In Reply to Weissman
Dr. Weissman is also correct in pointing out that the language of “cultural competence,” as typically applied, is problematic, an issue we noted in the introduction of the article. This is especially the case when the skills we are seeking to develop are not technical (e.g., learning to tie a knot) but instead involve ongoing, iterative, and intentional approaches at monitoring, sculpting, and transforming one’s thinking. In preparing the article there were extended debates among the authors about including the phrase “cultural competence” in the title. We decided to use it given how deeply entrenched it is in the language of medical education, with the expectation that the reader would see that the IMS model represents a significantly different approach for students to engage the influences of social, cultural, and structural processes on physician relationships. Finally, we readily endorse, as is emphasized in the IMS model, that “self-awareness … is the foundation for cultural awareness.