Modern Medicine Is a Colonial Artefact: Introducing Decoloniality to Medical Education Research.

This commentary presents the position that modern medicine is a colonial artefact in the sense that the type of scientific thinking that underpins modern medicine emerged from western knowledge structures based on a history of colonialism. The author suggests the colonial roots of Western-based modern medicine must be re-examined. While there are various critical theories that may be applied in this reexamination, most do not adequately account for intersectional, intergenerational, and sociohistorical inequities encountered in the multiplicity of global contexts in practice teaching and research within medicine. The author presents decoloniality as a theoretical perspective from which to interrogate sociohistorical, geopolitical, and economic perspectives on gender, race, and heteropaternalistic influences in medicine emanating from a basis in colonially developed systems of knowledge production. The author offers definitions of relevant theoretical terms and suggests that decolonial praxis begins with an initial realization or awareness of one's position within the colonial matrix of power followed by the reflecting or deliberation, or a grappling with real-life struggles that are encountered in confronting the oppressive operations of the colonial matrix of power. Decolonial praxis involves action through challenging mainstream foundational theories-the questions they generate, the research methods they support, and the writing styles they employ. In medical education this may involve changing powerful actors, such as medical journal editors and researchers, with historical privilege; shifting the balance of power in research spaces; and dismantling physical and intellectual structures and institutions established on colonial epistemologies.