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Medical students’ experience of the hidden curriculum around Primary Care careers: a qualitative exploration of reflective diaries

Parekh, R; Jones, M; Singh, S; Yuan, JSJ; Chan, SCC; Mediratta, S; Smith, R; ... Park, S; + view all (2021) Medical students’ experience of the hidden curriculum around Primary Care careers: a qualitative exploration of reflective diaries. BMJ Open , 11 (7) , Article e049825. 10.1136/bmjopen-2021-049825. Green open access

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Abstract

Objectives: Primary healthcare internationally is facing a workforce crisis with fewer junior doctors choosing general practice (GP) as a career. In the UK, a national report on GP careers highlighted adverse influences during medical school on students’ career choices. The authors explored these influences in two urban UK medical schools, both with relatively low numbers of students entering GP training. // Design: Using a phenomenological approach, the authors thematically analysed the reflective diaries of four medical students who were recruited as ‘participant researchers’ over a period of 10 months. These students made regular reflexive notes about their experiences related to GP career perceptions in their academic and personal environments, aiming to capture both positive and negative perceptions of GP careers. The research team discussed emerging data and iteratively explored and developed themes. // Setting: Two UK medical schools // Participants: Undergraduate medical students // Results: Seven key themes were identified: the lack of visibility and physicality of GP work, the lack of aspirational GP role models, students’ perceptions of a GP career as default, the performativity of student career choice with the perceptions of success linked to specialism, societal perceptions of GP careers, gender stereotyping of career choices and the student perception of life as a GP. // Conclusions: Students overwhelmingly reflected on negative cues to GP careers, particularly through their experience of the hidden curriculum. Three recommendations are made: the need for increased representation of GP role models in clinical curricula content delivery and senior leadership; ensuring GP clerkships involve an active and authentic student role with patients, enabling students to experience GP’s ‘work’ including managing complexity, uncertainty and risk. Finally, institutions need to consider students’ experiences of the hidden curriculum and the effect this can have on students’ perception of careers, alongside the challenges of rankings and perceived hierarchical positioning of disciplines.

Type: Article
Title: Medical students’ experience of the hidden curriculum around Primary Care careers: a qualitative exploration of reflective diaries
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2021-049825
Publisher version: https://doi.org/10.1136/bmjopen-2021-049825
Language: English
Additional information: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10130967
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