Curriculum as orchid

The mapping of the curriculum in medical education is an important process. Yet there is an assumption that what is taught (as reflected in the documents) will be representative of students’ learning experiences – a tracing of the requirements to become a good Doctor.

In the image above (drawn on my iPad using flowpaper) I consider the medical curriculum as the Deleuzian orchid that opens up with complexity through the years. If the students are Deleuzian wasps who interact with the curriculum at different places, then the in-between space of becoming-curriculum and becoming-doctor can be explored rhizomatically. In the process of learning there are movements of indeterminancy.

“The rhizome is altogether different, a map and not a tracing…. The orchid does not reproduce the tracing of the wasp; it forms a map with the wasp, in a rhizome. What distinguishes the map from the tracing is that it is entirely oriented toward an experimentation in contact with the real. The map does not reproduce an unconscious closed in upon itself; it constructs the unconscious. It fosters connections between fields, the removal of blockages on bodies without organs, the maximum opening of bodies without organs onto a plane of consistency. It is itself a part of the rhizome. The map is open and connectable in all of its dimensions; it is detachable, reversible, susceptible to constant modification. It can be torn, reversed, adapted to any kind of mounting, reworked by an individual, group, or social formation” (Deleuze & Guattari (1987:12).

Similarly our students are open to the influences of the practices they observe when immersed in their Obstetrics practical rotation. When a midwife chooses to watch television in preference to attending to the needs of a woman in pain or when a Doctor does not ensure informed consent before a procedure, these actions leave marks on students, like sticking pollen.

“The orchid deterritorializes by forming an image, a tracing of a wasp; but the wasp reterritorializes on that image. The wasp is nevertheless derritorialized, becoming a piece in the orchid's reproductive apparatus. But it reterritorializes the orchid by transporting its pollen. Wasp and orchid, as heterogeneous elements, form a rhizome. It could be said that the orchid imitates the wasp, reproducing its image in a signifying fashion (mimesis, mimicry, lure, etc.). … At the same time, something else entirely is going on: not imitation at all but a capture of code, surplus value of code, an increase in valence, a veritable becoming, a becoming-wasp of the orchid and a becoming-orchid of the wasp. Each of these becomings brings about the deterritorialization of one term and the reterritorialization of the other; the two becomings interlink and form relays in a circulation of intensities pushing the deterritorialization ever further (Deleuze & Guattari 1987:11).

In the rhizomatic connection between the students and the curriculum, I question whether the relationship is presently fostering the acceptance of injustice to women in labour. When students write about their unwillingness to respond to wrong-doing (by those who are meant to teach them), it reflects the impact for both now and later – leaving pollen on their being and becoming. This choice of inaction takes on a form of protection for themselves towards advancement in the course objectives. In order to bring change towards developing a socially just curriculum, we need to consider the reciprocal-becoming in the orchid-wasp/curriculum-student relationship.

Deleuze, G., & Guattari. F. 1987. A thousand plateaus: Capitalism and schizophrenia. Trans. B. Massumi. Minneapolis, MN: University of Minnesota Press.