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

This project aims to understand how colonialism is
manifested in educational guidelines that govern Obstetrics
& Gynaecology (O&G) education for doctors, how it
influences the experiences of O&G trainees and trainers,
and what changes are needed to improve specialist
education for doctors, which may lead to more equitable
care for patients in the future.

Colonialism has informed how systems and knowledge
have been built and implemented for the past 500 years
and still has a very tangible effect in today's medical
education and patient care and outcomes. In the field of
O&G, being minoritised means being at increased risk of
adverse health outcomes and discrimination. O&G trainee
doctors from minoritised backgrounds, and especially
racially minoritised backgrounds, are more likely to fail
exams, receive unsatisfactory outcomes during their
Annual Review of Competency Progression, and experience
discrimination in training and at work.

I will use Critical Discourse Analysis to analyse the
guidelines that govern O&G postgraduate specialty training
focusing on the power dynamics and potential inequality
embedded within the codified texts produced over time. I
will interview trainee doctors and trainers to elicit their
educational experience. Based on the analyses of the two, I
will co-produce a structured recommendation to improve
the equality and fairness in O&G education.

As illustrated in the recent Lancet series, racism,
xenophobia, and discrimination exist in every modern
society causing avoidable disease and premature death
among groups who are often already disadvantaged
(Devakumar et al., 2022). One of ways to address the
health harms caused by these phenomena is to recognise,
examine, and undo the legacies of colonialism (Abubakar
et al., 2022).