Beyond the cultural myth of medical meritocracy

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Beyond the cultural myth of medical meritocracy. / Razack, Saleem; Risør, Torsten; Hodges, Brian; Steinert, Yvonne.

In: Medical Education, Vol. 54, No. 1, 01.2020, p. 46-53.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Razack, S, Risør, T, Hodges, B & Steinert, Y 2020, 'Beyond the cultural myth of medical meritocracy', Medical Education, vol. 54, no. 1, pp. 46-53. https://doi.org/10.1111/medu.13871

APA

Razack, S., Risør, T., Hodges, B., & Steinert, Y. (2020). Beyond the cultural myth of medical meritocracy. Medical Education, 54(1), 46-53. https://doi.org/10.1111/medu.13871

Vancouver

Razack S, Risør T, Hodges B, Steinert Y. Beyond the cultural myth of medical meritocracy. Medical Education. 2020 Jan;54(1):46-53. https://doi.org/10.1111/medu.13871

Author

Razack, Saleem ; Risør, Torsten ; Hodges, Brian ; Steinert, Yvonne. / Beyond the cultural myth of medical meritocracy. In: Medical Education. 2020 ; Vol. 54, No. 1. pp. 46-53.

Bibtex

@article{0c69b3c449964ad78ac31b1fa9abbda6,
title = "Beyond the cultural myth of medical meritocracy",
abstract = "BACKGROUND: We examine the cultural myth of the medical meritocracy, whereby the {"}best and the brightest{"} are admitted and promoted within the profession. We explore how this narrative guides medical practice in ways that may no longer be adequate in the contexts of practice today.METHODS: Narrative analysis of medical students' and physicians' stories.RESULTS: Hierarchies of privilege within medicine are linked to meritocracy and the trope of the {"}hero's story{"} in literature. Gender and other forms of difference are generally excluded from narratives of excellence, which suggests operative mechanisms that may be contributory to observed differences in attainment. We discuss how the notion of diversity is formulated in medicine as a {"}problem{"} to be accommodated within merit, and posit that medical practice today requires a reformulation of the notion of merit in medicine, valorising a diversity of life experience and skills, rather than {"}retrofitting{"} diversity concerns as problems to be accommodated within current constructs of merit.CONCLUSIONS: Three main action-oriented outcomes for a better formulation of merit relevant to medical practice today are suggested: (a) development of assessors' critical consciousness regarding the structural issues in merit assignment; (b) alignment of merit criteria with relevant societal outcomes, and (c) developing inclusive leadership to accommodate the greater diversity of excellence needed in today's context of medical practice. A reformulation of the stories through which medical practitioners and educators communicate and validate aspects of medical practice will be required in order for the profession to continue to have relevance to the diverse societies it serves.",
keywords = "Academic Success, Anthropology, Cultural, Cultural Diversity, Female, Humans, Internship and Residency, Leadership, Male, Narration, Sex Factors, Students, Medical/psychology",
author = "Saleem Razack and Torsten Ris{\o}r and Brian Hodges and Yvonne Steinert",
note = "{\textcopyright} 2019 John Wiley & Sons Ltd and The Association for the Study of Medical Education.",
year = "2020",
month = jan,
doi = "10.1111/medu.13871",
language = "English",
volume = "54",
pages = "46--53",
journal = "Medical Education",
issn = "0308-0110",
publisher = "Wiley",
number = "1",

}

RIS

TY - JOUR

T1 - Beyond the cultural myth of medical meritocracy

AU - Razack, Saleem

AU - Risør, Torsten

AU - Hodges, Brian

AU - Steinert, Yvonne

N1 - © 2019 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

PY - 2020/1

Y1 - 2020/1

N2 - BACKGROUND: We examine the cultural myth of the medical meritocracy, whereby the "best and the brightest" are admitted and promoted within the profession. We explore how this narrative guides medical practice in ways that may no longer be adequate in the contexts of practice today.METHODS: Narrative analysis of medical students' and physicians' stories.RESULTS: Hierarchies of privilege within medicine are linked to meritocracy and the trope of the "hero's story" in literature. Gender and other forms of difference are generally excluded from narratives of excellence, which suggests operative mechanisms that may be contributory to observed differences in attainment. We discuss how the notion of diversity is formulated in medicine as a "problem" to be accommodated within merit, and posit that medical practice today requires a reformulation of the notion of merit in medicine, valorising a diversity of life experience and skills, rather than "retrofitting" diversity concerns as problems to be accommodated within current constructs of merit.CONCLUSIONS: Three main action-oriented outcomes for a better formulation of merit relevant to medical practice today are suggested: (a) development of assessors' critical consciousness regarding the structural issues in merit assignment; (b) alignment of merit criteria with relevant societal outcomes, and (c) developing inclusive leadership to accommodate the greater diversity of excellence needed in today's context of medical practice. A reformulation of the stories through which medical practitioners and educators communicate and validate aspects of medical practice will be required in order for the profession to continue to have relevance to the diverse societies it serves.

AB - BACKGROUND: We examine the cultural myth of the medical meritocracy, whereby the "best and the brightest" are admitted and promoted within the profession. We explore how this narrative guides medical practice in ways that may no longer be adequate in the contexts of practice today.METHODS: Narrative analysis of medical students' and physicians' stories.RESULTS: Hierarchies of privilege within medicine are linked to meritocracy and the trope of the "hero's story" in literature. Gender and other forms of difference are generally excluded from narratives of excellence, which suggests operative mechanisms that may be contributory to observed differences in attainment. We discuss how the notion of diversity is formulated in medicine as a "problem" to be accommodated within merit, and posit that medical practice today requires a reformulation of the notion of merit in medicine, valorising a diversity of life experience and skills, rather than "retrofitting" diversity concerns as problems to be accommodated within current constructs of merit.CONCLUSIONS: Three main action-oriented outcomes for a better formulation of merit relevant to medical practice today are suggested: (a) development of assessors' critical consciousness regarding the structural issues in merit assignment; (b) alignment of merit criteria with relevant societal outcomes, and (c) developing inclusive leadership to accommodate the greater diversity of excellence needed in today's context of medical practice. A reformulation of the stories through which medical practitioners and educators communicate and validate aspects of medical practice will be required in order for the profession to continue to have relevance to the diverse societies it serves.

KW - Academic Success

KW - Anthropology, Cultural

KW - Cultural Diversity

KW - Female

KW - Humans

KW - Internship and Residency

KW - Leadership

KW - Male

KW - Narration

KW - Sex Factors

KW - Students, Medical/psychology

U2 - 10.1111/medu.13871

DO - 10.1111/medu.13871

M3 - Journal article

C2 - 31464349

VL - 54

SP - 46

EP - 53

JO - Medical Education

JF - Medical Education

SN - 0308-0110

IS - 1

ER -

ID: 279348945