Podcast Summary

New Books Network – Interview with Vania Smith-Oka

Book: "Becoming Gods: Medical Training in Mexican Hospitals" (Rutgers UP, 2021)
Host: Regan Gillum
Guest: Dr. Vanya Smith-Oka
Date: November 8, 2025

Episode Overview

This episode centers on Dr. Vanya Smith-Oka's ethnographic book, Becoming Gods: Medical Training in Mexican Hospitals. Through a detailed conversation, Dr. Smith-Oka discusses her research following a cohort of medical interns in Puebla, Mexico, unpacking how they are socialized into the medical profession, the practices and abuses embedded in medical training, the role of gender, and the broader social forces shaping medicine in Mexico. The discussion offers a nuanced portrait of both the struggles and transformations experienced by aspiring doctors, placing a special emphasis on issues of power, gendered dynamics, and medical culture.

Key Discussion Points and Insights

1. Path into Medical Anthropology (02:32–05:21)

• Dr. Smith-Oka describes her journey from studying biology and ecological anthropology to focusing on medical anthropology.
  • Early research explored indigenous medicine and ecological questions.
  • Realized, during fieldwork, the importance of examining power, well-being, and problematic interactions between indigenous mothers and medical institutions.
  • “It was a sort of winding path that took me from ecological anthropology to this medical anthropology perspective. And I've pretty much stayed in that so far.” (Smith-Oka, 04:57)

2. Genesis of Becoming Gods (05:21–09:41)

• The impetus for the book came from ethnographic observation of frequent mistreatment of women in maternity wards in Puebla.
  • Witnessed verbal, emotional, and physical abuse, aligning with the concept of “obstetric violence.”
  • Interested in understanding whether this violence was taught during medical training or reflective of broader social dynamics.
  • Shifted from seeing doctors as antagonists to studying the complexities of their training, including the violence they experience.
  • “The book 'Becoming Gods', for me at least... fleshes out the idea of a doctor. It shifts it from a one dimensional perspective into a more complex, three dimensional, flawed, but also caring human being.” (Smith-Oka, 09:20)

3. Interns’ Roles and Medical Training Structure in Mexico (09:41–15:39)

• Mexican medical training is a six-year bachelor’s program; interns do a year in hospitals after four years of classes.
• Interns rotate through medical specialties, undertaking both mundane and complex duties: paperwork, patient intake, case presentations, and minor procedures.
• Gradually, interns develop increased responsibility and agency.
  • “Paperwork was a huge part of their duties... as they got closer to the end of their internship, you could tell that they just had a greater sense of responsibility for their patients...” (Smith-Oka, 13:51)

4. The Gendered Nature of Medical Training (15:39–19:51)

• Gender permeates training and specialty choices:
  • Female doctors are seen as technically competent but stereotyped as “emotional” or “physically weak.”
  • Discouraged (explicitly or implicitly) from specialties like trauma or surgery.
  • Women face harassment—including “dirty trade,” where clinical help is conditional on romantic or sexual favors.
  • Men subjected to harsher training and humiliation.
  • Example: “Samantha,” an intern who publicly shuts down a harassing surgeon—called “la respetada” (the one who owned the situation).
  • “As I really dug into this more, I realized that these stereotypes hit a much deeper gendered issue of abuse.” (Smith-Oka, 18:11)

5. Formation of the “Medical Self” (19:51–26:56)

• The concept of the “medical self” involves learning embodied practices (using technologies, interacting with patients), performing expertise, and internalizing hospital culture.
  • Example 1 (Carlos): Tasked with removing a cast from a frightened child, Carlos must improvise with little supervision—learning “on the deep end.”
  • Example 2 (Cesar): Presents complex medical cases, learning to filter patient subjectivity into clinical “objectivity” and perform expertise for peers.
  • “Their medical self wasn’t just learning how to wield an unfamiliar instrument. It also consisted of learning how to enter a patient’s room with authority, being able to present a case with confidence.” (Smith-Oka, 26:17)

