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White supremacy culture and the assimilation trauma of medical training: ungaslighting the physician burnout discourse
  1. Rupinder K Legha1,
  2. Nathalie N Martinek2
  1. 1Los Angeles, California, USA
  2. 2Melbourne, Victoria, Australia
  1. Correspondence to Dr Rupinder K Legha, Rupinder K Legha MD PC, Los Angeles, CA 90056, USA; antiracistmd{at}gmail.com

Abstract

The physician burnout discourse emphasises organisational challenges and personal well-being as primary points of intervention. However, these foci have minimally impacted this worsening public health crisis by failing to address the primary sources of harm: oppression. Organised medicine’s whiteness, developed and sustained since the nineteenth century, has moulded training and clinical practice, favouring those who embody its oppressive ideals while punishing those who do not. Here, we reframe physician burnout as the trauma resulting from the forced assimilation into whiteness and the white supremacy culture embedded in medical training’s hidden curriculum. We argue that ‘ungaslighting’ the physician burnout discourse requires exposing the history giving rise to medicine’s whiteness and related white supremacy culture, rejecting discourses obscuring their harm, and using bold and radical frameworks to reimagine and transform medical training and practice into a reflective, healing process.

  • medical education
  • cultural history
  • medical humanities
  • mental health care
  • medical ethics/bioethics

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Footnotes

  • Twitter @RupiLegha

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note NNM and RKL's contributions to this paper were synergistic, based on a collaboration and dialogue that lasted nearly a year and drawing on their individual expertise and observations, cultivated over decades. The current system used to signify authorship reflects a linear, hierarchical structure that is divisive in nature, disrespecting of this and like-minded collaborations, and reinforcing of the white supremacy culture this paper strives to challenge. It does not lend credence to the shared contributions, rooted in solidarity, of racially and otherwise socially diverse collaborators. Nor does it acknowledge the risk of undermining the collective they consciously created through their anti-oppressive and introspective writing approach.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.