The teaching of cultural issues in US and Canadian medical schools

Purpose. Despite the importance of culture in health care and the rapid gro wth of ethnic diversity in the United States and Canada, little is known ab out the teaching of cultural issues in medical schools. The study goals, th erefore, were to determine the number of U.S. and Canadian medical schools that have courses on cultural issues, and to examine the format, content, a nd timing of those courses. Method. The authors contacted the deans of students and/or directors of cou rses on cultural issues at all 126 U.S. and all 16 Canadian medical schools . Using a cross-sectional telephone survey, they asked whether each school had a course on cultural sensitivity or multicultural issues and, if so, wh ether it was separate or contained within a larger course, when in the curr iculum the course was taught, and which ethnic groups the course addressed. Results. The response rates were 94% for both U.S. (118) and Canadian (15) schools. Very few schools (U.S. = 8%; and Canada = 0%) had separate courses specifically addressing cultural issues. Schools in both countries usually addressed cultural issues in one to three lectures as part of larger, most ly preclinical courses, Significantly more Canadian than U.S. schools provi ded no instruction on cultural issues (27% versus 8%; p = .04). Few schools taught about the specific cultural issues of the largest minority groups i n their geographic areas: only 28% and 26% of U.S. schools taught about Afr ican American and Latino issues, respectively, and only two thirds of Canad ian schools taught about either Asian or Native Canadian issues. Only 35% o f U.S, schools addressed the cultural issues of the largest minority groups in their particular states. Conclusions. Most U.S. and Canadian medical schools provide inadequate inst ruction about cultural issues, especially the specific cultural aspects of large minority groups.