The short version
- Jonas Hildrum and Mohammed Almashhadani are calling for teaching about racism and discrimination in medical studies at the University of Oslo.
- They believe that the medical students should be better prepared for the racism they may encounter in professional life and that the faculty should have a notification system.
- The Faculty of Medicine at UiO agrees that racism must be taken seriously and is working to include it in teaching.
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He is supported by doctor Jonas Hildrum, who says that as a newly qualified doctor he immediately noticed that different groups of patients received different treatment.
– I was told that the pain of Somali women should not be taken so seriously, that they were in half as much pain as they expressed, says Hildrum to VG.
The statement is said to have come from a doctor Hildrum met on duty when he was a student. Because he was completely new to the profession, he was unsure how to react.
– In another context, a doctor used the N-word as the most natural thing in the world. Should I reprimand the person, who is then my superior? I missed a forum to address problematic behaviour, he says.
Hildrum finished his medical studies last year, and works at Akershus University Hospital. Together with Mohammed Almashhadani, a fourth-year medical student, they are now calling for more teaching about and focus on racism in the medical profession.
Unprepared when they come out
The two believe that the six-year medical course lacks lectures, courses, groups and discussions about racism.
– We are not prepared for the racism we will encounter when we get out. There are no people we can talk to about what we are experiencing, and no effective notification systems either. It is the same people who both teach you and who will give you a job. It is not easy to tell those above you in the system, Almashhadani points out.
During the six years the study lasts, they have little teaching about racism, the two believe. They believe that discrimination should be included in all the subject areas they learn about.
– We learn more about how a cancerous tumor looks under a microscope than how we treat different patient groups. I will not look under a microscope again, but I will constantly deal with different patient groups. Learning more about it is important, says Hildrum.
What is the problem?
– Our challenge is that we are not prepared for the racism we encounter when we go out. It can be from colleagues, superiors or patients, says Almashhadani.
Today, there is no effective system for who to talk to in order to deal with such situations, he believes.
Almashhadani himself has a background from Iraq and has been concerned with racism since he arrived as a refugee. He tells about stories from fellow students. About how prejudice strikes in meetings with people who have a different background, religion or appearance.
– The nurses have included this in their education for many years. Perhaps because they are more concerned with this issue when meeting with patients?
What is the reason?
The two believe that the reason for the lack of teaching and awareness of the subject is that those at the top of the system do not see racism as a problem at the medical faculty.
– It is not natural to look for a solution to something they do not think is a challenge, says Almashhadani.
Hildrum has not experienced being discriminated against, but thinks the attitudes he encounters in his professional life are problematic. Doctors are not aware of the power they have, he believes.
– I think we doctors like to think we are neutral, but of course we are not. Our background also influences our decisions. Therefore, we should have forums and discussions where we discuss attitudes, discrimination and health.
– Don’t you do it in your studies?
– There is a lot of fear in the medical faculty. Remember, it is the same people who lecture you, prepare you for exams and give you a job. It’s the goat that fits the oat sack. If you are perceived as a nuisance, who brings up problematic things in the teaching, you may run the risk of having challenges when you apply for a job.
Like health care
It was in the shift service that Hildrum began to read and think about what he had learned and experienced in the past five years. It was not comfortable.
– As a doctor, I am part of a system that treats people differently. Not out of unwillingness, but perhaps out of lack of interest. It is enshrined in law that we must have equal rights to health care, but we still get different health outcomes based on skin colour, ethnicity and language.
I see that these patients live shorter lives, they receive worse treatment for their cancer, and are followed up worse.
Unconscious attitudes and different treatment of patients based on skin colour, gender, sexual orientation or language are an important source of ill health in these groups, he believes.
– What are we going to do with it?
– At least we have to talk about it.
Working on it
Magnus Løberg at the University of Oslo highlights the Institute of Public Health, which points out that racism is a public health challenge, and agrees that medical education must take racism seriously.
Vice-dean for studies at the Faculty of Medicine, University of Oslo
– We therefore want to work with and train the clinical teachers to take these perspectives into their teaching, he writes in an e-mail to VG.
Løberg believes that racism is thematized in several places in teaching, including when it comes to discrimination and medicine in a multicultural society. This winter, a seminar was also organized with the theme “An anti-racist medical faculty?”
This is how they want to improve education
- A mentor with a duty of confidentiality with whom you can talk and discuss various situations. Is this racism? Or are there misunderstandings?
- An introduction before you are out in practice. What can arise in the meeting with patients, colleagues and superiors. Here’s how to handle it.
- How much racism do students experience during their education? Map the extent of racism to put it on the agenda.
Source: Hildrum and Almashhadani.
