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如何体现在管理妇产科（O&G）医生教育的教育指南中，它如何影响O&G学员和培训师的经验，以及需要进行哪些改变来改善医生的专业教育，在过去的500年里，殖民主义已经告知了系统和知识是如何建立和实施的。在今天的医学教育和病人护理和结果中仍然有着非常明显的影响。在O &G领域，被少数化意味着更有可能出现不利的健康结果和歧视。来自少数民族背景，特别是种族少数民族背景的O&G培训医生更有可能考试不及格，在他们的能力进展年度评估中获得不满意的结果，并在培训和工作中经历歧视。我将使用批判性话语分析来分析O&G研究生专业培训的指导方针，重点关注权力动态和潜在的不平等，这些不平等嵌入在随着时间的推移而产生的编纂文本中。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O&G教育的平等和公平。正如最近的柳叶刀系列所说明的那样，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过早死亡，这些疾病和歧视往往已经处于不利地位的群体（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年）。

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).