Intended for healthcare professionals

Rapid response to:

Letters Stop racism to stop covid-19

Medical schools and other educational institutions need to tackle racism head on

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2746 (Published 13 July 2020) Cite this as: BMJ 2020;370:m2746

Rapid Response:

COVID-19 PANDEMIC, SOCIAL DISPARITIES AND MEDICAL EDUCATION REFORMATION: A REMINDER ON THE IMPERATIVE FOR ‘MEDICAL SOCIOECONOSOPHY (MSE)’

The ‘Global Fight’ against the ‘COVID-19 Pandemic’ is increasingly becoming a ‘Hydra-headed Fight’ with many evolving ‘Other Pandemics’ to be contended with: ‘Social Disparity Pandemic’, ‘COVID-19 Infodemic as a Pandemic’, ‘COVID-19 Research Waste Pandemic’ just to mention but a few! The ‘COVID-19 Pandemic’ has unveiled the ‘Systemic and Systematic Complexities and Importance’ of these ‘Other Pandemics’ throwing them up for ‘Urgent Global Attention and Interventions’ as ‘Winning the Fights’ may become possible ‘COVID-19 Pandemic Benefits’!! As it is said, every ‘Crisis’, indeed, comes with some ‘Benefits’!!! This ‘Communication’ focuses on an aspect of ‘Racism’ as a ‘Structural Social Disparity’ and as amplified by the ‘COVID-19 Pandemic’!!!

The ‘COVID-19 Pandemic and Structural Racism Conversation’ has directed ‘Global Attention’ to certain ‘Issues in the Works’: The ‘Differential Determinants of Health and Racism’, ‘COVID-19 Pandemic Presentations and Racism’, ‘COVID-19 Pandemic Priority Health Access and Racism’, ‘COVID-19 Pandemic Mortality and Racism’, ‘COVID-19 Pandemic Racial Disparities and Solution Approaches’ etc [1-6]! Recent ‘Communications’ have rekindled interest in ‘Medical Education Improvement and Reformation’ as the ‘Primordial Approach’ to solving ‘Health Disparities, Healthcare Access Inequalities and Racism’ [7,8]! It is suggested that ‘Systemic and Systematic Contents and Configuration of Teaching and Learning Resources’ are ‘Major Determinants’ of the ‘Racial Health Inequalities’! Most ‘Learning Resources Contents’ are ‘White Patients, Pictures, Illustrations, Data/ Numbers etc’!! Practising Doctors, therefore, have immense ‘Compromised Clinical Skills’ in the ‘Recognition, Analytics, Diagnostics and Therapeutics’ of ‘Non-White Patients’: ‘Blacks, Asians and Minor Ethnic (BAME) Populations’ [7]! These ‘Difficult Clinical Encounters’ ultimately contribute to ‘Unacceptable Differential Mortalities’ in these ‘BAME Populations’!! As a ‘Tantalizing Teaser’: Recognition of ‘Cyanosis, Erythema and Pallor’ in ‘White Patients’ in ‘Several Conventional Teaching and Learning Resources’ which have proportionately different ‘Skin Tones Represented’ (Light Skin 74.5%, Medium Skin 21% and Dark Skin 4.5%) [7]!!

Another ‘Communication’ highlights ‘Institutional Racism’ for addressing ‘Racial Inequalities’ and ‘Educated and Reflective Workforce on Racism’ [8]! The Norwich Medical School, as a ‘Case-in-Point’, is reported as having ‘Co-created Bystanders among Students and Staff’ to ‘Call Out for Rectification’ some possibilities, among several others: Biased Racism-denominated Training, Intentional and Unintentional Racist Behaviour, Microaggressions on Campus, During Placements etc [8]!! The ‘Academic Mentoring Scheme for BAME Medical Students’ is being implemented and other ‘Medical Schools’ are encouraged to emulate the ‘Medical School Interventional Approach’ to solving the ‘Structural Racial Disparities’ [8]!!! It is hoped that ‘Medical Doctors’ will be produced that will be ‘Competent and Prepared for Practice’ and also ‘Well-informed about Racism’!!!

