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Structural competency is a new curricular framework for training health professionals to recognise and respond to disease and its unequal distribution as the outcome of social structures, such as economic and legal systems, healthcare and taxation policies, and international institutions. While extensive global health research has linked social structures to the disproportionate burden of disease in the Global South, formal attempts to incorporate the structural competency framework into US-based global health education have not been described in the literature. This paper fills this gap by articulating five sub-competencies for structurally competent global health instruction. Authors drew on their experiences developing global health and structural competency curricula—and consulted relevant structural competency, global health, social science, social theory, and social determinants of health literatures. The five sub-competencies include: (1) Describe the role of social structures in producing and maintaining health inequities globally, (2) Identify the ways that structural inequalities are naturalised within the field of global health, (3) Discuss the impact of structures on the practice of global health, (4) Recognise structural interventions for addressing global health inequities, and (5) Apply the concept of structural humility in the context of global health. [ABSTRACT FROM AUTHOR]

Background: The influence of societal inequities on health has long been established, but such content has been incorporated unevenly into medical education and clinical training. Structural competency calls for medical education to highlight the important influence of social, political, and economic factors on health outcomes.Aim: This article describes the development, implementation, and evaluation of a structural competency training for medical residents.Setting: A California family medicine residency program serving a patient population predominantly (88 %) with income below 200 % of the federal poverty level.Participants: A cohort of 12 residents in the family residency program.Program Description: The training was designed to help residents recognize and develop skills to respond to illness and health as the downstream effects of social, political, and economic structures.Program Evaluation: The training was evaluated via qualitative analysis of surveys gathered immediately post-training (response rate 100 %) and a focus group 1 month post-training (attended by all residents not on service).Discussion: Residents reported that the training had a positive impact on their clinical practice and relationships with patients. They also reported feeling overwhelmed by increased recognition of structural influences on patient health, and indicated a need for further training and support to address these influences. [ABSTRACT FROM AUTHOR]

The article focuses on the inconsistent and often uncritical use of patients' racial identities in clinical documentation, which can perpetuate biases and disparities in healthcare. It discusses the need for antiracist documentation practices to actively identify and dismantle racism in medical records, emphasizing the importance of critical awareness when using race as a social and political category in healthcare documentation.