Understanding and addressing the influence of colonialism on obstetrics and gynaecology postgraduate specialty training through participatory action

该项目旨在了解殖民主义是如何体现在指导医生妇产科教育的教育指南中，它如何影响妇产科学员和培训师的经历，以及需要做出哪些改变来改善医生的专业教育，这可能会导致未来对患者的更公平的照顾。在过去的500年里，殖民主义告诉我们系统和知识是如何建立和实施的，并且在今天的医学教育和病人护理和结果中仍然有非常明显的影响。在o&g领域，成为少数群体意味着面临更大的不良健康后果和歧视风险。来自少数族裔背景的实习医生，尤其是来自少数族裔背景的实习医生，更有可能在考试中不及格，在年度能力进步评估中得到不满意的结果，并在培训和工作中受到歧视。我将使用批判性话语分析来分析管理油气研究生专业培训的指导方针，重点关注随着时间的推移而产生的编纂文本中嵌入的权力动态和潜在不平等。我将采访实习医生和培训师，以了解他们的教育经验。基于对两者的分析，我将共同提出一个结构化的建议，以改善油气教育的平等和公平。正如最近的《柳叶刀》系列所述，种族主义、仇外心理和歧视存在于每个现代社会，导致本可避免的疾病和往往已经处于不利地位的群体过早死亡（Devakumar等人，2022年）。解决这些现象造成的健康危害的方法之一是认识、检查和消除殖民主义的遗产（Abubakaret al., 2022）。

This project aims to understand how colonialism ismanifested in educational guidelines that govern Obstetrics& Gynaecology (O&G) education for doctors, how itinfluences the experiences of O&G trainees and trainers,and what changes are needed to improve specialisteducation for doctors, which may lead to more equitablecare for patients in the future.Colonialism has informed how systems and knowledgehave been built and implemented for the past 500 yearsand still has a very tangible effect in today's medicaleducation and patient care and outcomes. In the field ofO&G, being minoritised means being at increased risk ofadverse health outcomes and discrimination. O&G traineedoctors from minoritised backgrounds, and especiallyracially minoritised backgrounds, are more likely to failexams, receive unsatisfactory outcomes during theirAnnual Review of Competency Progression, and experiencediscrimination in training and at work.I will use Critical Discourse Analysis to analyse theguidelines that govern O&G postgraduate specialty trainingfocusing on the power dynamics and potential inequalityembedded within the codified texts produced over time. Iwill interview trainee doctors and trainers to elicit theireducational experience. Based on the analyses of the two, Iwill co-produce a structured recommendation to improvethe equality and fairness in O&G education.As illustrated in the recent Lancet series, racism,xenophobia, and discrimination exist in every modernsociety causing avoidable disease and premature deathamong groups who are often already disadvantaged(Devakumar et al., 2022). One of ways to address thehealth harms caused by these phenomena is to recognise,examine, and undo the legacies of colonialism (Abubakaret al., 2022).