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In one of our first few meetings for the Diversity Council (DC), our first faculty advisor, Dr. Braciale, told us she would write a course proposal.  The idea was simple; have every teacher do one to two hours of lecture a semester on their own lecture material having to do with health disparities and/or cultural competency.  You can read the actual course proposal here (click here) but know that the idea was a 10 year old one we borrowed from the AAMC (Association of American Medical Colleges, click here).  Also, you may want to know that there are certain states which dictate that this must be taught in their medical schools (such as New York) as well as the LCME (the folks who accredit a medical school in the US) and the ACGME (folks who accredit residency programs) request or require cultural competency be taught/understood.  Furthermore, you should know that AUC spends approximately 4 hours or less talking a mixture of issues, one of which is cultural competency.

When dave, joe, mike, chanell and myself learned all this, we were shocked.  We had been talking for some time about our frustrations with the curriculum and how health disparities in the US and Canada were ignored.  What was disturbing was that many of our colleagues didn’t even know there were health disparities, and to make matters worse, our teachers were propagating an ideology that biology and genetics are a significant factor/cause.  Thing is most US institutions place high importance on health disparities and know that such ideologies are totally untrue, “Current information about the biologic and genetic characteristics of minority and underserved populations does not explain the health disparities experienced by these groups” (CDC, Office of Minority Health Disparities).

Knowing all this we were ecstatic to hear about Dr. Braciale’s course proposal.  However, there were some within the Diversity Council who worried we were moving to fast.  So I tried to go to all the teachers and get their support for the proposal before Dr. Braciale presented it to the monthly Teacher Meeting.  Unfortunately, the proposal was shot down anyhow.  Complaints from teachers included, “We don’t have enough time”, “It’s not that important”, “I can’t teach this and I am not qualified to teach this.”  Furthermore, the Behavioral Department chair, Dr. Johnson, walked into Dr. Braciales office and dropped the Behavioral Course syllabus onto her office before walking out.  Behavioral science has one lecture, depending on the semester, for 50 minutes devoted to this subject.  Afterwards I was told to be careful and not step on “anyones toes” or that people have “long toes” at AUC.

Not one to give up, I tried to write a proposal after my term as president of the Diversity Council was up.  During my time as President I had found that Dr. Johnson had wrote a similar proposal to Dr. Braciale’s years back.  I spoke with her a few times on the subject matter and she told me that other Caribbean schools had such a course.  I looked at other Caribbean medical schools such as Ross and SGU and found they had specific courses for this subject matter.  One of which was called Doctor, Patient and Society.  I modeled my course off it (click here to read about it) with the fundamental focus on health disparities and Culture Competency.  The problem was I needed a Course director; someone who would teach the course, write the syllabus and pitch it to the curriculum committee/administration.  I tried Dr. Johnson.  She said that she didn’t really want to but that she would co-direct the proposal.  I asked Dr. Braciale if she would co-direct with Dr. Johnson such a course.  She said sure.  A short time later Dr. Johnson tells me she does not want to do the course.  I decided that I would get all the teachers I had spoken too together and see once and for all if anyone would chair my course.  I asked Dr. Johnson to organize such a meeting briefly between classes and she tells me that, “Yes, well, I think we should take this off your shoulders.”  I thought nothing of it but a short time later I was told that I was being to aggressive.  Dr. Johnson had requested to meet Dr. Testa and Dr. Braciale about me and my course proposal so that everyone was on the same page when she told me no.

Then came my last two semesters and I met our Medical Ethics teacher Dr. Edwards.  I spoke with her about my course proposal and Dr. Braciale’s and she said that she wanted to teach such a course.  She said that she would write a syllabus and get back to back to me and my colleagues who were working on the proposal (myself, kyle, gundi, jessica – they helped write both of my course proposals).  We gave her a bunch of ideas for the syllabus and course which you can read here.  More than anything we wanted this course to be the course where everything AUC didn’t teach was finally being taught.  Tragically, however, a family member of Dr. Edward’s died.  She had to drop everything and I know I would have done the same had I been in her shoes.  I wish I had met Dr. Edwards sooner.

