization and integration of undergraduate PH education in the EU so that the specialty can reach the status of a regulated health profession similar to medicine, nursing, and others.

Recent developments in undergraduate education in psychiatry in Japan.

The 2010 announcement by the Education Commission for Foreign Medical Graduates, related to accreditation by the World Federation for Medical Education, accelerated medical education reform in Japan. This article reviews reports on reforms undertaken in undergraduate medical education in psychiatry in Japan after 2010, and discusses resulting implications. While Japanese medical education has made significant progress, achieving global standards in less than a decade, there remain issues related to utilisation of active learning - inclusion of self-directed learning, problem-based learning, team-based and small group learning, and clinical training - as well as the provision of opportunities for students to be involved in certain medical procedures, and the integration of behavioural and social sciences, including communication skills, decision making, medical ethics, medical psychology, and general health promotion perspectives. These issues imply considerable paradigm shifts for psychiatry in Japan. It remains to be seen whether these progressive perspectives in undergraduate education can be effectively incorporated into postgraduate training, as well. There is also an issue of balance with specific important areas. The question of how undergraduate education in psychiatry in Japan can assimilate issues relevant to the practice of psychiatry in Japan, while ensuring conformity with high-level global standards, remains a serious challenge.

The clarion call for a third wave in medical education to optimise healthcare in the twenty-first century.

During the years preceding 1910, the education and training of physicians (doctors) -to-be was based mainly on a master-apprentice model; the primary focus then was on the teaching and development of clinical skills. In 1910, however, Abraham Flexner submitted a highly influential report to the American medical authorities: in it, he recommended that all medical schools should be university-based and that, importantly, medical practice should have a scientific basis strongly underpinned by the basic medical sciences. The recommendation provided the impetus for the design of medical education that begins with a pre-clinical phase to provide the strong scientific foundation for the clinical phase that follows. During the clinical phase, student learning will focus primarily on the clinical sciences relating to the diagnosis, treatment and management of patient care. Thus, two key 'pillars' (the basic sciences and the clinical sciences) of medical education were established; this two pillar model of medical education persisted for many decades thereafter and remained so till today. However, in order to optimise delivery of health care this must be viewed as an 'eco-system' taking into account the practice setting both present and future. The authors will attempt to provide a background to the changing trends in medical education and the changing practice environment, due primarily to the disruptive forces of change in this article.

10-year review of Africa's first student surgical society - UCT Surgical Society.

The UCT Student Surgical Society is an undergraduate surgical society based at the University of Cape Town (UCT) which aims to promote surgical education amongst medical students early in their medical careers. Founded in 2006, this was Africa's first student surgical society and has been joined by other medical schools in Africa also establishing their own undergraduate student surgical societies. In this review of the first 10 years of the society, we describe its objectives, its evolution and its international role.

Reform in teaching preclinical pathophysiology.

Pathophysiology is a scientific discipline that studies the onset and progression of pathological conditions and diseases, and pathophysiology is one of the core courses in most preclinical medical curricula. In China, most medical schools house a Department of Pathophysiology, in contrast to medical schools in many developed countries. The staff in Chinese Departments of Pathophysiology generally consists of full-time instructors or lecturers who teach medical students. These lecturers are sometimes lacking in clinic knowledge and experiences. To overcome this, in recent years, we have been trying to bring new trends in teaching pathophysiology into our curriculum. Our purpose in writing this article was to share our experiences with our colleagues and peers worldwide in the hope that the insights we have gained in pathophysiology teaching will be of some value to educators who advocate teaching reform in medical schools.

[Computer technologies in teaching pathological anatomy].

The paper gives experience with personal computers used at the Academician A.L. Strukov Department of Pathological Anatomy for more than 20 years. It shows the objective necessity of introducing computer technologies at all stages of acquiring skills in anatomical pathology, including lectures, students' free work, test check, etc.

A short history of providing medical history within the British medical undergraduate curriculum.

This article aims to discuss the history of medical history in the British medical undergraduate curriculum and it reviews the main characters and organisations that have attempted to earn it a place in the curriculum. It also reviews the arguments for and against the study of the subject that have been used over the last 160 years.

Dissecting the doctor: from character to characteristics in North American medical education.

Medical educators develop student selection criteria and design curricula based on underlying assumptions about who is best suited to the profession and how these learners should be taught. Often these assumptions are not made explicit but instead are embedded in the words and phrases used to describe trainees and curricula. They may then be considered inevitable, rather than being seen as particular social constructs. Using Foucauldian critical discourse analysis methodology, the authors examined a major shift in language in the late 1950s in North American medical education texts. The discourse of the good doctor as a man of character, which had been present since the 1910 Flexner Report, was replaced by a new discourse of characteristics. Analysis of this sudden discursive shift shows a change in thinking about the medical trainee and learning environment from a personal journey of discovery to a dissectible set of component parts that could be individually measured and manipulated. Understanding the discursive effects of language that we use will allow medical educators greater insight into the implications and consequences of different constructions of important issues in medical education.

"No struggle, no fight, no court battle": the 1948 desegregation of the University of Arkansas School of Medicine.

