Training for Unequal Care: Medical Students, Social Inequalities and the Clinical Gaze
Summary of the research project
This project explores the ways in which physicians are trained to perceive and respond to social difference and social inequalities in their apprenticeship for the work of medical care among patients with diverse illnesses, injuries and diseases, including importantly cancers. This work utilizes several years of first-hand, in-depth ethnographic research with medical students, interns, residents and their attending physician and nurse colleagues in order to explore especially the ways in which health professional subjectivation leads to the visibility and invisibility of certain forms of social difference and inequality in relation to health and health care. The proposed book manuscript will analyze and theorize the process of clinical subjectivation – to use Foucault’s term for the production of a particular kind of subject – among medical trainees, specifically focused on the ways in which they are explicitly and implicitly taught to understand and respond to the sociocultural, political and economic categories in which their patients and they themselves are positioned. The book will conclude with a critical consideration of the new framework of “structural competency” as it emerges from the medical social sciences in the U.S. and Europe to impact and intervene in health professional training.
I completed my PhD in Cultural and Medical Anthropology at the University of California Berkeley and my MD in the School of Medicine of the University of California San Francisco in 2007. After my internship and residency in internal medicine at the University of Pennsylvania (2007-2009), I completed my post-doctoral fellowship as a Robert Wood Johnson Foundation Health & Society Scholar at Columbia University (2009-2011). In addition, I taught in the Department of Global Health and Social Medicine at Harvard University in 2010. I joined the faculty of the University of California Berkeley as Martin Sisters Endowed Chair in Public Health and Medical Anthropology in 2011. Today, I am Associate Professor with Tenure and Chair of Society, Environment and Medical Anthropology at the University of California Berkeley. I founded and am Co-Chair of the Berkeley Center for Social Medicine as well as Co-Director of the MD/PhD Track in Medical Anthropology coordinated between the University of California Berkeley and the University of California San Francisco. My research focuses on the ways in which social difference and social inequality lead to differential experiences of health and illness and the means by which these social and health inequalities come to be understood as normal and natural in society and in health care. Some of my research focuses on the health and health care experiences of immigrants, migrants and refugees, while other projects focus on the training of medical students and physicians in relation to social factors.