Dr. Margaret Bia (second from left) talks with three of the Yale medical students who have taken her cultural diversity seminars: (from left) Shika Pappoe, Liza Cariaga-Lo and Aaron Covey. Yale is one of the few medical schools in the nation to require such training.

Seminars help medical students learn
how to become 'culturally competent'

Although the U.S. population has become increasingly diverse, few medical schools provide the kind of cultural diversity training offered at the School of Medicine, according to a recent study of medical schools. The study examined medical school curriculums in the United States, Canada, Australia and the United Kingdom and found that few specialties other than family medicine, community medicine and psychiatry offered cultural diversity courses for medical students. Of the 17 programs that touched on cultural diversity, only seven were part of required core teaching. Published in the Sept. 1 issue of The Journal of the American Medical Association (JAMA), the study listed Yale's School of Medicine as one of the seven schools that made cultural diversity instruction a requirement. This study reflects the growing need for medical schools to train doctors who can address the needs of a more diverse patient population, according to Liza Cariaga-Lo, director of the Office of Multicultural Affairs at the School of Medicine. "As medical students become immersed in the courses needed to prepare them for a medical career, it's important that they also become culturally competent," says Cariaga-Lo. "This means being attuned to and understanding the needs of diverse patients, which leads to better diagnosis and more successful doctor-patient relationships." The cultural diversity program at Yale consists of a series of seminars that are part of the required doctor-patient encounter course given to first- and second-year students. Students are presented with a variety of case histories involving issues such as patients who do not speak English, patients with religious views that might conflict with medical care, and patients who refuse to see a doctor who is of a different race or sex. Each student delivers a presentation on how he or she would handle each case, and the presentations are followed by group discussions. "The most valuable lesson I learned from the seminar is that as you encounter each patient, you have to be aware of your own biases and put them aside so you won't be too judgmental," says Shika Pappoe, a third-year Yale medical student. "The class also taught me how to confront uncomfortable situations so I can move on to the important task of treating the patient." The cultural diversity seminars were developed three years ago as a joint effort among the Office of Multicultural Affairs, the Office of Education and the Urban Health Program. Dr. Margaret Bia, course director for the doctor-patient encounter course, sees a need for expanding Yale's current program beyond the first year. "This training is essential for improving communication between doctors and patients, and the case studies are just the beginning," says Bia, professor of internal medicine and nephrology. "We would like to see an expanded program run throughout the entire four years of medical school and beyond." In addition to helping develop the cultural diversity section of the doctor-patient encounter class, the Office of Multicultural Affairs works to recruit and retain students, fellows, faculty and housestaff from underrepresented ethnic groups in the fields of science and medicine. The office also sponsors the medical school's annual Martin Luther King Jr. Day celebration and provides outreach support to assist the City of New Haven and its schools in meeting education and health care goals for all underrepresented groups. 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