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LECTURE: Structural Competency, 5 Years On: Tracking a New Medical Approach to Stigma and Inequality
May 30 @ 8:00 am - 5:00 pm
This talk described a shift in medical education away from approaches to stigma and inequalities that emphasize cross-cultural understandings of individual patients, toward attention to forces that influence health outcomes at levels above individual interactions. It reviewed existing structural approaches to stigma and health inequalities developed outside of medicine, and proposed changes to U.S. medical education that will infuse clinical training with a structural focus. The approach, termed “structural competency,” consists of training in five core competencies: 1) recognizing the structures that shape clinical interactions; 2) developing an extra-clinical language of structure; 3) rearticulating “cultural” formulations in structural terms; 4) observing and imagining structural interventions; and 5) developing structural humility. Dr. Metzl’s lecture argued that increasing recognition of the ways in which social and economic forces produce symptoms or methylate genes needs to be better coupled with medical models for structural change.
The Health & Humanities Pop-Up Institute was a collaboration between the Office of the Vice President of Research and the Humanities Institute at the University of Texas at Austin through the following endowments: the Holloway Centennial Lectureship, the Hoffman Centennial Lectureship, the Kidd Centennial Lectureship, and the Ho Distinguished Lecture in China Studies Endowment. Additional support came from the College of Liberal Arts, the Department of English, and the Dell Medical School.