Columbia Ob/Gyn launches health justice-focused medical education curriculum

The Department of Obstetrics and Gynecology at Columbia University Irving Medical Center recently launched a pilot curriculum for Ob/Gyn residents and medical students, focused on health justice and equity. The aim of the curriculum is to educate trainees in recognizing and addressing health injustices that impact the department’s patient population, and fostering stronger relationships with community-based resources that serve these patients. Alongside larger department initiatives, the curriculum will also help to build dialogue around justice, diversity, equity, and inclusion among all faculty, staff, and trainees.

The curriculum brings together elements of health justice education from other institutions, including Duke University and the University of California - San Francisco, and also leverages community partnerships in Washington Heights to include outside of the classroom learning. While it is based on a foundation of resources and best practices from universities around the country, the curriculum is custom-designed not just to address the history of systemic racism in medicine and medical education, but specifically the historical disparities and inequities in obstetrics and gynecology, the New York City area, and at Columbia University.

Designed to incorporate as broad a variety of perspectives as possible, the curriculum will feature speakers from many institutions and sub-specialties. Topics addressed range from the history of racism in medicine to practical sessions on navigating Medicare and Medicaid, as well as reflection sessions in narrative medicine and advocacy. In the outside-the-classroom components of the curriculum, residents will engage in a variety of activities in partnership with local community-based organizations, including visiting women’s shelters to offer education and advertise resources available to potential patients.

The curriculum was developed and implemented by Rini Ratan, MD, Vice Chair of Education and the Berkowitz Family Professor of Women's Health in the Department of Ob/Gyn at NYP/CUMC, and Ana Cepin, MD, Director of Community Women's Health and an Assistant Professor of Obstetrics and Gynecology in the Department of Ob/Gyn at NYP/CUIMC.

“We must ensure that the residents learn about, appreciate, and respect the community where they train,” said Dr. Cepin. “This curriculum is a vital step toward achieving that goal. Our hope is also to equip our residents with tools they can use to play a role in combatting the systemic factors that have led to health disparities.”

The ultimate goal of the curriculum, according to Dr. Ratan, is to help residents better understand the challenges their patients may face, in order to provide higher-quality care.

“We hope that this curriculum will translate to our residents being more aware of these issues, so that when a patient presents with a problem, they will understand whether the treatment is realistic, feasible, and acceptable to the patient,” said Dr. Ratan. “We hope that our patients feel they are coming to providers that are culturally sensitive, attuned to their overall needs, and able to meet their clinical needs.”

A scholarly assessment, led by Ob/Gyn PGY-3 resident Anna Staniczenko, MD and medical student Edith Antonio, will also be conducted in order to measure the effectiveness of the curriculum. All those who participate in the curriculum will undergo pre- and post- tests to assess knowledge gained and see how the learning has reframed the way residents think about these issues when seeing patients in a clinical setting. 

While implementing the new curriculum and particularly the community-based learning has been challenging during the ongoing COVID-19 pandemic, the team was eager to move forward so they could see the curriculum in action. The COVID-19 pandemic disproportionately affected people of color and people in poverty, according to the Columbia University National Center for Disaster Preparedness, which heightened the urgency of implementing the new curriculum.

Since this is a pilot program, Dr. Ratan hopes that there will be ample opportunity to adapt and shift as needed.

“The wheels of change turn slowly, but they turn,” said Dr. Ratan. “You have to be committed. We can’t be daunted by the fact that this hasn’t been done before. We see this curriculum as iterative and adaptive, and we plan to gather feedback at every stage so we get to the point where we can deliver the material as effectively as possible.”

The Department of Ob/Gyn announced a strong department-wide anti-racism commitment in 2020, leading to the establishing of a taskforce and the founding the Office of Diversity, Equity, and Inclusion. Mary D’Alton, MD, Chair of the Department of Ob/Gyn, has supported numerous initiatives to continue the work that gained momentum in 2020.

“The new health justice curriculum is an important step forward in combatting injustice and promoting health equity, not just for our department today, but for the future of medicine,” said Dr. D’Alton. “By investing time in this learning for our residents and trainees, we work to ensure that the future leaders in our specialty are building their careers as clinicians and researchers on a foundation of health justice.”

To learn more about our commitment to diversity, equity, and inclusion in medical education, visit our website.