When we learnt about the Musculoskeletal system last year, we were told that in dermatomyositis, a connective tissue condition, a signature heliotrope/lilac rash is seen on the upper eyelids. I remember thinking at the time, “Does this show on black people too?” But I didn’t ask.
I thought the same when we learnt about lupus, and the lecture slides showed how it presented in people with lighter skin tones. From Gottron’s papules to Psoriasis to Jaundice to Giant Cell Arteritis, the majority of pictures we were shown were of white patients.
It continued this year with the Respiratory system. A clear sign of respiratory distress is cyanosis, and this is when skin appears bluish in colour because of inadequate oxygenation of the blood. Again I thought, “…Does this show on black people too?” But this time I decided to ask, and my GP tutor then told us the other signs you’d have to look for in patients with darker skin, because ofcourse they don’t turn blue.
You see, what we don’t really get taught as medical students is how to recognise signs in people of colour. For some conditions, there are signs and symptoms that don’t present in the same way as they do in people with lighter skin tones, so it’s not good that this isn’t really emphasised, because when we’re doctors not all our patients will be white.
I’m going to try to make more of an effort to speak up in the future, but to be honest, sometimes it gets tiring being “the person who makes things all about race.” So I guess because of this I can agree that from what I’ve experienced so far, yes, my curriculum is white.
Life As A Junior Doctor 
You have a legit point. My friend pointed out that trans-man can get ob/gyn conditions and the professor had a chance to address it in the lecture. She just talked to the professor post lecture to ask about it and gave him a suggestion and the professor was very receptive to it. I think if you just ask a question post lecture and request that information to be included in the future, it would probably help out everyone else in the future.
Yeah, that’s what I’m going to try and do more from now on. Thanks! 🙂
I think population demographics influence the way medicine is taught. Since the UK is predominantly made up of white people, you get taught to recognise clinical presentations on them as they are the patient you are most likely to see when you are practising.
South Africa has a completely different demographic composition so we get taught to recognise the clinical presentation on the spectrum of patients that we are most likely to see. This spectrum ranges from incredibly pale to incredibly dark.
You should always ask because race does make a difference in presentation and it’s to your benefit to know how to recognise specific disease presentation on every type of patient you could possibly encounter 🙂 Sorry for the essay 🙂
Hmm I do see where you’re coming from, but there are many areas in the UK where people of Asian and African backgrounds are now more common- London, for example, is very racially diverse, so I think the way medicine is taught here should reflect that change.
And no worries, thanks for commenting! It’s always good to see things from a different perspective 🙂
Wow, I’ve never really thought about that. Thank you for making me
aware of it, even it’s still earlier for me. I also am to see Chinese patients, but I’m South African which is very diverse. I’ll definitely put that in mind when I start my clinical years.
Yeah definitely do, and try and speak up if you can 🙂
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