Transforming existing norms for payment and legitimacy of ‘teaching work’ in medical education

Abstract

What counts as work and the rewards attributed by society for that work are complex. Norms are often well-established within societies and organisations. These norms produce particular power relations and, when not democratically distributed, related inequalities. What we value as work and how this is measured and rewarded, are crucial questions for medical education. At the heart of medical education is a tension between curricula ambitions and immersion in the complex, patient-driven world of clinical healthcare. Work as a clinical teacher crosses these two worlds of university-based academia and healthcare service. Each has deeply embedded hierarchical cultures which value certain work and rewards as legitimate; and particular modes of outcome measurement as more or less valuable and reliable.