Organizing for racial justice in medicine and medical education: An ethnographic study of medical trainee experiences

This article investigates the experiences of medical trainee participants in movements for racial justice in medicine and the implications of these experiences in the context of growing attacks on programs and practices for equity in medical education. This study involved ethnographic participant observation - especially what some refer to as observant participation - and ethnographic interviews with a majority of the individuals organizing two movements of medical trainees confronting medical, institutional and structural racism. Interviews and ethnography focused on medical trainee experiences in these two movements as they took shape in the San Francisco Bay Area, though the research also included participants, interviews and questions to give national context. Data were analyzed via grounded theory with ethnographic and interview data coded first and then organized into categories by the authors. White Coats for Black Lives began in 2014 in response to multiple police killings to confront police and carceral violence against Black people and other people of color, as well as to demand changes in medical education itself. Several years later, medical trainees organized against the use of “race-correction factors” in clinical labs, considering the problematic evidence supporting such correction factors and the health and health care disparities they cause. In light of the data, we argue that medical trainees who experienced discrimination and inequality affecting themselves, their families or their communities bring critical expertise, insights and analyses to medical education related to social justice and health equity. The trainees involved in these movements employed these forms of expertise to push against the hidden and explicit curricula in medical education as well as to work for health and health care equity more broadly. This article considers the impressive successes and deep challenges faced by trainees in each of these movements and concludes with implications for medical education, medicine and the medical social sciences.