Racist Inclusion and Marginalization in Medical Education and Practice in Germany

Social cohesion can be seen as mainly constituted by social relations, sense of belonging, and orientation towards the common good, whereas inequality in access to material and symbolic resources and quality of life outcomes may be seen as antecedents or consequences of social cohesion (cf. Schiefer and Van der Noll 2017). Our exploratory study on racism in medical education and practice in Germany revealed connections to social cohesion understood in this way. This chapter takes a first step toward addressing these connections, arguing, above all, that different levels of institutional racism are closely intertwined. For example, exclusionary practices towards racialized patient groups are reflected in the de-thematization of racism in medical education, and exclusionary semantics, such as ‘us-them’ distinctions in teaching materials, are reflected in the everyday experiences of students and physicians. As a result, we conclude that the various elements of social cohesion cannot be considered in isolation from one another, especially in the context of racist social relations and with respect to the challenge of transformative social change.