The Perils and Rewards of Critical Consciousness Raising in Medical Education.

Inequalities in society are reflected in patterns of disease and access to health care, where the disadvantaged suffer most. Traditionally, doctors have kept politics out of their work, even though politics often shape medicine. What political responsibilities, then, should doctors have as they facilitate the learning of medical students? The article in this issue by Kumagai, Jackson, and Razack goes straight to the heart of this question. These authors ask whether educators should be wary of "cutting close to the bone" in discussing issues that may restimulate trauma in some medical students.Kumagai and colleagues suggest that it is actually the ethical responsibility of educators to introduce students to discomfort as a means of raising students' critical consciousness or their ability to sensitively gauge the positions of others and to engage in dialogue to address issues such as inequality and inequity so that previously silent and silenced voices can be heard. The author of this Commentary expands on this argument, further supporting the need to democratize medical culture and politicize doctors. Educators, as expert facilitators of this new critical consciousness raising, must create safe spaces for students to work through issues to avoid educational iatrogenesis. Such an approach to medical education is an extension of the traditional art of medicine, at the core of which are patient care and tolerance. Ethics, aesthetics, and politics can come together in such a reflexive medicine curriculum.