Association of Medical Colleges Prioritizes Radical-Left Dogma over Patient Care

T he Association of American Medical Colleges (AAMC) has issued a 36-page memorandum titled Diversity, Equity, and Inclusion Competencies to guide medical schools in revising their curricula and related activities to emphasize DEI and so-called “anti-racism.” AAMC “competencies” also are used by accrediting agencies to establish mandatory standards for all medical schools and residency programs.

In an article announcing the DEI Competencies, the president of the AAMC and the chair of its Council of Deans declare that DEI “deserves just as much attention from learners and educators at every stage of their careers as the latest scientific breakthroughs.”

In DEI Competencies, AAMC claims that health-care inequities are rooted in systemic racism and compounded by poor housing, food, and transportation, and that physicians and medical-school faculties must imbue health care and teaching with a focus on disrupting white privilege, understanding the oppression of intersectionality, and achieving social justice. Specific sets of goals are set for graduating students entering their residencies, physicians entering practice (thus effectively governing their residencies), and faculty members.

Recent graduates must be able to identify “systems of power, privilege and oppression,” including colonization, white privilege, white supremacy, heterosexism, acculturation, assimilation, and ableism; articulate race as a “social construct that is a cause of health and health care inequities” and not a risk factor for disease; “describe public policy that promotes social justice”; understand how a patient’s intersectional identities result in “multiple forms of oppression”; and include “diversity” in a patient’s health-care plan.

Upon completing their residencies, physicians must be able to: apply intersectionality to clinical decisions; advocate “diversity”; adhere to policies and practices that promote diversity and inclusion; make decisions based on how “systems of power, privilege, and oppression influence health care”; promote social justice; uphold “inclusive policies and practices”; and report violators.

Faculty are instructed to lead, advocate, and support policies and practices that promote, build, and sustain diversity and inclusion; to “disrupt” oppressive practices; and to promote social justice. Faculty members must be role models for anti-racism, “including strategies grounded in critical understanding of unjust systems of oppression,” and must lead culturally responsive interventions.

Some of these requirements may gravely impair patient care, including the pretense that there are no genetic or biological bases for diseases that are more prevalent among certain races or ethnicities. Some may violate a range of First Amendment free-speech rights that generally prohibit requiring, or limiting, what an individual may say. This is particularly true for public university faculty members, whom the Supreme Court in Connick v. Myers (1983) and subsequent cases, and most circuits have made clear, may not be disciplined for exercising free speech in their private lives, or the classroom. In federally funded institutions, imposing a political litmus test for admission, graduation, employment, or other benefits may also violate civil-rights laws, as well as a “right of association” identified in numerous Supreme Court decisions. All these requirements impose radical-left ideologies, including discrimination based on race, sex, sexual orientation, anti-capitalism and social justice.

DEI Competencies is the latest in a series of mandates from the AAMC, the American Medical Association (AMA), and the two accrediting agencies for medical schools, the Liaison Committee on Medical Education (LCME), which accredits M.D. programs, and the Accreditation Council for Graduate Medical Education (ACGME), which accredits internship, residency, and graduate medical programs. Their mandates are enforced through their interlocking control. The AAMC and AMA control the LCME and are among a small group that appoints the directors of the ACGME.

In November 2020, the AMA adopted policies that denounced racism as a public-health threat and called for the elimination of race as a proxy for ancestry, genetics, and biology in medical education, research, and clinical practice. Then, in May 2021, the AMA issued its Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity. The Marxist-infused manifesto proclaims that “it is common that discussions in the field of equity begin with the recognition that our current state was built on the land and labors of others in ways that violated the fundamental principles of equity. Another distinction of the equity field, which essentially is an extension of this land and labor acknowledgment, is to initiate discussion with recognition of the specific harms of the past including those of the more recent past (termed ‘truth and reconciliation’).”

The AMA plan complains that the use of calculators and artificial intelligence is racist, demands “just representation of Black, Indigenous and Latinx people in medical school admissions as well as medical school and hospital leadership ranks,” and envisions “a nation in which . . . all physicians are equipped with the consciousness, tools and resources to confront inequities and dismantle white supremacy, racism, and other forms of exclusion.”

In October 2021, the AAMC and AMA jointly issued A Guide to Language, Narrative and Concepts. Starting with a land and labor acknowledgment that their respective headquarters are located on lands taken from indigenous tribes, and invoking the “extraction of brilliance, energy and life for labor forced upon millions of people of African descent for more than 400 years,” the guide characterizes individualism and meritocracy as “malignant narratives” and falsely asserts that race has no genetic, biological, or scientific basis, and therefore that offering medical treatment based on these narratives harms minorities. The guide calls for improving medical care by focusing attention on “inequitable systems, hierarchies, social structure, power relations, and institutional practices.”

Many of these concepts and medical-school anti-racism programs draw from the work of a little-known organization, White Coats for Black Lives (WCBL), which claims chapters at more than 70 medical schools. The AAMC and AMA have cited WCBL’s work with approval. Founded in 2014, WCBL describes its mission “to dismantle racism and accompanying systems of oppression in health, while simultaneously cultivating means for collective liberation that center the needs, priorities, and self-determination of Black people and other people of color, particularly those most marginalized in our communities.” WCBL’s Vision Document, updated this June, requires dismantling cisheteropatriarchy, white supremacy, capitalism, and fatphobia, abolishing prisons, and embracing socialism, queer feminist praxis, and the liberation of trans people. WCBL sees professionalism as a manifestation of white supremacy.

The DEI Competencies, LCME standards, AMA plan, and WCBL vision require that choices for testing, care, caregivers, and other resources be based on political factors, rather than science or what is best for the patient. Their directives to physicians to disregard genetic and biological markers associated with race and ethnicity will reduce the quality of life, and potentially kill.

Because of their interlocking control, these organizations have the power to force compliance by schools, students, physicians, and faculty, including the unconstitutional demand that they advocate, and refrain from disagreeing with, the organizations’ dictates, and that they report violators. Noncompliance can be punished with loss of accreditation, expulsion or termination, and potentially loss of licenses. Despite these risks, some brave physicians have expressed concern that progressive ideology will harm patient care.

The New England Journal of Medicine published a particularly pointed rebuttal last year from five black health-care professors who complained that a refusal to recognize that genetic differences contribute to clinically significant health disparities is likely to “perpetuate and potentially exacerbate” those disparities.

Progressive domination of America’s health-care sector is reaching a crisis. When leaders of the nation’s most respected health-care organizations assert that social justice, including dismantling capitalism and selecting health-care professionals by race or sexual orientation, is more important than science, and demand that physicians be complicit in the lie that racial biology and genetics play no role in health, purported caregivers have become dangerous ideologues.