When I left AUC, after all the efforts my colleagues and I made, student opinion had changed.  I remember sitting in class and watching peers of my semester go back and forth with teachers on cultural competency.  It was a good feeling, knowing that my arguments did not fall on deaf ears.  But then the hate crime happened and I watched people’s reactions and my doubts grew.  I realized that the newer semesters had no clue about cultural competency and health disparities.  Also, that only one or two organizations were continuing the discussion, half heartily, on cultural competency.

Remember though that on the heels of the hate crime incident the school has promised a new pilot course for May 2011.  I for one hope they come thru.

What do you think???

It was after class when the other founders of the DC (Diversity Council) and I got together to take over lecture hall 1.  We sat on the stage and began formulating our first plan of what we needed to do.  In essence, we wanted to change the school so that we felt more welcome, less alienated and less at odds.  Some of us had dealt with the school and were frustrated by the amount a bureaucracy enjoyed by a small school in the Caribbean.  To us, the most important characteristics for a doctor were respect and open-mindedness.  Few seemed to agree with us though and even fewer were willing to do anything about it.  However, for me, I realized how desperately AUC needed to change during my second semester in a lecture for Introduction to Clinical Medicine:

Imagine watching a teaching video where the point of the video is to teach students not to be a jerk to your patient, not to be dismissive and to truly listen.  The scene plays out where the young doctor is totally out of line with his older black patient and is condescending.  Now picture everyone laughing; laughing at what the patient is saying.  My colleagues were laughing at how the patient spoke, his accent and his phrases.  They were laughing because he was speaking in slang and apparently that is hilarious.

Another video clip we saw later that lecture, or the next I cannot remember, was about being respectful of different cultures/practices (aka cultural competency).  Again, students had a similar reaction to that of the first clip.  The clip starts off with a nurse complaining about how patients are doing the work of the “devil” and how the doctor must stop it.  They, the nurse, doctor and coworkers, go off to see what is afoot but before doing so speak to the patients daughter waiting at the patients door.  She tells them they are doing a Native American ritual and it will pose no medical problem to the patient, her father.  Regardless, the doctor looks in on the ritual briefly and comes out of the room.  He tells the nurse that it is nothing and that all is well.  The clip ends and the teacher changes topic while students behind me are saying, “God damned injuns,” laughter, “Yeh, like we’re going to see one of those”, more laughter.

It should go without saying that AUC is not the only medical school which suffers from this type of ignorance.  However, unlike a good number of American schools which have entire courses dedicated to this subject matter and certain states that dictate how “cultural competency” must be taught, AUC sprinkles the subject matter tangentially into its curriculum for a sum total of approximately 4 hours.  Furthermore, few teachers are willing to even teach on the matter let alone talk about it.  Issues of race, gender, culture, etc are like the black sheep of the AUC curriculum.  But instead of totally ignoring the issue, AUC’s administration and advertisers boast that AUC has a diverse student body and thus, is culturally competent.  If you don’t believe me, read the sign outside Dr. Yoshida’s office.

Now perhaps such ignorance has lessened or disapeared, or at least I hope it has, but I firmly believe that my colleagues and I played a part in the school’s progress.  When we first met together (me, dave, joe, mike and chanell) we wanted to change how the university and its students looked at ‘different’ and educate people to the health disparities our countries and communities have faced or will face.  Over the course of our inception we wrote two different course proposals, bought a movie series to educate students, started Culture Week and more.  We did this all without any support from the school or its administration.  However, as already mentioned, there were quite a lot of road bumps.  No one had started an organization for years at AUC, no one felt more organizations were needed, and no one knew how to start an organization.  It should be noted that Dr. Testa told me he did not know how to start another organization but months later he told Mike and Allison how to do so (they started BGLAM – Bisexuals, Gays, Lesbians and Allies in Medicine).

