Thinking the post-colonial in medical education.

CONTEXT: Western medicine and medical techniques are being exported to all corners of the world at an increasing rate. In a parallel wave of globalisation, Western medical education is also making inroads into medical schools, hospitals and clinics across the world. Despite this rapidly expanding field of activity, there is no body of literature discussing the relationship between post-colonial theory and medical education. DISCUSSION: Although the potential benefits of international partnerships and collaborations in education are incontrovertible, many medical educators are sometimes too unreflecting about what they are doing when they advocate the export of Western curricula, educational approaches and teaching technologies. The Western medical curriculum is steeped in a particular set of cultural attitudes that are rarely questioned. We argue that, from a critical theoretical perspective, the unconsidered enterprise of globalising the medical curriculum risks coming to represent a 'new wave' of imperialism. Using examples from Japan, India and Southeast Asia, we show how medical schools in non-Western countries struggle with the ingrained cultural assumptions of some curricular innovations such as the objective structured clinical examination, problem-based learning and the teaching of clinical skills. CONCLUSIONS: We need to develop greater understanding of the relationship between post-colonial studies and medical education if we are to prevent a new wave of imperialism through the unreflecting dissemination of conceptual frameworks and practices which assume that 'metropolitan West is best'.