6. Ethnographic Research Process (29:24–37:16)

• Gaining access required navigating institutional gatekeepers, ethics boards, and establishing rapport with directors and interns.
• Dr. Smith-Oka details following interns through their rotations, with deeper relationships forming with some.
• Highlights the logistics and challenges of fieldwork as a mother, with crucial support from a research assistant.
  • “Many times people think of ethnography as a full time thing... many of us have to balance other identities while in the field and we have to rely on the support of others to get the work done.” (Smith-Oka, 35:54)

7. Reflections on Academic Training & Violence in Institutions (37:16–41:31)

• Dr. Smith-Oka draws explicit parallels between medical and academic training:
  • Both normalize abusive practices (bullying, shaming, overwork) as part of professional socialization.
  • “Departments need to be very aware of how different mentors engage with graduate students who, like the interns, are lower on the hierarchy and have much less power.” (Smith-Oka, 39:54)

8. Teaching Medical Anthropology & Biomedicine as Culture (41:31–45:59)

• Incorporates her research into university teaching, emphasizing to pre-med students that biomedicine is culturally shaped—not just technical knowledge.
  • “Medicine is a social thing... and the illness of a person isn’t just something that occurs in their body. It is something shaped by much, much larger things.” (Smith-Oka, 44:45)
• Advocates for integrating medical humanities and cultural perspectives in medical education to foster empathy and awareness.

9. Upcoming Research on Obstetric Violence and Racialized Medical Practices (46:54–50:00)

• Dr. Smith-Oka and Lydia Dixon have secured an NSF grant to study cesarean incisions and their links to race/class in Mexico.
  • Hypothesis: Whiter/wealthier women receive more “aesthetic” incisions, while poorer/darker women get vertical incisions.
  • Broader aim: Unpack systematic racism and inequity in Mexican medical practice.

Notable Quotes & Memorable Moments

• On Nuancing the Image of Doctors:
  “I went into that research thinking of doctors as the enemy… but the more time I spent with them and the more nuanced my perceptions… they also cared deeply about their patients as well as medical care. And many of them also experienced violence in their own training…”
  — Dr. Smith-Oka (08:42)

• On Gendered Medical Stereotypes:
  “They said that because women like creams and stuff, right? … it was really fascinating to hear these very gendered perspectives from people who were all equally capable, regardless of their gender.”
  — Dr. Smith-Oka (17:08)

• On Internalized Abuse and Professional Socialization:
  “They naturalize these practices in medicine as just part of how things are done… being awake for more than 36 hours straight, being scolded… shamed for not knowing something… are perceived to be natural parts of medical training.”
  — Dr. Smith-Oka (38:50)

• On the Ethnographer’s Collective Experience:
  “It also disrupts our idea of the lone ethnographer by themselves with their little notebook and pen... It's not just us... we need other people to go about what we do.”
  — Regan Gillum (37:18)

• On Incorporating the Book into Teaching:
  “My colleagues really supported me and so I have assigned it to my students. So we will be discussing it next week. So I actually don’t have any clue how they’ll be receiving it…”
  — Dr. Smith-Oka (42:29)

Timestamps for Important Segments

• Path to Medical Anthropology: 02:32–05:21
• Book Motivation & Obstetric Violence: 05:21–09:41
• Structure & Experiences of Interns: 09:41–15:39
• Gender and Power in Training: 15:39–19:51
• Medical Self, Embodiment, and Case Presentations: 19:51–26:56
• Research/Ethnographic Methods & Challenges: 29:24–37:16
• Comparisons with Academic Training: 37:16–41:31
• Teaching Medical Anthropology: 41:31–45:59
• Upcoming Research on Racism & Cesareans: 46:54–50:00

Conclusion

Dr. Vanya Smith-Oka’s Becoming Gods is a rich ethnographic account of Mexican medical interns’ journeys, illuminating the complexity of medical socialization, the embeddedness of violence and gendered norms, and the interplay of empathy and power. The episode offers valuable insights for anyone interested in medical anthropology, healthcare training, and the cultural forces that shape professional identities and institutional abuses.