Medical students’ journey towards Cultural Humility – navigating diverse others and systems with extreme inequity

Abstract Introduction: Cultural humility (CH) is a vital journey for addressing diversity, but its application remains elusive. While existing literature covers cultural humility’s why and what mainly in the context of western countries, the holistic development of its parts during medical training remains underexplored. Given the foundational role of interactions in cultural humility, this study explores its development during various interactions with peers, teachers, patients and researchers across a diversity of education and clinical health care settings marked by inherent power imbalance and inequity. Methods: An interpretivist qualitative case study approach was employed, involving purposive sampling of diverse medical students from one medical school in a country with one of the highest inequity coefficients in the world. Data collection was through semi-structured interviews and analysed using thematic analysis. Ethical clearance and participant consent was obtained. Results: Interactions between actors unfolded in multiple dimensions and layers. Findings were classified into four themes i.e. journeying from feeling like an outsider to embracing interactions, from absolute truth to questioning perceptions, journeying within power imbalance; and embracing future roles through introspection. For participants two fundamental dilemmas remained, i.e. whether to navigate social relations and how to navigate intergroup conflict. Discussion: This study argues that the development of CH is context based and dynamic; however, it’s development should not be assumed but should be considered as multifaceted and layered, where the individual process is significantly influenced by past contexts as well as enhancing interactions with peers, teachers, patients and researchers both formally and informally.