Medical Schools Want Help in Providing


Cultural Competence Curriculum


By Houkje Ross


Closing the Gap, Cultural Competence • January 2000


Learning how to interview patients and take a medical history is 

a requirement of all medical schools. Some schools go even 

further and train students on culture and how it impacts the 

care they give. For example, Dartmouth/Brown Medical School’s 

“Clinical Experience” class covers cultural beliefs and values, race, 

ethnicity, and sexual orientation. Dave 

training in place indicated they would like additional help. That figure jumped to 80 percent for the schools who did not have a program 

in place. 

The most commonly requested forms of assistance were information on model programs, faculty development materials, formal teaching materials, and evaluation instruments. Of 

Some medical schools need to 

the school, said he learned how to work with 

an interpreter for the many patients from His- learn how to fit cultural 

over 40 percent asked for help in the form of 

justifying the need for cultural competency 

panic and Portuguese backgrounds he encounters. 

competency into the rest of the training. “This is an indication that some medical schools need to learn how to fit cultural com­

“It was helpful to learn that it is impor­ medical school curriculum. petency into the rest of the medical school curOsborne, a White student in his third year at	 the schools that don’t have a program in place, 

tant to maintain eye contact with your patient 

and to keep the interpreter in the background. You need to speak 

directly to your patient,” he said. Osborne said the class content on 

culture was good, but there could have been more. 

AAMC studies culture in medical schools 

In late 1997, staff in the Division of Medical Education at the 

American Association of Medical Colleges (AAMC) began gathering 

information on the activities in place at medical schools regarding 

cultural competence curriculum. AAMC’s ongoing study aims to find 

out if medical schools considered it their responsibility to teach cultural competency and to find out what schools needed to do it better, 

said Deborah Danoff, MD, assistant vice president of AAMC’s Division of Medical Education. 

So far, AAMC has surveyed 141 medical education programs in 

the United States and Canada, of which 96 percent responded. Of 

those who responded, 67 percent indicated that they had some form 

of teaching on cultural competence already in place. Fourteen percent 

have plans to introduce the topic. The study also found that: 

•	 At least 86 percent of medical schools provided at least one opportunity in multicultural medicine. 

•	 Seventy-one percent said that multicultural medicine was part of a 

required course. 

•	 Only one school teaches multicultural medicine as a separately 

required course. 

Survey results also showed that most of the medical schools 

thought they needed assistance in developing or implementing a cultural competency program, said Dr. Danoff. Approximately 60 percent of schools that already had some form of cultural competency 

riculum,” said Dr. Danoff. 

But medical schools soon may not have a choice about including 

cultural competency in their curriculum. The Liaison Committee on 

Medical Education (LCME) proposed a standard on cultural diversity that would hold faculty and students accountable for recognizing 

and dealing with cultures and belief systems and how this impacts 

perceived health, illness, and responses to various symptoms, diseases, 

and treatments. LCME is the nationally recognized accrediting authority for medical education programs leading to the medical degree 

in U.S. and Canadian medical schools. LCME will vote on the adoption of the standard in February 2000. 

Although AAMC’s survey indicates most medical schools are 

providing some cultural competence training for students and are 

asking for assistance, some are questioning whether this is enough. 

“Most U.S. medical schools are not providing adequate instruction in 

cultural competency,” said Glen Flores, MD, assistant professor of 

pediatrics and public health at Boston University Schools of Medicine and Public Health. For example, little is known about how to 

teach cultural issues in medical school. Dr. Flores, who is also a Robert 

Wood Johnson Minority Medical Faculty Development Scholar, is 

writing a research paper on cultural competency curricula in medical 

schools, to be published in the spring of 2000. 

AAMC continues to gather information on cultural competence 

efforts at medical schools. The association will collect information 

from course directors on cultural competency programs or courses in 

place at medical schools, identify model programs, and share techniques for implementation with other schools. From the data it collects, AAMC hopes to write a summary paper, develop an expertise 

list, resource materials, and a professional development workshop. 

For more information on the project, contact: Dr. Deborah Danoff, 

Assistant Vice President in the Division of Medical Education, AAMC, 

(202) 828-0982.

Office of Minority Health Resource Center	 U.S. Department of Health and Human Services