“I didn’t think I had much to say.”

That was my first thought when I was invited to speak on a podcast exploring personal journeys into Health Professions Education (HPE). As a dentist trained in the Global South, working in Malaysia, and educated in the Global North, I’ve often felt like an imposter in these spaces—present, but peripheral. But what began as a conversation about my entry into HPE quickly opened into something more: a reflection on epistemic injustice, disciplinary silencing, and the quiet strategies many of us learn to survive—and sometimes resist—in academic spaces not built with us in mind.

In a powerful 2023 article, Thirusha Naidu asserts, “Reflexivity is not indulgence but resistance.” Her piece, which speaks candidly of the shapeshifting required of Global South scholars, resonated deeply with my own experience, particularly within dentistry. Dentistry, though foundational to health systems, remains epistemically and institutionally marginal in many HPE spaces. As Neville (2023) argues, there is an urgent need for a “sociology of dental education” that explores not just technical training, but the broader sociocultural and political dimensions of the field.

This marginality is reflected in publishing patterns, authorship hierarchies, and disciplinary representation. Collyer (2016) documents how academic publishing continues to favour Global North perspectives, with contributions from the Global South often considered “local” or context-specific, rather than generative of theory or innovation. Ajjawi et al. (2009) similarly critique the way Global South scholars must adapt their writing and framing to meet Global North standards—a process Khan et al. (2022) describe as linguistic and epistemic coloniality.

As a dental educator based in Southeast Asia, I’ve often felt the burden of translation—not just of language, but of intellectual legitimacy. Even within interdisciplinary HPE forums, dentistry can feel sidelined. As Demopoulos et al. (2022) note, structural disparities in dental education curricula often mirror broader patterns of racial and disciplinary exclusion. This aligns with Sims (2024), who critiques how the Global North/South binary obscures ongoing hierarchies and homogenises Global South experiences.

These experiences are not limited to geography or discipline. They are layered with identity. As someone who identifies as queer and neurodiverse, I often navigate spaces not just as a dental professional but as someone whose way of knowing and being remains unintelligible to dominant frameworks. Cornett et al. (2023) point out that professional identity formation in dental education is still under-theorised, especially from poststructural, feminist, or critical perspectives. The result? A flattening of identity and the silencing of difference.

When I spoke on the podcast, I shared moments of feeling like an imposter. But what I didn’t fully articulate then was how those feelings are symptoms of epistemic injustice. As Heggen and Berg (2021) remind us, epistemic injustice is not just about exclusion—it is about the systemic devaluation of one’s capacity as a knower. In my case, it is not only my personal knowledge that is undervalued, but also the disciplinary knowledge of dentistry, the affective knowledge of emotional labour, and the embodied knowledge of intersectional identities.

Naidu (2023) describes this as the cost of “shapeshifting” to survive in the Global North’s academic order. I know this cost intimately. The effort to conform, to simplify, to suppress—these are not academic techniques; they are coping strategies. Reich and Reich (2006) propose a culturally competent interdisciplinary collaboration model, which recognises the tensions and negotiations across disciplines. Such a model could help reframe how we engage with dentistry and allied health not as peripheral, but as critical sites of knowledge.

Still, despite these tensions, I chose to speak. The podcast became a site of gentle disruption—where a dentist didn’t have to justify her presence, but could speak from it. That matters. I recall Ajjawi’s (2009) description of the ‘us and them’ mentality in medical education—where dental professionals are often made to feel like intruders rather than colleagues. That small acknowledgement, that pause in which I could speak freely, disrupted that narrative. And in speaking, I found clarity. As I shared my journey, I was reminded that the discomfort of visibility is often less painful than the silence of invisibility. And perhaps that is where resistance begins—not in shouting, but in staying.

So what would it mean for HPE to genuinely centre epistemic plurality—not only by inviting different disciplines and geographies into the room, but by reimagining who gets to build the room in the first place? Moving forward, I hope to collaborate with other marginalised scholars, not to assimilate, but to co-create new grammars of legitimacy. I’m increasingly interested in conversations that make space for discomfort, contradiction, and care. Perhaps it is in these margins that the most important truths are waiting.

I believe that dentistry has much to offer HPE—not only in clinical expertise, but in understanding identity, marginalisation, and care. Acknowledging the epistemic injustice embedded in our systems is the first step toward change. As a scholar-educator, I now see my work not as fitting in, but as carving space.

So, here I am. Still speaking. Not with the loudest voice, perhaps, but with a voice that no longer seeks to shapeshift. And that, I think, is enough.

References

Ajjawi, R., Hyde, S., Roberts, C. and Nisbet, G. (2009) ‘Marginalisation of dental students in a shared medical and dental education programme’, Medical Education, 43(3), pp. 238–245. https://doi.org/10.1111/j.1365-2923.2008.03280.x

Collyer, F.M. (2016) ‘Global patterns in the publishing of academic knowledge: Global North, global South’, Current Sociology, 66(1), pp. 56–73. https://doi.org/10.1177/0011392116663477

Cornett, A., Henson, H., and Jain, N. (2023) ‘Professional identity research in the dental literature: A scoping review’, European Journal of Dental Education, 27(2), pp. 289–299. https://doi.org/10.1111/eje.12827

Demopoulos, C., Crim, M. and Perry, S. (2022) ‘Racial and oral health equity in dental education: Gaps and opportunities’, Journal of Dental Education, 86(5), pp. 626–634. https://doi.org/10.1002/jdd.12918

Heggen, K. and Berg, A. (2021) ‘Epistemic injustice in the age of evidence-based practice: Reflections on teaching and learning’, Nursing Philosophy, 22(3), e12312. https://doi.org/10.1111/nup.12312

Khan, M., Rattani, S. and Khamis, T. (2022) ‘How we classify countries and people—and why it matters’, Medical Teacher, 44(7), pp. 707–709. https://doi.org/10.1080/0142159X.2022.2032333

Naidu, T. (2023) ‘The personal is political in the struggle for equity in global medical education research and scholarship’, Medical Teacher, 45(1), pp. 1–3. https://doi.org/10.1080/0142159X.2022.2152207

Neville, P. (2023) ‘Rethinking the sociology of dental education’, British Dental Journal, 234(9), pp. 665–667. https://doi.org/10.1038/s41415-023-5695-9

Reich, S.M. and Reich, J.A. (2006) ‘Cultural competence in interdisciplinary collaborations: A method for respecting diversity in research partnerships’, American Journal of Community Psychology, 38(1–2), pp. 51–62. https://doi.org/10.1007/s10464-006-9064-1

Sims, D. (2024) ‘When I say… global South and global North’, Medical Education, 58(1), pp. 89–90. https://doi.org/10.1111/medu.14903

Read more blog posts from Avita:

• Emotional labour in academia: The unspoken burden
• Leveraging technology for effective Assessment feedback (part 1): How to do I.T.?
• Leveraging technology for effective Assessment feedback (part 2): How did I do I.T.?
• An Ode to Academia in the post-pandemic era: Ableism, (un)Seen (dis)Abilities & access-ability of Online Teaching

Avita Rath

Dr Avita Rath is a recent graduate (MSc Clinical Education) at Edinburgh Medical School, the University of Edinburgh. She is also a senior lecturer, academic coordinator and periodontist at the Faculty of Dentistry, SEGi University, Malaysia. She is a Common Wealth scholar, a Fellow in Advance Higher Education, UK (FHEA), and an Association of Medication Education in Europe (AMEE) member. Some of her research interests include equity, diversity and inclusivity issues in health professional education, mindfulness in dental education, and student engagement concepts.