Authored by Tanisha Pallerla
Art by Ashley Chopra
When you open the average medical textbook in the United States, you will often find images depicting human anatomy presented as the generalized human being. Oftentimes, however, these images are not reflective of the diverse population we have in the United States—favoring the representation of white populations over the representation of people of color. Over recent years, there has been a rise in discussion around decolonizing medical education, especially when it comes to representation in medical imagery. With this being said, diversity in medical education through diverse imagery has become increasingly important.
In a study published in 2018, researchers found that only 4.5% of the images in the analyzed textbooks contained images featuring dark skin, while 74.5% of the images featured light skin . Research has shown that this lack of diversity impacts a healthcare provider’s ability to diagnose and treat patients with darker skin tones. The diagnosis of skin conditions in people with dark skin are disproportionately missed compared to those of lighter skin tones, which is associated with the underrepresentation of those skin tones in medical textbooks [2, 3]. Advances in the field of medical illustration could have a huge impact on this issue.
The significance of medical illustrations in medical education makes the diversity of skin tones represented extremely important. Illustrations have been used to teach human anatomy since the 4th century, but the field of medical illustration was not formally established in the United States until the 19th century . At this time, an artist named Max Brödel left his home in Germany to illustrate at the Johns Hopkins School of Medicine . Soon after, he became the director of the first medical illustration program, which was offered through the Department of Art as Applied to Medicine at Johns Hopkins. His work set the precedent for the field of medical illustration as it is known today .
Decades after Brödel’s innovation, in 1945, the Association of Medical Illustrators was founded. Their goal was, and still is, “...to encourage the advancement of medical illustration and allied fields of visual education…” . Since then, they have launched initiatives such as the Diversity Fellowship to increase representation in medical imagery. This initiative aims to create a digital library of illustrations that work to fill gaps in current medical images . In addition to organizational efforts to tackle this issue, individual artists have done work to advance diversity in medical illustration. In 2021, an illustration depicting the anatomy of a pregnant Black woman created by a medical student named Chidiebere Ibe went viral. The image gained attention because of its need in the field of medical illustration. Ibe said that the piece was difficult to create because he had no model to base it off of, calling for more diversity in medical imagery and illustration .
Medical illustration and imagery is a field of medicine that is constantly evolving and advancing to improve the teaching of medicine. Diversity should be a significant area of focus as this field continues to develop in order to better equip future healthcare providers to care for their increasingly diverse patient populations.
Louie P, Wilkes R. Representations of race and skin tone in medical textbook imagery. Soc Sci Med. 2018 Apr;202:38-42. doi: 10.1016/j.socscimed.2018.02.023. Epub 2018 Feb 23. PMID: 29501717.
Gordon, D. (2022, May 12). Health equity comes to medical illustrations with launch of New Image Library. Forbes.
Papier, A. (2023, July 25). To begin addressing racial bias in medicine, start with the skin. STAT. https://www.statnews.com/2020/07/20/to-begin-addressing-racial-bias-in-medicine-start-with-the-skin/
A century of medical illustration. (2011). A century of medical illustration : Gazette Archives. (n.d.). https://gazette.jhu.edu/2011/07/18/a-century-of-medical-illustration/
Ami diversity fellowship. AMI. (n.d.-a). https://ami.org/professional-resources/diversity-fellowship