Students perspectives of the effect of ethnicity on experiences in a graduate entry medicine course in Wales: a qualitative study

TL;DR

This study explores how ethnicity affects the experiences of medical students in Wales and highlights the challenges they face, especially from clinician interactions and institutional factors.

Contribution

The study provides new insights into how ethnicity influences graduate-entry medical students' experiences and identifies areas for improvement in medical education.

Findings

BAME students reported more disadvantages and microaggressions compared to White students.

Clinician interactions and unfamiliar names were major sources of negative experiences.

Institutional factors like outdated language and lack of support worsened the sense of 'other' for BAME students.

Abstract

To explore the clinical experiences of graduate-entry medical students; whether ethnicity impacts this and how medical education can better prepare students from a diverse range of backgrounds.

Qualitative study using semi-structured interviews.

A medical school in Wales.

Seventeen graduate-entry MBChB students were recruited using volunteer and snowball sampling; 9 students self-identified as being from Black, Asian or Minority Ethnic backgrounds (BAME) and 8 from White Caucasian backgrounds.

When asked whether they felt they had experienced disadvantage during their time on the course, 6 BAME students report feeling disadvantaged during their studies and 2 were unsure. This was compared to 2 white students who felt disadvantaged. Gender was most frequently linked to disadvantage, followed by ethnicity and racial background. Patient interactions were most linked to microaggressions and overt racism, leading to uncomfortable situations for BAME and White students. Clinician interactions were identified as a source of disadvantage, often linked to students’ being overlooked in teaching and opportunities. ‘Unfamiliar’ names were associated with negative experiences, which ranged from being blanked for having a name perceived as difficult to pronounce to being disrespected.

Microaggressions by clinicians and patients were identified by BAME and White participants alike, with participants feeling unsure of how to handle them. Institutional factors were divided into language used by lecturers and clinicians and lack of support. Language was felt to be out-dated and furthering the feeling of ‘other’ felt by BAME students. Students reported feeling unsupported and dismissed when trying to escalate issues, leading to a lack of trying after a while.

In this cohort, although patients were repeatedly linked to discrimination, the disadvantage in medical education was perceived to be impacted most by clinician interactions. Names and being ignored by clinicians most impacted on learning experiences. Institutional factors compounded this and reinforced the feeling of ‘other’ by BAME students.

The online version contains supplementary material available at 10.1186/s12909-023-04852-7.

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