Postgraduate medical education positions in Canada are determined through a residency match selection process. The process was developed to provide an organised, equitable, learner-centric way to balance the interests of programs and applicants. However, previous feedback from learners in several match systems has highlighted inherent moral and professional tensions. A deep understanding of how learners experience the navigation of such tensions, and the match in general, could focus future research and educational quality improvement around those areas most relevant to preparing medical students for the match process. Six individuals who had taken part in the Canadian residency participated in semi-structured interviews, which were then recorded, transcribed, and analysed according to Van Manen’s hermeneutic phenomenological approach. Essential individual themes were combined into core experiential categories and composite narrative constructed. Core experiential themes were (1) feeling that residency matching processes is flawed and lacks transparency; (2) perceiving that to be successful one needs to play the “game”; (3) struggling to convey to programs what trainees feel matters; (4) perceiving inconsistency in support availability and efficacy; and (5) possessing awareness that implications of residency matching processes are life-changing. The reported elements of trainee experience suggest that the high stakes of the match process and perceived lack of transparency play core shaping roles here. Research clarifying what really matters to selection committees, and provision of opportunities in medical curricula for broader career wayfinding outside a context where impression management overshadows authentic exploration, may impact this experience positively in the future.
Human donor dissection is a formative psychological experience in medical education that elicits diverse emotional, cognitive, and behavioral responses. The influence of cultural context on students’ emotional experiences, anxiety, and coping strategies remains insufficiently understood across geographically and culturally diverse settings. This study examined and compared these psychological responses among first-year medical students before and after their initial dissection experience. First-year medical students from four institutions: Oakland University William Beaumont School of Medicine (USA), the American University of Beirut (Lebanon), Queen’s University Belfast (Northern Ireland), and Addis Ababa University (Ethiopia) completed surveys one week before (T1) and one week after (T2) their first dissection. Data were analyzed using one-way analysis of variance with Bonferroni correction. Emotional experiences differed significantly among institutions at T1 but converged at T2, suggesting that the dissection experience itself brought students from different cultural backgrounds to a similar emotional level. Cultural attachment remained stable across time points. Anxiety decreased at T2 across all institutions. Positive coping showed no significant differences at T1 but differed significantly at T2, while negative coping differed significantly at both time points. These findings indicate that donor dissection produces largely adaptive psychological responses across culturally diverse medical student populations, reinforcing its value as a pivotal shared experience in professional identity formation. The stability of cultural attachment suggests that it shapes how students interpret and emotionally process dissection rather than being altered by it. These results support the development of anatomy curricula that are evidence-based and responsive to the cultural background of their students.
Professional identity formation has become a concern in medical education, within sociocultural perspectives emphasizing participation, interaction, and meaning-making. Although collaborative learning is used in undergraduate curricula, its role in shaping identity trajectories, especially during early training, remains insufficiently understood. This study explored how medical students in early stages of an integrated curriculum based on collaborative learning construct and narrate their identities as learners and future professionals. We conducted a qualitative study within an interpretive paradigm using focus groups with 45 students transitioning from preclinical to clinical training. Data were analyzed following grounded theory principles through iterative coding, constant comparison, and category development. Students described collaborative learning as a cross-cutting element shaping both how they learned and who they were becoming. Four dimensions were identified: perception of the curriculum, knowledge construction in groups, personal transformation as learners, and professional projection. Across these dimensions, identity development emerged as a dynamic, tension-laden process characterized by negotiation, adaptation, and narrative reconstruction. Collaborative learning environments functioned not only as spaces for cognitive interdependence but also as contexts in which students were recognized as participants in a community of practice and constructed continuity between past experiences, present participation, and future professional aspirations. These findings suggest that collaborative learning can be understood as a mediational space for professional identity formation, where becoming a doctor is shaped through collective practices and narrative processes. This perspective extends sociocultural understandings of identity by showing that learning together is central not only to what students know, but to who they become. Collaborative learning functions as a key sociocultural mediator in the construction of medical students’ professional identity. Early exposure to situated clinical and community-based learning supports students’ transition from learner to future physician. Students associate group learning dynamics with the development of empathy and interdisciplinary collaboration. Students’ narrative trajectories reveal meaningful links between current academic practices and projected professional commitment. The study provides evidence to inform integrated curriculum design in undergraduate medical education in Latin America.
Structurally vulnerable patients experience worse health outcomes, exacerbated by healthcare workers’ negative attitudes and limited understanding of structural barriers to care. Structural competency may improve attitudes towards structurally vulnerable patients, but the impact on attitudes and practices has not been rigorously evaluated, particularly in clinical settings. Medical students at Weill Cornell Medical College in New York City participated in a structural competency-informed curriculum aligned with transformative learning theory which incorporates clinical skills training with simulation and reflection during academic years 2022–2023 and 2023–2024. Authors conducted a convergent mixed-methods study using pre-post surveys and thematic analysis of reflections to explore if and how the curriculum impacted students’ attitudes and practices towards structurally vulnerable patients. Surveys included the Medical Condition Regard Scale (MCRS) and items accessing self-efficacy in applying the curriculum’s learning objectives. Of 190 students, 77 (40.5
Despite integration being a theme in medical education for curricular development, a practical framework guiding faculty on session-level horizontal integration is lacking. Many curricular integration efforts occur at a much higher level, integrating across entire courses or programs. Using established integration theories as a foundation, the Session-level Horizontal Integration Fit for Teaching (SHIFT) framework has been developed as a practical tool to aid in session integration logistics. SHIFT has four main phases to guide educators, from planning to teaching and evaluating their sessions. We utilized SHIFT to horizontally integrate biochemistry and physiology in three acid-base disorder sessions in one institution.
