Revisiting Pharmacology Curricula with an Anti‐racist Lens
Authors: Roni Monzurul , Chang Linda , Gangopadhyaya Ananya 
Published: May 2022

Background

Evidence suggests that race is often misrepresented in undergraduate medical school curricula, particularly in the basic sciences. Incorrect discussion of race as a biological construct has long been present and is not only inaccurate but also prevents discussion of structural racism, sociopolitical and historical implications of health inequities. Although there has been increasing attention and awareness of racial bias in different areas of medical curricula like pathology and epidemiology, little has been shared about potential bias or race misrepresentation in pharmacology education.

Methods

As part of our institutional effort to promote anti‐racism curricula, pharmacology educators at the University of Illinois College of Medicine have reviewed the learning objectives, instructional materials, assessments, and required textbooks of the pharmacology curriculum used in the academic year 2018‐2020. All the curricular and assessment databases along with digital copies of required pharmacology textbooks were searched for keywords like ‘African American’, ‘black’, ‘Caucasian’, ‘white’, ‘Hispanic, ‘Latino, ‘Asian, ‘Chinese, ‘European, ‘native’, ‘race’, and ‘ethnic’. All search results were reviewed to determine if race was appropriately mentioned with context, as a social construct, or if race was adequately representing the ancestry or with combined race/ethnicity. Based on the findings, revisions were carried out in the instructional materials and assessment in the academic year 2020‐2021. The first‐ and second‐year medical students were surveyed in each course to comment on any perceived potential bias in instructional materials and assessment items.

Results

Misrepresentation of race was identified in 9% of our pharmacology instructional materials and 1% of our assessment items. The most common areas of misrepresentation were in pharmacogenomics related concepts where the race was referenced as a risk factor for certain genetic polymorphisms. Broad racial categories like Black, Asian, and Caucasian were used in pharmacogenomics despite evidence of intrapopulation genetic variations. The second most common misrepresentation was the use of race as a biological construct where race‐based medicine like isosorbide dinitrate/hydralazine (BiDil) was described or race was presented as a risk factor for a disease. Evaluation of the pharmacology textbooks revealed a similar trend. Our curriculum was revised in the academic year 2020‐2021 based on the findings. The student surveys revealed no potential bias in the pharmacology curricula after the revision.

Conclusions

Misrepresentation of race appeared in some parts of the pharmacology curriculum in the preclinical years as pharmacology textbooks consistently emphasize race‐based biological differences. Revisiting the curriculum with an anti‐racist lens helped to mitigate the racial bias and identify an opportunity to highlight the limitation and adverse consequences of using race in research and patient care. Our study revealed that there is an opportunity to integrate a holistic understanding of health disparities in the pharmacology curricula.