The experience of Black medical specialists in training at two medical schools in the Western Cape

Shabalala, Nokulunga Candice (2019-12)

Thesis (PhD)--Stellenbosch University, 2019.

Thesis

ENGLISH ABSTRACT: Medical education has seen the increase of previously marginalised groups (Black, female, disabled) in undergraduate training. However, this shift is not as noticeable at postgraduate level. This has led to a number of calls for the transformation of medical education. Recent student protests in South Africa have illuminated issues of access and citizenship in higher education and have led to urgent calls for decolonised curricula and the transformation of higher education institutions. There are contestations regarding what transformation really is, with arguments suggesting that while policies exist, there is a huge gap between policy and practice. In order to realise the efforts of transformation, it is important to understand the lived experiences of students in South Africa. This study looks at the experiences of medical specialists in training (registrars) at Stellenbosch University (SU) and the University of Cape Town (UCT). The concept of race trouble was used to conceptualise the racialised experience of registrars in relation to their training and the extent to which they felt a sense of belonging. The dissertation also theoretically explores Black subjectivity in post-apartheid South Africa by looking at how the persistence of coloniality in historically advantaged institutions presents itself, and shapes the experience of higher education. The intersection of race, class and gender is also briefly discussed in this body of work; however the main focus is on race and the experience thereof within medical training. Due to recent conversations about the pace at which historically advantaged institutions are transforming and what this really means, I set out to explore the day-to-day experiences of medical specialists in training at SU and UCT. A qualitative research design was employed. A total of 19 semi-structured, individual interviews were conducted with 11 registrars from both SU and UCT. Initial themes from the interview data were presented to a group of registrars in a form of a focus group for the purpose of respondent validation. Thematic analysis was used to code and analyse the data. This was done in efforts to find patterns and themes for interpretation. Registrars mostly spoke about their undergraduate experiences, but also reflected on their current training. Results highlighted the complexity on the road to medical specialisation. The core finding related to the level at which registrars felt they had access to supportive structures. As such, one of the most salient themes in the data is the sense of registrars not feeling at home at these institutions, and they highlighted a need for more support and mentorship structures. The data show that there is still a need to discuss what deep transformation in higher education can look like in the future. Keywords: Black Medical Registrars, Race Trouble, Transformation, Higher Education, Institutional Racism, Medical Education, South Africa

AFRIKAANSE OPSOMMING: Voorheen benadeelde grope (swart, vroulik, gestremd) betree toenemend mediese opleiding op voorgraadse vlak. Hierdie skuif is egter minder sigbaar op nagraadse vlak, wat op sy beurt, die transformasie van mediese opleiding vertraag. Die onlangse Suid-Afrikaanse studenteproteste het kwessies rakende toeganklikheid en burgerskap in hoër onderwys aan die lig gebring en, op sy beurt, aanleiding gegee tot ‘n drigende beroep vir die dekolonisering van kurrikulum en die transformasie van hoër onderwys instellings. Die ware betekenis van transformasie is debateerbaar en argumente hou voor dat, alhoewel beleide in die verband wel bestaan, daar steeds ‘n groot gaping tussen beleid en praktyk is. Dit is dus belangrik om die belewenisse van Suid-Afrikaanse studente te begryp binne konteks van transformasie In hierdie studie word die belewenisse van mediese opleidingsspesialiste (registrateurs) aan die Universiteit van Stellenbosch (SU) en die Universiteit van Kaapstad (UK) ondersoek. Die rasverwante opleidingsbelewenisse van die registrateurs asook hulle gevoel van behoort is deur middel van die rasse-probleme “race trouble” konsep gekonseptualiseer. Die verhandeling ondersoek ook, op ‘n teoretiese wyse, swart subjektiwiteit in post-Apartheid Suid-Afrika. Dit sluit ‘n ondersoek na die voorkoms van volgehoue kolonialiteit binne histories bevoordeelde instellings in, asook die wyses waarop laasgenoemde die belewenisse van hoër onderwys beïnvloed. Hoewel die kruising van ras, klas en gender ook kortliks in hierdie werk bespreek word, bly ras en die belewenis hiervan binne mediese opleiding die oorhoofse fokus van hierdie werk. As gevolg van die onlangse gesprekke rakende die pas waarteen histories bevoordeelde instellings transformeer en die dieper betekenis hieraan verbonde, is die daaglikse belewenisse van mediese opleidingsspesialiste aan US en UK begin ondersoek. ‘n Kwalitatiewe navorsingsontwerp is gevolg. Negentien individuele, semigestruktureerde onderhoude is gevoer met elf registrateurs van beide US en UK. Die aanvanklike temas is in fokusgroep formaat vir ‘n groep registrateurs aangebied. Dit het dus ook gedien as respondente validering. Data is volgens die tematiese data-analise metode gekodeer en ge-analiseer. Hierdie metode het patrone en temas vir interpretasie aan die lig gebring. Registrateurs het grotendeels hul voorgaadse ondervinge bespreek, maar hulle het ook op hul huidige opleiding gereflekteer. Bevindinge het die komplekse opgang na mediese spesialisering na vore gebring. Die kern bevinding behels die mate waarin registrateurs toegang tot ondersteuningsnetwerke ervaar het. Een van die mees opvallendste temas wat voortgespruit het uit die data is dat die registrateurs nie tuis voel binne hierdie instellings nie. Hulle het ook die behoefte aan verhoogde ondersteuning en mentorskapsstruktuur uitgewys. Die data dui op die behoefte aan voortgesette gesprekke rakende die wyse waarop ware transformasie in hoër onderwys in die toekoms daarna kan uitsien. Sleutelwoorde: swart mediese registrateurs, rasse-probleme “race trouble”, transformasie, hoër onderwys, institusionele rassisme, mediese opleiding, Suid-Afrika

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/107089
This item appears in the following collections: