BACKGROUND:
Medicine has historically been shaped by colonialism and scientific racism, with racialised knowledge systems used to legitimise exploitation, slavery, and hierarchical social orders. Although race is now widely recognised as a social rather than biological construct, race-based assumptions continue to influence medical education, research, and clinical practice. These legacies contribute to persistent inequities in diagnosis, treatment, and access to care for marginalised populations. Understanding how historical and epistemic forms of racism continue to shape contemporary health systems is essential for advancing equity in public health.

METHODS:
This chapter employs a critical historical and conceptual analysis to examine the intersections between colonialism, scientific racism, and race-based medical practice. It traces the development of racialised medical knowledge from Enlightenment-era human classification systems and craniometry through their institutionalisation in colonial medicine, law, and governance. The analysis then examines how these logics persist in contemporary contexts, including race-based clinical algorithms, biased medical curricula, and research practices that reify race as biological rather than social.

RESULTS:
The analysis demonstrates that scientific racism remains embedded within modern medical practice through institutional norms, pedagogical frameworks, and clinical decision-making tools. These practices perpetuate health inequities by reinforcing biological interpretations of race and obscuring the structural and social determinants of health. While recent institutional acknowledgements and curricular reforms signal growing recognition of medicine’s complicity in racial injustice, such efforts are often fragmented and insufficient to address deeply rooted structural harms.

CONCLUSIONS:
Dismantling scientific racism in medicine requires more than symbolic recognition or isolated reforms. It demands structural transformation in how medical knowledge is produced, taught, and applied, alongside a clear commitment to equity-driven public health practice. Addressing the enduring influence of colonial and racialised epistemologies is essential for building inclusive, just, and equitable health systems.