The hidden curriculum in undergraduate medical education: qualitative study of medical students' perceptions of teaching

OBJECTIVE: To study medical students' views about the quality of the teaching they receive during their undergraduate training, especially in terms of the hidden curriculum. DESIGN: Semistructured interviews with individual students. SETTING: One medical school in the United Kingdom. PARTICIPANTS: 36 undergraduate medical students, across all stages of their training, selected by random and quota sampling, stratified by sex and ethnicity, with the whole medical school population as a sampling frame. MAIN OUTCOME MEASURES: Medical students' experiences and perceptions of the quality of teaching received during their undergraduate training. RESULTS: Students reported many examples of positive role models and effective, approachable teachers, with valued characteristics perceived according to traditional gendered stereotypes. They also described a hierarchical and competitive atmosphere in the medical school, in which haphazard instruction and teaching by humiliation occur, especially during the clinical training years. CONCLUSIONS: Following on from the recent reforms of the manifest curriculum, the hidden curriculum now needs attention to produce the necessary fundamental changes in the culture of undergraduate medical education.