Patients are the heart of medicine. They play a pivotal role in medical education as vital liaisons between hospitals and homes. Equipped with the knowledge of what a diagnosis feels like, compounded with their life histories and first-hand experience as active participants within the medical system, their insight expands beyond what can be taught in any medical textbook.
Without the infusion of patient-centered learning in medical curricula, medical students are denied the opportunity to learn from the people they will be serving, a vital step in addressing health inequity and disparity.
While much of medicine is objective, it is centered around the subjective. Beyond finding a potential diagnosis, we must ask ourselves: How does the parent of a child with terminal cancer navigate life with their family? How is someone’s sense of self impacted when their hand shakes so much they can no longer feed themselves? How can we rebuild trust with the Black and brown communities the medical system has historically exploited? When I sit in the medical lecture hall for a patient presentation, I realize the stories patients share are irreplaceable.
Medicine helps us learn, but patients help us understand.
Providing a seat in the classroom for a patient to be an educator breaks down long-standing power dynamics of the physician-patient relationship by challenging the notion that patients do not have the skills or knowledge to uniquely contribute to their care. Patients are provided opportunities where they can express the difficulties they have faced while navigating the medical system.
As students, allowing patients to guide our practice helps us view patients as colleagues and cultivates the idea of medicine as a partnership. The medical stories weaved by patients in intimate and authentic discussions help anchor medical learning in students’ minds through connection, engagement and emotional and conceptual information sharing.
The intimacy and authenticity of these stories are illuminated by the fact that patients are not a homogenous group; they vary in their areas of expertise and experience. The interactions of patients with and within medical institutions and the manifestations of various illnesses are shaped by a multitude of cultural, religious and political influences. In a society where these institutions are outlined by structural racism and continue to perpetuate health inequities, the early exposure of medical students to appropriate diversity (encompassing sexual orientation, gender identity, religious beliefs, race, marital or parental status, differently-abled, age, culture, ethnic or national origin and socioeconomic status) encourages respect for different life histories. It instills confidence in communicating with and caring for various historically excluded groups. To learn from someone who holds similar identities to yourself is an opportunity; to learn from someone who holds differing identities is a gift. Celebrating diversity can turn diverse encounters into facilitators of empathy and curious growth.
As future healthcare providers, we will inevitably interact with various unique identities. Although the already heavy course load of many medical curriculums makes it challenging to prioritize educational sessions that do not directly correlate with exam content, we must engage with and learn from patient presentations. It is our duty to purposefully seek out this knowledge and respect it as authentic and valuable. The responsibility of continuing to ensure that diverse and intersectional patient voices exist within the classroom and are feasibly woven into a medical curriculum falls on academic institutions. As Audre Lorde writes:
“... and where the words of women are crying to be heard, we must each of us recognize our responsibility to seek those words out, to read them and share them and examine them in their pertinence to our lives. That we not hide behind the mockeries of separations that have been imposed upon us and which so often we accept as our own.”
I interpret her message as a call to uplift the voices that medical institutions have silenced and to challenge our silence as students. This type of diversity, equity and inclusion work should be protected by the state — its omission would be a disservice to the communities our national healthcare systems claim to serve.
Including diverse patients in medical education is a valuable proponent of social justice and solidarity. No career is absolved from the need to rewrite stereotypical narratives and — most importantly — the path to equitable care is complicated and sometimes necessitates sitting in the uncomfortable. It requires active participation, learning and unlearning from all.
Sanila Math
Sanila Math received her bachelor’s degrees in anthropology and ethnic studies from the University of Utah and is now a 2nd-year medical student at the University of Utah School of Medicine. She is passionate about advocacy and health care access. Her favorite part of her career is learning about and interacting with people, and in her free time, she enjoys spending time with friends and family, creating art and climbing.
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