In 1948, over 30 percent of the approved medical schools in the United States excluded black students. However, on September 10, 1948, the University of Arkansas School of Medicine became the first Southern medical school to desegregate when Edith Mae Irby matriculated. Her admission occurred without incident. There were no jeering white mobs, no court action, and no federal troops. Irby's admission had its roots in a successful legal campaign launched by the National Association for the Advancement of Colored People to eradicate racial inequalities in professional and graduate education. A confluence of factors led the University of Arkansas to desegregate. These included the state's lack of the financial resources necessary to comply with U.S. Supreme Court decisions, a climate of racial moderation in Arkansas, shrewd political maneuvering by officials at the University of Arkansas, and Irby's academic accomplishments. Irby's historic admission is frequently overlooked as a historical milestone. Its invisibility is due in part to its sharp contrast to the dominant narratives of school desegregation in the South. Yet, the story of Irby's entrance into medical school is critical for a more complete understanding of the history of medical education and the civil rights movement.

Feminization of Canadian medicine: voices from the second wave.

In 2009 a Globe and Mail pundit claimed that the current doctor shortage stems from increasing numbers of women in medicine. This opinion is widely held, despite articulate opposition from medical deans who characterized it as a new variant of the old "sexist blame game" (CMAJ 2008). In this ambivalent climate, we interviewed 10 women who entered the Canadian profession between 1945 and 1960, when strict limits on female students were established in most schools. Using semi-structured, in-person and telephone interviews, we found that they worked as much as their male colleagues. Several also raised three to five children; and negotiation of the domestic sphere usually fell to them. Most worked past age 65, and two are still working well into their eighties. Our findings will be set in the context of the existing literature on women in medicine. We will also examine the results of surveys on physicians' working hours, in which all specialties show a decline, including those that have not been feminized. We conclude that the women who entered the profession between 1945 and 1960 did not contribute to the current doctor shortage.

The contribution to our understanding of spinal disorders by the great Windmill Street School of Anatomy.

STUDY DESIGN: This is a review article. OBJECTIVES: The aim of this study is to investigate the contribution of the private school of anatomy, the Great Windmill Street School, in our understanding of the physiology, anatomy and pathology of the spine and spinal cord and its role in the treatment of spinal diseases in the eighteenth century. Much has been written about the Hunter brothers and Sir Charles Bell and their contribution to anatomy and medical teaching but the significant role of the Great Windmill Street School of Anatomy in our understanding of the spinal cord and the treatment of spinal disorders had not been previously explored. SETTING: Wendover, UK. METHODS: Review of the literature. RESULTS: Not applicable. CONCLUSION: The Great Windmill Street School of Anatomy was unique and fundamental in our understanding of the spine and the spinal cord and the treatment of spinal diseases. What is remarkable is that this work emanated from a private school and not a hospital or a university and it allowed an outstanding school of surgeons and physicians to carry out their work unfettered.

Undergraduate medical education in Nigeria: current standard and the need for advancement.

The post-independence era in Nigeria ushered in an array of fundamental structuring and development in all sectors of the Nigerian economy including medical education and training. This era saw the establishment of medical schools across the country which mirrored the medical curriculum of British universities. This paper dives into the general structure of undergraduate medical education in Nigeria, its historical background and how it compares with neighboring and distant countries. Since the undergraduate medical education curriculum has not seen significant modifications since conception, this paper presents the challenges of the existent structure to include biased admission process, emphasis on irrelevant pre-medical courses, paucity of of technologically-advanced teaching and learning aids, increased workloads of lecturers amongst others. Importantly, solutions and recommendations are prescribed in this paper, which if considered, may improve undergraduate medical training in Nigeria, and ultimately improve the standard of healthcare service provision in the country.

A historical perspective on training students to create standardized maps of novel brain structure: Newly-uncovered resonances between past and present research-based neuroanatomy curricula.

Recent efforts to reform postsecondary STEM education in the U.S. have resulted in the creation of course-based undergraduate research experiences (CUREs), which, among other outcomes, have successfully retained freshmen in their chosen STEM majors and provided them with a greater sense of identity as scientists by enabling them to experience how research is conducted in a laboratory setting. In 2014, we launched our own laboratory-based CURE, Brain Mapping & Connectomics (BMC). Now in its seventh year, BMC trains University of Texas at El Paso (UTEP) undergraduates to identify and label neuron populations in the rat brain, analyze their cytoarchitecture, and draw their detailed chemoarchitecture onto standardized rat brain atlas maps in stereotaxic space. Significantly, some BMC students produce atlas drawings derived from their coursework or from further independent study after the course that are being presented and/or published in the scientific literature. These maps should prove useful to neuroscientists seeking to experimentally target elusive neuron populations. Here, we review the procedures taught in BMC that have empowered students to learn about the scientific process. We contextualize our efforts with those similarly carried out over a century ago to reform U.S. medical education. Notably, we have uncovered historical records that highlight interesting resonances between our curriculum and that created at the Johns Hopkins University Medical School (JHUMS) in the 1890s. Although the two programs are over a century apart and were created for students of differing career levels, many aspects between them are strikingly similar, including the unique atlas-based brain mapping methods they encouraged students to learn. A notable example of these efforts was the brain atlas maps published by Florence Sabin, a JHUMS student who later became the first woman to be elected to the U.S. National Academy of Sciences. We conclude by discussing how the revitalization of century-old methods and their dissemination to the next generation of scientists in BMC not only provides student benefit and academic development, but also acts to preserve what are increasingly becoming "lost arts" critical for advancing neuroscience - brain histology, cytoarchitectonics, and atlas-based mapping of novel brain structure.

Personal statement: reflections on Dr. Richard F. Bakemeier's impact on cancer education.

This study presents the reflections on the role and impact that Dr. Richard F. Bakemeier has had and continues to have on the field of cancer education, the training of medical students, and the careers of cancer educators.