Medical students' experience and achievement: the effect of ethnicity and social networks

  • Suzanne Vaughan

    Student thesis: Phd


    There is a well-established 'achievement gap' in medical education, with 'ethnic minority' students achieving less well in examinations than their white counterparts. The processes underlying this difference are currently unknown. Most research to date has taken a student-deficit approach, suggesting that lower performing students lack the cognitive or cultural capacity of their higher achieving peers. These models have so far failed to explain the variation in achievement by ethnicity.In order to address this gap in the literature and further our understanding of ethnic minority students' underachievement, this thesis takes a sociocultural approach to the problem. It addresses two research questions: firstly, how does ethnicity impact on medical school achievement? Secondly, how do social networks affect achievement? This research uses qualitative interviews (n=33 medical students), quantitative survey methods and social network analysis (n=160 medical students) to explore ethnicity and the achievement gap within medical education. Sociocultural theories of learning, specifically concepts from communities of practice and Pierre Bourdieu are employed in the design and analysis phases.This thesis demonstrates that medical students' achievement is best conceptualised as part of a wider learning trajectory toward becoming a doctor. Relationships are important channels through which the resources and support can flow, these in turn facilitate learning and achievement. Lower achieving students are less well connected to their PBL peers and have fewer tutors or clinicians in their network. The medical world has a tightly prescribed, yet often hidden, set of legitimate dispositions; students must learn to embody these norms, values and behaviours in order to succeed. This process relies on experiences of participation, facilitated by relationships with peers and seniors. Socialisation is clearly mediated by culture. Ethnic minority students, due to their differing cultural practices and identities, have fewer experiences of participation, often experience the medical domain as outsiders and find it harder to interact with tutors and clinicians. This is reflected in their social networks as some minority students have fewer seniors in their network. These factors interact to cut ethnic minority students off from potential and actual resources that facilitate learning and achievement. If the situation is to be improved, medical schools must do more to acknowledge the extra difficulties many 'ethnic minority' students face in becoming an insider. Processes of identification and participation must be supported as these students negotiate the extra distance and tensions between their home world and those of medical education and medicine.
    Date of Award31 Dec 2013
    Original languageEnglish
    Awarding Institution
    • The University of Manchester
    SupervisorPaul O'Neill (Supervisor) & Nick Crossley (Supervisor)


    • medical students
    • sociocultural theory
    • ethnic underachievement
    • communities of practice
    • ethnicity
    • medical education
    • achievement

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