White supremacy culture and the assimilation trauma of medical training: ungaslighting the physician burnout discourse

Med Humanit. 2023 Mar;49(1):142-146. doi: 10.1136/medhum-2022-012398. Epub 2022 Oct 14.

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.

Keywords: cultural history; medical education; medical ethics/bioethics; medical humanities; mental health care.

MeSH terms

  • Burnout, Professional*
  • Curriculum
  • Education, Medical* / methods
  • Humans
  • Physicians*
  • White