The UNC School of Medicine is Undergoing a Rapid Social Justice Transformation

“A curriculum embedded in social justice is essential to patient care…and, most importantly, social change.”

“Policies, systems, and practices that influence health outcomes include…patriarchy, capitalism, and imperialism”

If the ECU English Department and the NC State Microbiology Department want to get serious about imposing a single worldview on their faculty and students, they might need to schedule a site visit with the Dean of UNC’s School of Medicine.

The UNC School of Medicine looks to be on track to fully integrate social justice and critical theory into its curriculum and staffing, tenure, and promotion decisions.

According to publicly available reports authored by top administrators, the school’s social justice transformation appears to be among the most aggressive of any entity within the UNC System.

Centering an entire curriculum (for medical school) on one political view, and punishing faculty who disagree, is hardly aligned with UNC's purported commitment to academic freedom.

A school with a political mission

In May 2021, the UNC School of Medicine amended its rules governing faculty appointment, promotion, and tenure decisions.

The new rules require staff to demonstrate their support for social justice ideas and to list what steps they’ve taken to advance the cause. The new rules state a written explanation outlining “positive contributions to DEI efforts” is a “required element that will be evaluated as part of promotion and tenure requests.”

Social justice and DEI concepts are famously difficult to pin down – definitions vary widely – so the school posted some examples. Here’s an excerpt from one:

“I am committed to promoting diversity, equity, and inclusion in my clinical work, research and training programs. I have completed Bias 101 and Safe Zone training, and proudly display an equity sign on my laptop…I commit to annually attending a seminar offered by the University Office of Diversity and Inclusion to learn more about the intersectionality of race, gender, and sexual orientation…”

Is the UNC School of Medicine using tenure and promotion policies to advance a political mission?

The school itself, in an annual report, answered that question. It described the new tenure and promotion requirements as a “level of accountability that will help to make all faculty stakeholders in the school of the School of Medicine’s DEI mission.”

One wonders how the School of Medicine aligns this new tenure requirement with the University’s purported embrace of academic freedom.

UNC Trustee Perrin Jones said over the summer, when the Board of Trustees passed two academic freedom resolutions, that the Board’s “goal was to remove any specter of politicization and ensure Chapel Hill remains a forum for free and open debate.”

But UNC School of Medicine has decided there is no debate, and that faculty who believe otherwise should suffer professional consequences.

‘Patriarchy and capitalism’

The School of Medicine’s effort to infuse social justice into its medical curriculum is more complicated.

Written reports by senior administrators suggest the school has agreed to center its curriculum on social justice, target dissenting faculty with an anonymous reporting system, and overhaul its student assessment policy until white and non-white students score equally. This is for future doctors, including pediatricians and surgeons.

A 2020 task force led by senior UNC School of Medicine administrators developed a list of 42 action items to “integrate social justice into the curriculum.” Authors included an associate dean for student affairs, a senior associate dean for medical student education, and a vice dean for DEI. The group named itself the “Task Force to Integrate Social Justice into the Curriculum.”

Some of their recommendations are quite radical. For example, they propose training medical students in political advocacy to “bring about change” on criminal justice, immigration, and climate policies.

That senior administrators at the School of Medicine would even propose such policies raises red flags about the school’s direction and governance.

In a 2022 status update, the School of Medicine, presumably with sign-off from the school’s dean, reported that it met 38 of the 42 Task Force recommendations (training students in political activism was one of recommendations the school rejected).

Several of the recommendations dealt specifically with social justice curriculum. The Task Force authors wrote that “a curriculum embedded in social justice and antiracist components is essential to patient care, health equity, reduction of health disparities, and most importantly, social change.”

Certain structures of society and governance, they wrote, impact health outcomes. Those structural determinants include “white supremacy,” “patriarchy,” “capitalism,” and “imperialism.” 

The report called for all course directors to have changed their curricula by the fall of 2021 to include the following requirements:

• “All lectures addressing known health disparities will attend to those disparities and WHY they exist,” almost certainly a nod to structural determinants like capitalism;

• “Each lecture should have a structural context section";

• “Explicitly include antiracism content during lectures and small group discussions.”

The report lists this as a main objective:

“All UNC SOM faculty, as part of the core expectations of being a faculty at UNC SOM, will be expected to effectively integrate social justice content into their teaching, [and] be able to teach their content through a social justice lens.”

In its 2022 status update, the School of Medicine indicated that it had met each of the recommendations associated with social justice curriculum.

As for students who may not respond favorably to the new curriculum, the administrators who authored the report proposed to “develop policies that promote greater transparency related to students who do not comply with the SOM professionalism competencies related to social justice.” The School of Medicine said it met the recommendation associated with this objective.

And as for faculty who may not sufficiently embrace social justice in the classroom, the administrators proposed a “curricular reporting system that is designed to allow students to anonymously report issues with the curriculum by 2022.”

Ultimately, the administrators wrote that they hope to “admit a class of medical students that shares the School of Medicine’s values of service, social justice, equity, and inclusion.”

Diversity of everything – except opinion.

Sounds like another admissions lawsuit waiting to happen.

And the students the school does admit may soon face an entirely different system to determine whether they’ve mastered the medical content they’re taught.

The report’s authors – including, again, a senior associate dean for medical student education – recommended moving away from “high stakes exams” and towards “criterion-referenced testing” by 2023. The reason, they wrote, is that multiple choice exams present “an extreme source of anxiety for underrepresented-in-medicine students.”

To measure success of the major testing shift, the School of Medicine administrators propose tracking “annual improvement in average course grade of underrepresented-in-medicine students beginning in 2023, until at or exceeding non-underrepresented-in-medicine students.”

The school, then, will rely on a grading system that compares white students to non-white students. 

In its status update, the School of Medicine listed this recommendation as “addressed by existing efforts.”

But this is where matters get a bit complicated. Unlike the tenure and promotion requirements, which are written plainly and for all to see, the school’s status updates do not go into much detail.

It’s impossible to discern from available information whether the School of Medicine has truly adopted the recommendations described in full detail in the Task Force report, or whether the school is playing word games to satisfy the Task Force authors.

Even if it’s the latter, it remains true that senior administrators at the School of Medicine hold a vision for the school’s future – and the state’s future doctors – that is inconsistent with academic freedom.

In their own words, the Task Force to Integrate Social Justice into the Curriculum seeks a class of students that mirrors its own political ideology, wishes to enforce an anonymous reporting system for professors who deviate from social justice curriculum, and prizes “social change” above all else, even patient care.

There’s something wrong in higher education.