Med Student, Heal Thyself: Discourses of Wellness in Undergraduate Medical Education
Bibliographic record
Abstract
This dissertation examines discourses of wellness in Ontario medical education. Despite an abundance of wellness resources and programming, medical students consistently report poorer mental, physical, and financial well-being than their peers. Using Foucauldian discourse analysis, I explore how historical foundations, institutional policies, research discourses, and professional guidelines construct wellness in ways that individualize responsibility and obscure structural contributors to student wellbeing and ill health. I analyze five key areas: 1) the sociohistorical contingencies underpinning wellness in undergraduate medical education, with a focus on the structural legacy of the 1910 Flexner Report within today’s corporate university; 2) the articulation of ideals and expectations of wellness through institutional texts such as mission statements, vision documents, and strategic plans; 3) the role of medical education research in perpetuating problematic discourses that place the burden of wellness on individual students, despite overwhelming evidence of systemic and cultural causes; 4) the intersection of wellness and medical professionalism, which came to be articulated through Canadian physician strikes and the CanMEDS roles; and, 5) the surveillance mechanisms tied to wellness discourses. I argue that discourses of wellness have become a central value in contemporary medical schools, shaped by broader socio-historical forces such as the widespread cultural preoccupation with wellness, the development of the corporate university, and the entrenched culture of medical education, with its emphasis on self-sacrifice, discipline, and hierarchy. These discourses produce the medical student as a responsibilized biopolitical subject, compelled to self-surveil and embody idealized notions of wellness for both patients and peers. I show that the concept of professionalism plays an especially important role as a tool of social regulation, reproducing ableism, sanism, and fatphobia within medical education. Ultimately, discourses of wellness both conceal and perpetuate structural and cultural barriers to health, resulting in students being blamed for their struggles and denied the collective conditions necessary for genuine wellness.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.024 | 0.053 |
| Scholarly communication | 0.010 | 0.008 |
| Open science | 0.001 | 0.011 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".