Between agency and systemic barriers: Pathways to medicine and health sciences among Black students with immigrant parents from the Caribbean or Sub-Saharan Africa in Quebec, Canada

Abstract

This qualitative study, based on life stories, documents the pathways to medicine and health sciences of Black students with immigrant parents from the Caribbean or Sub-Saharan Africa in Quebec, Canada. The aim of this study is to investigate the factors that shape their educational pathways using Doray’s framework. Even among students from families with substantial levels of education, the educational pathways to medicine or health sciences may be described as non-linear. Several obstacles can arise along these pathways, depending on various social markers. Many of the interviewees first enroll in a program other than their desired program, either to ensure their financial security or to improve their grades for a limited-enrollment program. Medicine and pharmacy studies remain a dream for most participants and their parents. However, in some cases, this dream is not coming true, and interviewees’ aspirations are sometimes stifled. These results shed light on the possible changes to be made within certain programs’ admissions policies. Nevertheless, the students (n = 12) demonstrate agency in facing a seemingly unfair admissions system for highly selective programs. We conclude with recommendations on how to better accommodate the so-called non-traditional pathways of Black students with immigrant parents from the Caribbean or Sub-Saharan Africa.

Practice points

• Most of the interviewees first enroll in a program other than their desired program (tiered approach), either to ensure their financial security or to improve their grades to get into a limited-enrollment program.

• The tiered approach that has been taken by the students indicates that universities should consider taking only the most recent grades into account during the selection process as well as non-academic life experiences.

• Access programs with support throughout students’ education remain an avenue for improving representation of students from underrepresented groups in medicine and other health programs.

• In future studies, it would be relevant to examine how pipeline programs can shape the pathways of students from underrepresented populations in health sciences, and how these students perceive the selection process.

Keywords:

• Black students
• immigration
• Canada
• educational pathways
• health sciences

Acknowledgments

We would like to acknowledge that this study was partially funded by the Citizen Forum on Black Student Representation in the Health Sciences, which was held virtually in Montréal in April 2021 and organized by the Faculty of Medicine of Université de Montréal, in partnership with the Faculty of Medicine and Health Sciences of McGill University, the Quebec Black Medical Association and the Black Youth Socio-Economic Development Summit.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Notes

1 In this article, we use the term “Black students.” Indeed, participants were asked if they self-identified as Black.

Additional information

Notes on contributors

Marie-Odile Magnan

Marie-Odile Magnan is a full professor in the Faculty of Education at the Université de Montréal. She holds the Chair in Ethnic Relations and is Director of the Centre for Interuniversity Research on Education and the Teaching Profession-Université de Montréal. Her research focuses on the equity and social justice policies and practices, as well as on academic inequalities as recounted by young people.

Roberta Soares

Roberta Soares is a doctoral student in Educational Sciences at the Université de Montréal. She completed a master’s degree in Sociology and a bachelor’s degree in Social Sciences at the Universidade de São Paulo. Her qualitative research focusses mainly on social and school inequalities through sociology of education and critical research.

Samantha Bizimungu

Samantha Bizimungu is a resident doctor at Centre Hospitalier Universitaire de Montréal. She completed her medical degree at Université de Montréal. Her research interests include equity and diversity in medical education.

Jean-Michel Leduc

Jean-Michel Leduc, MD, MMEd, FRCPC, is an associate clinical professor at Université de Montréal and a researcher at the Centre intégré universitaire de santé et services sociaux du Nord-de-l’Île de Montréal in Canada. He has completed a Master’s in Medical Education from the University of Dundee and has a research interest in the impact of admission tools on diversity.