“Being on Both Sides”: Canadian Medical Students’ Experiences With Disability, the Hidden Curriculum, and Professional Identity Construction
Bibliographic record
Abstract
PURPOSE: Medical students with disabilities hold firsthand knowledge as health care recipients, yet face barriers to disclosure and support. Their experiences provide a unique lens for understanding professional identity construction; this study explored how disabled medical students experience training as both patients and trainees. METHOD: The authors conducted qualitative interviews with 10 medical students at the University of Toronto Faculty of Medicine with self-identified disabilities. They performed textual analysis of documents concerning medical student wellness from 13 Canadian universities, including policies, student services, and student blogs (July 2016 to March 2017). Using principles of critical discourse analysis, the authors coded the interviews and texts to identify operating discourses and core themes, drawing from sociocultural theories of professional identity construction and the hidden curriculum. RESULTS: Two dominant discourses emerged from the interviews and texts, revealing institutionalized notions of the perceived "good student" and "good patient." These roles held contradictory demands, demonstrating how institutions often implicitly and explicitly framed wellness as a means to optimal academic performance. Two additional themes, "identity compartmentalization" and "identity intersection," captured students' experiences navigating identities as patients and trainees. Although students lacked explicit opportunities to express their expertise as patients in the formal curriculum, their experiences in both roles led to improved communication, advocacy, and compassion. CONCLUSIONS: Institutional discourses around disability and academic performance hold material implications for curricular content, clinical teaching, and availability of supports in medical school. By repositioning students' experiences with disability as sources of expertise, this study highlights opportunities for teaching compassionate care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.045 | 0.037 |
| Scholarly communication | 0.011 | 0.004 |
| Open science | 0.003 | 0.014 |
| Research integrity | 0.003 | 0.007 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".