{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:03:35Z","timestamp":1789625015716,"version":"build-2803163510"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>Mental health among medical trainees has typically been framed as an individual deficit, addressed through resilience training and counseling services. This perspective examines how the hidden curriculum within Chinese psychiatry training may shape psychological safety and professional identity formation. Drawing on psychological safety theory, hidden curriculum scholarship, Bronfenbrenner\u2019s ecological systems theory, and recent empirical literature on medical trainee distress in China, we propose a theoretically derived and empirically testable conceptual model through which experiences of vulnerability may become socially and professionally invisible. The proposed vulnerability-to-invisibility process describes four interconnected phases: the encounter with vulnerability, perceived or enacted prohibition of emotional expression, internalization of silence, and potential fragmentation of professional identity. Existing evidence supports several constituent components of this pathway, but direct empirical evidence establishing the complete sequence remains limited. We therefore call for institutional reforms that embed psychological safety into clinical training, including protected reflective spaces, reflective faculty modeling, peer support, and curriculum-integrated mentorship, while emphasizing adaptive emotional regulation rather than forced suppression.<\/jats:p>","DOI":"10.3389\/fpsyg.2026.1961068","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:31:11Z","timestamp":1789623071000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cYou are not allowed to break down\u201d: psychological safety and the hidden curriculum of psychiatry training in China"],"prefix":"10.3389","volume":"17","author":[{"given":"Cong","family":"Zhou","sequence":"first","affiliation":[{"name":"School of Mental Health, Jining Medical University","place":["Jining, China"]},{"name":"Department of Psychology, Affiliated Hospital of Jining Medical University","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianyang","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Jining Rencheng Mental Hospital","place":["Jining, China"]},{"name":"Department of Psychology, Jining Genshine Children\u2019s Rehabilitation Hospital","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoxue","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Mental Health, Jining Medical University","place":["Jining, China"]},{"name":"Department of Psychology, Affiliated Hospital of Jining Medical University","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sen","family":"Li","sequence":"additional","affiliation":[{"name":"School of Mental Health, Jining Medical University","place":["Jining, China"]},{"name":"Department of Psychology, Affiliated Hospital of Jining Medical University","place":["Jining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-026-09880-7","article-title":"Exhibiting failure toward building a growth mindset: a qualitative study of psychiatric trainees\u2019 experiences of a monthly reflective session","author":"Anantapong","year":"2026","journal-title":"BMC Med. 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