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Is it really a woke nightmare for medical schools?

Among the many definitions and meanings of the terms “woke” and “wokeism,” the two that capture the ideology best are contrasting meanings. The definitions are:

“The behavior and attitudes of people who are sensitive to social and political injustice” (Collins English Dictionary),

and:

“A system of thought and behavior characterized by intolerance, policing the speech of others and proving one’s own superiority by denouncing others” (Psychology Today).

The first implies a benevolent society that is tolerant of different viewpoints and considers its citizens’ race, religion, ethnicity, gender identity, culture, and other personal attributes. The latter implies a militant society bent on censorship due to beliefs and demographics that differ from the individual claiming wokeness.

Why is this distinction important? Because medical education is being supplemented by diversity, equity, and inclusion (DEI) competencies — indeed, mandating them to students and faculty across academic medical institutions in the United States.

Those who oppose teaching DEI tenets have been quite vocal. They are the ones shouting and writing “woke” to suppress the movement. Those in favor of teaching DEI competencies are gaining traction. However, they would do well to remember “every movement is susceptible to becoming the thing it despises.”

To gain a sense of how polarizing DEI education has become, you have to read a few online comments to the many op-eds published for and against DEI competencies being taught in medical schools. I have collected a sample of comments in response to the New York Post editorial “Top med school putting wokeism ahead of giving America good doctors.” The comments represent diverse opinions, and I have arbitrarily categorized them as follows:

Beneficence woke

“The idea that humility and empathy are unimportant in rendering the best care to patients is exactly what is wrong with medicine in America. While excellence in science is necessary, ignoring the importance of concern for the welfare of the people we serve is antithetical to the principles of medicine since the time of Maimonides. This includes marginalized and underserved people.”

Pluralistically woke

“[A]nti-racism means equitable care for EVERYONE who walks through and reduced barriers to care for everyone who lacks the capability to walk through. That includes EVERY person of EVERY skin color and background and of EVERY ideology and political belief, and therefore INCLUDES YOU.”

Selectively woke

“I guess from now on, I have to find out what medical school my doctor went to and when so I can try to eliminate those who majored In Woke instead of Medicine.”

Politically woke

“The Left’s ‘long walk through the institutions of power’ has become a full-on sprint … If fascism does come to America, it will arrive under the guise of anti-fascism.”

Progressively woke

“What is being woke and wokeism besides making sure every individual in this world is heard and their opinion matters, no matter how small … The sooner we realize this, the faster we could progress as a society, not regress as per tradition.”

Anti-woke

“Medicine, science, education, etc., are only about the best minds, and that’s the way it should ALWAYS be. NOT diversity quotas.”

Reasonably woke

“There is a lot of research that shows that minorities have worse health outcomes and are less likely to seek out healthcare, in part due to a lack of confidence in their medical professionals. So asking med school applicants how they might address these challenges seems completely reasonable. You don’t have to be woke to think we all deserve quality care.”

Historically woke

“Soon, they will be asking the patients the same questions [as medical school applicants] to see if they will be allowed to be treated. Then people on the street will be asked that and if answered incorrectly, off to the concentration camp.”

Reassuringly woke

“Everyone should calm down. First of all, applicants are very bright and know how to answer these essays regardless of their own opinions. Second, you can’t become a doctor without passing two very demanding national tests, which are only subject-related. Then there’s an additional test in one’s own specialty for board certification. So rest assured, your doctors are going to be highly qualified.”

Competently woke

“The guy who barely squeaks through the exam is not going to be as good as the guy who aces it. Selecting people based on any criteria other than competence will create many more of the former. Nobody should be defending Woke policies, and I don’t trust anyone who does.”

Research woke

“[I]f you’re going to make the claim that ‘selecting for woke-ism over the application and educational standards of students’ wouldn’t you…want to measure how the actual patient outcomes for their respective residencies or their respective students have held up over time?”

Disgustingly woke

“As a physician for over 40 years, I am disgusted with how my profession now kowtows at the woke altar. A large segment of the best and brightest future docs will be excluded unless they are able to swallow their principles of equality and fair play, so that they can appease these disgusting woke liberals in charge.”

Incredulously woke

“I don’t find this [editorial] particularly compelling. We haven’t had actual effective, smart, competent doctors throughout much of healthcare for a great many years now.”

Realistically woke

“These comments are hilarious. Trust me, you all will still be running to the hospitals and being treated by these ‘underqualified woke physicians’ and they will save your lives, as well as being well-rounded, open-minded human beings that actually care about others and furthering our society.”

Being “woke,” it seems to me, is OK. But it matters how you incorporate a DEI curriculum into medical education (what science content do you trim?), who teaches the competencies (managing not to offend anyone), and ensuring their teaching methods are unbiased. Most importantly, how will the instructor’s views be expressed — angrily or not — as the various comments mirror?

My faculty supervisor reminded me long ago that anger is like gasoline. It’s not intrinsically bad — it just depends on how you use it. Throw a match at it, and you’ll cause an explosion. Put it in your car’s gas tank, and you’ll get mileage out of it.

We live in the same world. We have only one planet to save. The medical universe is not infinite. Tone down the rhetoric, people. Or else it will be ourselves and our profession that needs saving.

Arthur Lazarus is a psychiatrist.


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