have succeeded in producing graduates with the full range of qualifications. As tools of the “social contract,” diversity and the core competencies presage a better likelihood that health care professionals have the capability and sensitivity necessary to treat all patients with the respect and understanding they deserve.

Leaders in health education, accrediting bodies, and federal agencies have debated the subject of competencies for many years, focusing on defining those they consider essential, attempting to determine indicators of achievement, and devising measurable outcomes. In recent years the Accreditation Council for Graduate Medical Education (ACGME) has worked with the American Board of Medical Specialties (ABMS) to delineate core competencies that must be attained by those in residency training and practice (ACGME, 2001). We believe that full implementation of such requirements will eventually alter the culture across all areas of medicine. It certainly appears likely that accreditation, particularly with inclusion and emphasis on diversity and cultural competence, also will be able to effect significant change. Modeling aspects of the approaches taken by ACGME and ABMS would provide a major step toward attaining the goal of producing a diverse workforce capable of proffering quality care to a diverse society.

In June 2002, the IOM held a Health Professions Education Summit that brought together 150 expert participants to generate a report on whether “doctors, nurses and other health-care professionals are being adequately prepared to provide the highest quality and safest medical care possible” (IOM, 2003a, p. 7). Their report stressed the importance of integrating a core set of competencies across professions, recommending that all programs that educate and train health professionals adopt these five core competencies: “the abilities to deliver patient-centered care, work as a member of an interdisciplinary team, engage in evidence-based practice, apply quality improvement approaches, and use information technology. The report calls on accreditation, licensing, and certification organizations to make certain that students and working professionals develop and maintain proficiency in these core areas.” (IOM, 2003b).

Cultural Competency as Part of the Social Contract

Cultural competency has been described as “a set of academic and personal skills that allow us to increase … understanding and appreciation of cultural differences among groups” (Archbold, 1996, pp. A1, A5). In light of this, cultural competency realistically falls under the objective of the IOM recommended core competency, the “ability to deliver patient-centered care.”

In her recent article, “Insurgent Multiculturalism: Rethinking How and



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