Negotiation of learning and identity among first-year medical students

The demand for medical schools to produce competent doctors to meet health needs in South Africa has increased. In response to this challenge, the Faculty of Health Sciences at a relatively elite university introduced a problem-based, socially relevant curriculum in 2002. The classroom environment is designed to facilitate a learning context where students from diverse backgrounds engage critically and learn from each other. This study draws on data from a larger qualitative case study to describe how a group of ‘black’ students who failed their first semester experienced the school–university transition. Drawing on post-structuralist theory, this article analyses how the students negotiated learning and identity. The argument is made that the students re-positioned themselves in deficit, outsider subject positions in order to survive their first year. This article ends with a consideration of the implications for developing a learning environment which recognises difference and fosters diversity.