In the face of these obstacles we decided on a three pronged plan; assess the student body’s view, get the word out about our new organization and build a coalition of support for the DC.  So we made a survey, passed out strips of paper in classes and in the rotunda (main part of the AUC campus) and I proceeded to meet with all the heads of the different organizations.  We approached the organizations already devoted to celebrating culture or religion such as SNMA (Student National Medical Association), MSA (Muslim Student Association), JMSA (Jewish Medical Student Association), IAPMSO (Inter-Asian Pacific Medical Student Organization, now ASMA), and CMDA (Christian Medical Dental Association).  All of them joined right away except CMDA who had reservations of a political nature.  After this we approached AMSA, AMWA and the honor society, all of which joined.  AMWA later pulled out before the first culture week/talent show because the DC was not in their best interests at the time.  AMSA joined after the first culture week.

The organizations joined because they wanted to work together, they wanted to be part of something bigger and we were all tired of SGA (the student government).  Organizations were angry about the money dispursements, how the richer organizations always got extra money, and how real issues at SGA were always tabled because Dr. Testa or whomever found the idea too dangerous.  Essentially, people felt like SGA was no longer worth their time.  As one teacher put it, “SGA is perhaps the most powerful tool students have and it is definitely muzzled, spade and neutered”.

As we collected surverys and we began to see such trends in our classes, we also quickly found that we weren’t going to get any support from SGA or the administration.  It was about this time that an idea of mine was seriously considered.  My idea was to have the DC also serve as an answer to the SGA’s corruption.  I felt that perhaps the DC could serve as another Student Government branch and/or replace the SGA.  Unfortunately, things didn’t work out that way.

But what do YOU think??  Does the SGA work as it is supposed to??  Should schools put their money where their mouth is when they teach concepts like “professionalism”??

Dear Readers,

I just finished writing most of the posts I am going to put up for this year and perhaps ever. They still need some editing but I will get them out soon enough. So don’t forget to keep checking on the site over the next few days.

Also, in other news, I will be adding another student story soon named “Practice What you Preach” and I will be adding a new tab called projects/great ideas, for all the projects/ideas I have worked on or were not able to.

Most importantly, enjoy your holiday(s) and may you be at peace,

MD C

Dear Reader,

Although I am on a Study break and on vacation from writing, I want to share the highlights of whats happened so far at AUC (American University of the Caribbean).  Most importantly, I want people to know that my posts often need to be read in a certain order, which I will be putting up below.  Also, from now on at the bottom of most of my posts I will have a link to the related posts before and after it.

Hate Crime Incident

1. It’s Not Safe at AUC

2. AUC’s Response to Hate Crime and the Logical Question

3. Final Products – Check it Out

4. Big Meeting Tomorrow

5. October Secret Meeting

6. Abusing American Medical Students in the Name of Business

Lesser Known Truths @ AUC

1. Living without Fear, Regrets and Secret Insurance Deals

2. Taking Everything for Granted

Student Stories

1. A Call for Transparency

2. So you have Asthma

Don’t forget to keep me in mind this Friday when I am destroying my comprehensive exam.  Any positive thoughts or prayers would be much appreciated!

May you be at peace,

MD C.

Picture Courtesy of cartoonstock.com

Dear Readers,

This is a public service announcement that your writer will be taking a break to kick his comprehensive exam next Friday.  Please keep this writer in your hearts and minds if you want this writer to pass his big exam that will free him of basic sciences and allow him to come back to the D and A2.

Tune in next week and I will have a new post for the “Student Stories” section about a student with good grades who was kicked out of school.  Plus, I have a great deal of new posts to share including one explaining why the American University of the Caribbean (AUC) was scared of new student organizations like the Diversity Council.

In the meantime, feel free to come by, check stuff out and leave a comment.

Most importantly, please pray/meditate for the family and loved ones of the AUC 2nd semester student who lost their life recently.

May you be at Peace,

MD C.

Image from http://rivertext.smugmug.com

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Purpose of this Blog

This blog is an account of past and present struggles at the American University of the Caribbean Medical School (AUC). My colleagues and I endeavored to make our Caribbean Medical School more progressive and supportive of all its students. We worked against an administration and student government to end marginalization of students and fight ignorance. When all was said and done, the administration at AUC claimed that they had single handily brought more diversity to AUC. It's time to share the whole story.

This is the story of those that fought for progress, stood up to AUC's administration/SGA and, just sometimes, won.

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