A black medical student is attempting to “decolonize” the British medical curriculum.
Malone Mukwende, a second-year at St George’s, University of London, noticed he was often only being taught about the way illnesses presented on white skin.
He both felt alienated and worried that people with darker skin would not be diagnosed as a result of doctors failing to spot the signs of disease on their bodies, as they had not been trained to spot them.
The student decided to take matters into his own hands, creating a handbook for medics showing the way skin afflictions and other common physical reactions – including Covid-19 symptoms – look on black and brown skin.
The handbook, Mind the Gap, includes side-by-side images showing the way diseases present differently on dark and light skin, and highlights appropriate language for doctors to use.
It will be released, with the support of St George’s, in the coming months.
Mr Mukwende said he hopes his work will make a real difference in BAME patients’ lives going forward.
He told the British Medical Journal: “On arrival at medical school I noticed a lack of teaching about darker skin. We were often taught to look for symptoms, such as rashes, in a way that I knew wouldn’t appear on my own skin.”
In a statement, the student explained that the way diseases present on darker skin is often not presented in medical textbooks “as there is a white skin bias”.
He said: “The booklet addresses many issues that have been further exacerbated during the Covid-19 pandemic, such as families being asked if potential Covid patients are ‘pale’ or if their lips ‘turned blue’.
“These are not useful descriptors for a black patient and, as a result, their care is compromised from the first point of contact.
“It is essential we begin to educate others so they are aware of such differences and the power of the clinical language we currently use.”
St George’s has backed the project, teaming the pioneering student with Lecturer in Diversity and Medical Education, Margot Turner, and Clinical Lecturer in Clinical Skills, Peter Tamony, to look at clinical teaching on diverse bodies.
The team will host training sessions based on the booklet for the university’s tutors this month.
In a statement, the university wrote: “It was agreed that this was a very important issue and an essential part of decolonizing the curriculum.”
Following worldwide Black Lives Matter protests into the death of George Floyd last month, countries and institutions have been facing a reckoning over symbolic issues – including statues in public places to those involved in the slave trade – and current systemic and institutional racism.
Many actions involve an attempt to tackle “unconscious racism” and implicit bias.
Mr Mukwende said: “Recently there was a petition calling for teaching clinical skills on black and brown skins that now has over 125,000 signatures. The petition, Covid-19 pandemic and the Black Lives Matter movement all illustrate there is an urgent need for change.”