Everyday classism in medical school: experiencing marginality and resistance
Objective To explore the medical school experiences of students who self‐identify as coming from a working‐class or impoverished family background. Methods A questionnaire was administered to Year 3 medical students at a Canadian medical school and in‐depth interviews were held with 25 of these st...
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| Published in: | Medical education Vol. 39; no. 8; pp. 777 - 784 |
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| Format: | Journal Article |
| Language: | English |
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Oxford, UK
Blackwell Science Ltd
01.08.2005
Blackwell Wiley Subscription Services, Inc |
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| ISSN: | 0308-0110, 1365-2923 |
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| Abstract | Objective To explore the medical school experiences of students who self‐identify as coming from a working‐class or impoverished family background.
Methods A questionnaire was administered to Year 3 medical students at a Canadian medical school and in‐depth interviews were held with 25 of these students (cohort 1). The same methods were repeated with another Year 3 class 3 years later (cohort 2).
Results While having (or not having) money was the most obvious impact of social class differences, students also discussed more subtle signs of class that made it easier or more difficult to fit in at medical school. Students from working‐class or impoverished backgrounds were significantly less likely to report that they fitted in well, and more likely to report that their class background had a negative impact in school. They were also more likely to indicate awareness that a patient's social class may affect their health care treatment.
Conclusion Students from working‐class or impoverished backgrounds may experience alienation in medical school. Through the commonplace interactions of ‘everyday classism’ they may experience marginalisation, isolation, disrespect and unintentional slights. At the same time, they suggest that their experiences of exclusion may strengthen their clinical practice. |
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| AbstractList | To explore the medical school experiences of students who self-identify as coming from a working-class or impoverished family background.
A questionnaire was administered to Year 3 medical students at a Canadian medical school and in-depth interviews were held with 25 of these students (cohort 1). The same methods were repeated with another Year 3 class 3 years later (cohort 2).
While having (or not having) money was the most obvious impact of social class differences, students also discussed more subtle signs of class that made it easier or more difficult to fit in at medical school. Students from working-class or impoverished backgrounds were significantly less likely to report that they fitted in well, and more likely to report that their class background had a negative impact in school. They were also more likely to indicate awareness that a patient's social class may affect their health care treatment.
Students from working-class or impoverished backgrounds may experience alienation in medical school. Through the commonplace interactions of 'everyday classism' they may experience marginalisation, isolation, disrespect and unintentional slights. At the same time, they suggest that their experiences of exclusion may strengthen their clinical practice. To explore the medical school experiences of students who self-identify as coming from a working-class or impoverished family background.OBJECTIVETo explore the medical school experiences of students who self-identify as coming from a working-class or impoverished family background.A questionnaire was administered to Year 3 medical students at a Canadian medical school and in-depth interviews were held with 25 of these students (cohort 1). The same methods were repeated with another Year 3 class 3 years later (cohort 2).METHODSA questionnaire was administered to Year 3 medical students at a Canadian medical school and in-depth interviews were held with 25 of these students (cohort 1). The same methods were repeated with another Year 3 class 3 years later (cohort 2).While having (or not having) money was the most obvious impact of social class differences, students also discussed more subtle signs of class that made it easier or more difficult to fit in at medical school. Students from working-class or impoverished backgrounds were significantly less likely to report that they fitted in well, and more likely to report that their class background had a negative impact in school. They were also more likely to indicate awareness that a patient's social class may affect their health care treatment.RESULTSWhile having (or not having) money was the most obvious impact of social class differences, students also discussed more subtle signs of class that made it easier or more difficult to fit in at medical school. Students from working-class or impoverished backgrounds were significantly less likely to report that they fitted in well, and more likely to report that their class background had a negative impact in school. They were also more likely to indicate awareness that a patient's social class may affect their health care treatment.Students from working-class or impoverished backgrounds may experience alienation in medical school. Through the commonplace interactions of 'everyday classism' they may experience marginalisation, isolation, disrespect and unintentional slights. At the same time, they suggest that their experiences of exclusion may strengthen their clinical practice.CONCLUSIONStudents from working-class or impoverished backgrounds may experience alienation in medical school. Through the commonplace interactions of 'everyday classism' they may experience marginalisation, isolation, disrespect and unintentional slights. At the same time, they suggest that their experiences of exclusion may strengthen their clinical practice. Objective To explore the medical school experiences of students who self‐identify as coming from a working‐class or impoverished family background. Methods A questionnaire was administered to Year 3 medical students at a Canadian medical school and in‐depth interviews were held with 25 of these students (cohort 1). The same methods were repeated with another Year 3 class 3 years later (cohort 2). Results While having (or not having) money was the most obvious impact of social class differences, students also discussed more subtle signs of class that made it easier or more difficult to fit in at medical school. Students from working‐class or impoverished backgrounds were significantly less likely to report that they fitted in well, and more likely to report that their class background had a negative impact in school. They were also more likely to indicate awareness that a patient's social class may affect their health care treatment. Conclusion Students from working‐class or impoverished backgrounds may experience alienation in medical school. Through the commonplace interactions of ‘everyday classism’ they may experience marginalisation, isolation, disrespect and unintentional slights. At the same time, they suggest that their experiences of exclusion may strengthen their clinical practice. |
| Author | Beagan, Brenda L |
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| References_xml | – reference: Dhalla IA, Kwong JC, Streiner DL, Baddour RE, Waddell AE, Johnson IL. Characteristics of first-year students in Canadian medical schools. CMAJ 2002;166: 1029-35. – reference: Beagan B. Micro inequities and everyday inequalities: 'race', gender, sexuality and class in medical school. Can J Sociol 2001;26: 583-610. – reference: Roter D, Hall JA. Doctors Talking with Patients/Patients Talking with Doctors. Westport, Connecticut: Auburn House 1992. – reference: Harrell SP. A multidimensional conceptualisation of racism-related stress: implications for the well-being of people of colour. Am J Orthopsychiatry 2000;70: 42-57. – reference: Health Canada. Strategies for Population Health: Investing in the Health of Canadians. Catalogue no. H39-3 16/1994E. Ottawa: Ministry of Supply and Services, Canada 1994. – reference: Dunk T. It's a Working Man's Town: Male Working-class Culture. Kingston: McGill-Queens University Press 1991. – reference: Willis P. Learning to Labour: How Working Class Kids Get Working Class Jobs. New York: Columbia University Press 1977. – reference: Haas J, Shaffir W. Becoming Doctors: the Adoption of a Cloak of Competence. Greenwich, Connecticut: JAI Press 1987. – reference: Cockerham WC. Medical Sociology. 6th edn. Englewood Cliffs, New Jersey: Prentice Hall 1995. – reference: Essed P. Understanding Everyday Racism: an Interdisciplinary Theory. New York: Sage 1991. – reference: Wilkinson R, Marmot M. Social Determinants of Health: the Solid Facts. Copenhagen: World Health Organisation European Office 1999. http://www.who.dk/document/E59555.pdf. [Accessed 21 October 2003]. – reference: Duffin J. What goes around comes around: a history of medical tuition. CMAJ 2001;164: 50-6. – reference: Kiefer CW. Health Work with the Poor: a Practical Guide. New Brunswick, New Jersey: Rutgers 2000. – reference: Raphael D. Poverty, Income Inequality and Health in Canada. Toronto: CSJ Foundation for Research and Education 2002. – reference: MacLeod J. Ain't No Makin' It: Aspirations and Attainment in a Low-income Neighbourhood. 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| Title | Everyday classism in medical school: experiencing marginality and resistance |
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