Abstract ID 27490

Poster Board 594

Healthcare inequities have become more of a focus in medical education in the last few years as we explore the impact of social, cultural, financial, and systemic factors on patient care. Barriers occur at the individual level as well as organizational and policy levels. We have recently added context to race-based and race-conscious treatment recommendations as well as information regarding treatment access to our pharmacology content.

We have included healthcare equity information impacting treatment in a number of pharmacology sessions. We do teach race-based treatment recommendations, but we provide context regarding both the strength of the underlying evidence along with presenting potential factors that may underlie differences in effectiveness among different populations. We explicitly discuss the limitations of using race as a proxy for population variations while also acknowledging that different populations face inherent health inequities. For example, when discussing the use of hydralazine/isosorbide dinitrate in Black patients, we discuss factors that impact racial disparities in heart failure. As we discuss options for monotherapy antihypertensive treatments, we include discussions of social, financial, and genetic factors. During our presentation on ethanol metabolism, we include information on variants of aldehyde dehydrogenase in certain ethnic groups and how those variants are associated with increased esophageal cancer risk. We talk about Medicaid coverage for direct-acting antiviral treatments for hepatitis C and state restrictions that negatively impact underserved populations. We discuss CYP2D6 isoforms across different populations and the impact on codeine metabolism. We continue to identify topics that impact healthcare equity. We want to avoid over-treating lower-risk patients in a particular population and missing risks in vulnerable patients who share contributing factors but are not included in a specific identified high-risk population.

As part of our focus on diversity, equity, and inclusion, we recognize that word-choice matters, and we are intentional in the language that we use. However, we also recognize that older language is not always updated and that students are often more attuned to this than faculty. We have recently begun including a question regarding DEI on a feedback form available for every session so that students can anonymously identify potential issues in content or delivery. We also enable a notes function in our exam software so that students can point out concerns with wording of exam questions. This has helped us respond in real time to concerns and has enabled students to be part of the process of improvement. Our overall strategy to addressing DEI in the pharmacology curriculum is a patient-centered approach that recognizes the impact of various factors on different populations.