There is no doubt that there are severe, concerning gaps in medical education – but, this
year, one student decided to do something about it.
Malone Mukwende, a second-year student at St George’s University of London, has created “Mind the Gap” – a handbook of clinical signs in black and brown skin. Talking to the BMJ, he said he realised many conditions wouldn’t appear the same way on his own skin and it is undeniably true that many medical professionals lack knowledge on the appearance of certain diseases.
A 2006, analysis of medical textbooks proved that images of symptoms on darker skin were rare - many only depicting white skin. However, the handbook seeks to educate and fill in these blatant gaps by presenting images of light and dark skin, side by side. A clear example of different appearances is Kawasaki disease, where a red rash appears on light skin but is far more difficult to see on black or brown skin.
In some cases, complications are fatal and failure to diagnose means the patient is further away from receiving treatment. This issue has current relevance with coronavirus patients being told to look for signs such as blue lips and pale skin, neither of which would be visible on darker skin.A petition with over 190,000 signatures was a catalyst for the production of the handbook, which called for medical schools to include BAME representation in their teaching and argued that “white normativity” has led to medical students being “unprepared in recognising signs.”
This could lead to a worse level of care for POC, as those in the medical profession haven’t had substantial exposure to visual examples as to how these conditions can present themselves on darker skin, and therefore obviously, there are significant improvements needed within medical education, but it is promising to see students making progressive steps to eradicate this gap within medical diagnosis.
Emily Nort
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