When it comes to education of its trainees, most health professions have adopted the use of competencies. Spanning across the domains of knowledge, skills and attitudes, these competencies assess trainee outcomes in familiar and often standardized contexts. While important, a checklist of competencies cannot address the demands of the complex context in which medical practice operates today. Developing a critical consciousness by means of pedagogies can help meet contemporary educational goals to foster a deeper awareness of these challenges. This involves moving from a naïve view of the world, to a more critical one that is ‘conscious' of the biological, social and historical aspects of power and privilege. By asking learners to think critically about social patterns and structural causes of ill health, one can promote opportunities to nurture their critically reflexive commitments towards a just and equitable society. Advocated by Brazilian educational theorist Paulo Freire, ‘critical pedagogy' is a means of empowering people to effect social change by questioning structures of power and oppression. While the discourse around its relevance has been gaining momentum within health professions education, the application of its theoretical constructs can be challenging for scholars and educators. This is evident across the many well-intentioned competency-based curricula that teach students and trainees about social inequities, but fail to educate them on the institutions that lead to the creation of those inequities. Many of these teachings reinforce stereotypes, generate biases, and diminish autonomy. As part of the Georgetown Medical Humanities Initiative, our project aims to develop frameworks to incorporate critical pedagogies in Undergraduate Medical Education. We specifically focus on the deterministic ways through which Problem Based Learning impose a biomedical worldview of disparities in healthcare among medical students, and propose novel ways to develop a contextual ‘worldview' of illness. This is especially timely given the recent changes within the MedStar Health network to adopt a Universal estimated Glomerular Filtration Rate (eGFR) without race modifiers. Other potential areas to explore through clinical vignettes include race corrections in spirometry, access to obstetric care among women of color, history of redlining and so on. By leveraging critical pedagogies, we hope to facilitate a robust understanding of social determinants and transition from a competency based medical education to one that is a capability based.

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