Key Points Question How do minority resident physicians view the role of race/ethnicity in their training experiences? Findings This qualitative study of 27 minority resident physicians found that participants described 3 major themes: a daily barrage of microaggressions and bias, minority residents tasked as race/ethnicity ambassadors, and challenges negotiating professional and personal identity while seen as “other.” Meaning Results of this study suggest that minority residents face extra workplace burdens during a period already characterized by substantial stress, warranting further attention from educators, institutions, and accreditation bodies.

Cultural competence programs have proliferated in U.S. medical schools in response to increasing national diversity, as well as mandates from accrediting bodies. Although such training programs share common goals of improving physician-patient communication and reducing health disparities, they often differ in their content, emphasis, setting, and duration. Moreover, training in cross-cultural medicine may be absent from students' clinical rotations, when it might be most relevant and memorable. In this article, the authors recommend a number of elements to strengthen cultural competency education in medical schools. This ''prescription for cultural competence'' is intended to promote an active and integrated approach to multicultural issues throughout medical school training.KEY WORDS: cultural competency; medical education; disparities. DOI: 10.1111/j. 1525-1497.2006.00557.x J GEN INTERN MED 2006 21:1116-1120 M edical education has witnessed a steady increase in efforts to train physicians to provide high-quality, culturally competent care. Training in cultural competence has risen to the forefront of medical education in part because the United States is becoming increasingly diverse. Ethnic minorities now comprise about 30% of the population, and demographic trends show that they will become the majority by the year 2050.1,2 In addition, greater appreciation exists for the impact of culture on health care and health disparities. 3,4Health seeking behaviors are affected by cultural mores. Some patients may delay seeking care due to perceived cultural insensitivity, 5 concern that they will receive a lower quality of care, 6 or the perception that they have been treated unfairly because of race or ethnic background. 7,8 Furthermore, health disparities have been widely recognized, with racial differences in treatment persisting after adjustment for insurance status, income level, and health status. 9-13Published research suggests cultural competence may improve physician-patient communication and collaboration, increase patient satisfaction, and enhance adherence, thereby improving clinical outcomes and reducing health disparities. 3,4,7,8,[14][15][16][17][18] In this manuscript, we describe current approaches to cultural competence education. Based on features of successful programs and drawing on established educational principles, we propose several elements that may improve cultural competence training in medical education. Current Approaches to Cultural Competence EducationConceptual Approach. Three major conceptual approaches have emerged for teaching cultural competence, focusing on knowledge, attitudes, and skills, respectively. 24 Knowledgebased programs (the multicultural/categorical approach) focus on information, such as definitions about culture and related concepts, social determinants of health, and variations in disease incidence and prevalence. These programs may also identify common ethno-medical beliefs and practices thought to influence the patient-physician relationship and medical outcom...

In recent years, academic health centers have made a considerable effort to encourage medical students and physicians-in-training to consider academic medicine as a career choice. For physicians, selecting a career in academic medicine may be the first hurdle, but the challenge of successfully maintaining an academic career is perhaps a more formidable task. Mentoring is a much-needed response to this challenge. But the success of traditional mentoring programs at academic institutions is often limited by, among other things, the availability of senior faculty who can serve as mentors. The authors describe the formation and organization of the Internal Medicine Research Group at Emory (IMeRGE), an innovative peer mentoring group within the Division of General Medicine at Emory University. This group, born partially out of the mentoring needs of our women and minority faculty, shared the primary goal of fostering a collaborative atmosphere among junior faculty, while simultaneously acquiring experience through advanced faculty development. The authors present our methods of garnering division support for designated time and financial resources, defining member responsibilities, developing a curriculum, providing peer support, and seeking advisors with expertise in the areas on which we wished to focus. In addition to the development of IMeRGE, the authors provide an overview of the pros and cons of traditional mentoring versus peer mentoring; discuss the challenges faced by IMeRGE and strategies for addressing these issues; and present the paradigm of IMeRGE as a template for alternative forms of academic mentorship.

Equal treatment by race occurs in nonopioid-related therapies, but white patients are more likely than black patients to be treated with opioids. Further studies are needed to better explain this racial difference and define its effect on patient outcomes.