Medical Education under Siege: Critical Pedagogy, Primary Care and the Making of “Slave Doctorsâ€

Abstract

According to Kerr White, medical education is "mired in unhelpful rhetoric, unbecoming hubris, and reliance on an outmoded biomedical paradigm that ignores social, environmental, and psychological influences on health and health care.”  This article is an ethnographic case study of a six-year, $6 million project at Michigan State University (and three surrounding communities) that challenged this reality. The goal was to create community-oriented primary care. Commu­nity participation was a paramount goal in all areas of project life. On paper the project was quite radical as local communities were to be empowered to shape and create the medical curriculum. The project was called the Community/University Health Partnerships. Underwritten by the W. K. Kellogg Foundation it was part of a larger$50 million effort in seven U.S. states. The author, an anthropologist, served as an evaluator on the project, charged with the mission to make it succeed. The article shows how he used critical pedagogy and critical ethnography towards these ends. It traces the relationship between neoliberalism and medical education and highlights significant instances of hegemony and counterhegemony between the medical schools and the communities in the doomed project.