Growing trends toward patient engagement increasingly risk commodification of lived experience, wherein personal narratives are appropriated to reinforce hegemonic discourses of mental illness. These narratives are frequently used as illustrative examples in medical education. In this chapter, we offer a reflexive duoethnographic account of Centering Madness: Building Capacities for Community Engagement—a course designed, developed, and taught by service users for psychiatry residents at the University of Toronto. The curriculum is grounded in social justice and anti-oppressive praxis, drawing on intersectionality to examine how structural injustice is experienced by diversely situated Mad people. Our course directly confronts the ways in which foundational medical training and the historical trajectory of psychiatry have contributed to a legacy of harm and mistrust among service-users, including power dynamics that disproportionately affect marginalized service users in clinical settings. Drawing on the rich history of service user movement organizing and scholarship, the course invites residents to meaningfully engage with Mad scholarship and its critical interventions into emerging equity discourses in medicine. We explore the power and potential of integrating service user scholarship into an academic setting traditionally dominated by biomedical frameworks, illuminating opportunities for paradigms shifts in practice and pedagogy.