Peer and near-peer discourse and medical student well-being during the transition to clinical training: A phenomenological study

INTRODUCTION: Transitions in medical education are well recognised as periods of increased vulnerability to diminished well-being. While peer and near-peer interactions are known to influence student experiences, their role in shaping well-being during the transition to clinical training remains underexplored, particularly in relation to informal social processes. METHODS: This qualitative study employed interpretative phenomenological analysis (IPA) to explore the lived experiences of seven pre-clinical medical students at a UK medical school. Semi-structured interviews explored how peer and near-peer discourse influenced perceptions of well-being in preparation for clinical training. RESULTS: Five superordinate themes were identified through iterative analysis: (1) personal definitions of well-being; (2) hopes regarding transition; (3) fears of inadequacy and exposure; (4) peers as supportive; and (5) peers as detrimental. Peer discourse operated simultaneously both as a source of reassurance and as a mechanism through which anxiety and uncertainty were amplified. DISCUSSION: This study reframes peer and near-peer discourse as a meaning-making process within the hidden curriculum, through which students construct expectations of transition and professional identity. These findings highlight the need to address not only formal support structures, but also the informal social processes that shape student well-being within medical education environments.