The ‘Medical Education Reformation Approach’, with the ‘Basic Medical Education Curriculum (BMEC)’ Improvement Intervention, is also proposed for ‘Exploration and Evaluation’ in considering the ‘Primordial Formation and Production’ of ‘Medical Doctors’ that will be ‘Skilled and Knowledgeable in Medical Professionalism’ and ‘Fit-For-Purpose’ in the ‘Fight against Racism’ [9-11]! This involves the ‘Innovative Intervention’ with ‘Medical Socioeconosophy (MSE)’ in ‘Basic Medical Education Improvement (BMEI)!! The Bacronym ‘PRICE’ in ‘Medical Socioeconosophy (MSE)’ facilitates the ‘Introduction’ of ‘Racism’ as a ‘Non-Medical Academic Discipline (NMAD)’ for improving the ‘Interdisciplinarity Content’ of the ‘Basic Medical Education Curriculum (BMEC)’!! This ‘MSE Intervention’ also holds possible promise for impacting positively on Teaching, Research and Practice in ‘Medical Education Reformation’ with emphasis on ‘Racial Disparities and Health Inequalities’!!!

This ‘Communication’ is another ‘Contribution’ to the extant ‘Medical Education Reformation Approach Conversation’ to the ‘Global Fight’ against the ‘Racial Disparity Pandemic’ in these ‘COVID-19 Pandemic Trying Times’! This is a ‘Clarion Call and Reminder’ for ‘Medical Socioeconosophy (MSE)’ in ‘Basic Medical Education Improvement (BMEI)’ and ‘Medical Education Reformation’! Successfully ‘Addressing the Racial Disparity Pandemic’ may become a ‘COVID-19 Pandemic Positive’!!

REFERENCES
1. Adebowale V, Rao M. Racism in medicine: why equality matters to everyone. BMJ 2020; 368:m530
2. Douglass C, Fyfe M, Lokugamage AU. Structural racism in society and the covid-19 ‘stress test’. https://blogs.bmj.com/2020/06/08/structural-racism-in-society-and-the-co... of 8th June 2020
3. Covid-19: PHE has failed ethnic minorities; leaders tell BMJ. BMJ 2020; 369:m2264
4. Kmietowicz Z. NHS launches Race and Health Observatory after BMJ’s call to end inequalities. BMJ 2020; 369:m2191
5. Godlee F. Racism: the other pandemic. BMJ 2020; 369:2303
6. Eregie CO. COVID-19 pandemic tragic octad: The evolving conceptual qualitative interventional equation to fight the pandemic. https://www.bmj.com/content/369/bmj.m2303/rr-9 of 24th June 2020
7. Lynch CA. Diversifying medical education to represent BAME backgrounds. BMJ 2020; 370:m2745
8. Semlyen J, Hariharan B, Josiah B, Okongwu K, Quarshie LS, Rodrigues V. Medical schools and other institutions need to tackle racism head on. BMJ 2020; 370:m2746
9. Eregie CO. More Talk on the ‘Health Professional Associations-Industry Funding’; Conflicts of Interest are better avoided: A Proactive Role for ‘Medical Socioeconosophy. https://www.bmj.com/content/365/bmj.l2093/rr-3 of 22nd May 2019
10. Eregie CO. ‘’Fit-for-Purpose’ Medical Doctors in Today’s Globalized World: Further Imperative for ‘Medical Socioeconosophy’ in Basic Medical Education Improvement. https://www.bmj.com/content/366/bmj.l4997/rr-1 of 30th August 2019
11. Eregie CO. COVID-19 Pandemic and the ‘Determinant Nonad’: Rekindling the imperative of the twin medical reformation interventions of ‘Multiparameter-Based Medicine (MBM)’ and ‘Medical Socioeconosophy (MSE). https://www.bmj.com/content/369/bmj.m2379/rr of 7th July 2020

Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria and
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria.
UNICEF-Trained BFHI Master Trainer and ICDC-Trained in Code Implementation.
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria.
*No Competing Interests.

Competing interests: No competing interests

01 August 2020
CHARLES OSAYANDE EREGIE
MEDICAL DOCTOR
Professor of Child Health and Neonatology, University of Benin and Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria. Also, UNICEF-Trained BFHI Master Trainer and ICDC-Trained in Code Implementaion. Also a Technical Expert/ Consultant on FMOH-UNICEF-NAFDAC Project on Code Implementation in Nigeria
Institute of Child Health, College of Medical Sciences, University of Benin, Benin City, Nigeria.