Travels in extreme social mobility: how first-in-family students find their way into and through medical education

ABSTRACT

Higher education is understood as essential to enabling social mobility. Research and policy have centred on access to university, but recently attention has turned to the journey of social mobility itself – and its costs. Long-distance or ‘extreme’ social mobility journeys particularly require analysis. This paper examines journeys of first-in-family university students in the especially high-status degree of medicine, through interviews with 21 students at an Australian medical school. Three themes are discussed: (1) the roots of participants’ social mobility journeys; (2) how sociocultural difference is experienced and negotiated within medical school; and (3) how participants think about their professional identities and futures. Students described getting to medical school ‘the hard way’, and emphasised the different backgrounds and attitudes of themselves and their wealthier peers. Many felt like ‘imposters’, using self-deprecating language to highlight their lack of ‘fit’ in the privileged world of medicine. However, such language also reflected resistance to middle-class norms and served to create solidarity with community of origin, and, importantly, patients. Rather than narratives of loss, students’ stories reflect a tactical refinement of self and incorporation of certain middle-class attributes, alongside an appreciation of the worth their ‘difference’ brings to their new destination, the medical profession.

KEYWORDS:

• Higher education
• medical education
• non-traditional students
• social mobility
• widening participation

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Centre of Excellence for Equity in Higher Education, University of Newcastle, Australia.

Notes on contributors

Erica Southgate

Erica Southgate is Associate Professor of Education at the University of Newcastle Australia. In 2016, she was appointed as national Equity Fellow to conduct a project that explored the issue of connecting young people from low socio-economic backgrounds to high-status professions.

Caragh Brosnan

Caragh Brosnan is a senior lecturer in sociology in the School of Humanities & Social Science, University of Newcastle, Australia. Her research interests are in health, higher education and the professions, focusing especially on how different kinds of knowledge come to be valued in these arenas.

Heidi Lempp

Heidi Lempp is a senior lecturer in Medical Sociology, King’s College London, UK, and has a particular interest in the influence of the hidden curriculum upon the training of undergraduate medical students, the medical school culture and the practice of medicine.

Brian Kelly

Brian Kelly is head of the School of Medicine and Public Health, Dean of the Joint Medical Program, and Professor of Psychiatry, University of Newcastle, Australia. His interests include mental health research, medical student selection, and widening participation in medical education.

Sarah Wright

Sarah Wright is a research scientist at Michael Garron Hospital and an assistant professor in the Department of Family and Community Medicine, University of Toronto, Canada. Her research focuses on reproduction of hierarchies in medical education through assessment and admissions practices.

Sue Outram

Sue Outram is an Associate Professor and Discipline Lead in Health Behaviour Sciences in the School of Medicine and Public Health, University of Newcastle, Australia.  Her research interests include teaching and learning in vocational medical education and experiences of social disadvantage in healthcare.

Anna Bennett

Anna Bennett is a senior lecturer and convenor of an open access university pathways programme, University of Newcastle, Australia. Her research interests include the study of approaches that enable opportunities for students in higher education and those that limit and exclude them.