P3.P306: Minority Tax Doesn’t Start in Hospital: The Burden Presents in Medical School

Background: Despite the AAMC's efforts, the anticipated increase in the number of Black medical students who identify as women has not materialized. Experts believe that this is due to the culture of medical schools, which features a power dynamic that students must navigate. This "hidden curriculum" is realized in institutional policy, assessment and evaluation, funding, and institutional verbiage/language that shape the learning environment and puts undue pressure on populations underrepresented in medicine. In a 2022 study, five Black medical students who identify as women recounted their experiences with the hidden curriculum during their pre-clinical years of medical education.
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Methods: This Interpretative Phenomenological Analysis (IPA) study captured the lived experiences of utilizing qualitative data methods. Five participants from four predominantly white medical schools consented and participated shared their experiences with the hidden curriculum during their pre-clinical years of medical schools and the meanings they assigned to their experiences. The study’s primary inclusion criteria were Black medical students who identify as women. Participants also needed to be rising second or third-year medical students because the study focused on the student’s experiences in their pre-clinical years of medical school. Data was collected using a writing prompt and semi-structured interviews. IPA does not have a single prescribed method of analyzing data; rather, it focuses on the participant making meaning or sense of their experiences. It is, however, characterized by a set of “common processes and principles” that are applied according to the analysis needed and is not linear in nature, but rather iterative and inductive.

Results: The results indicated that the students experience the hidden curriculum similarly and included themes like pressure resulting from the minority tax, cultural influences on the student and working on behalf of all Black women medical students. The study's additional findings propose an update to Hafferty and Frank's (1994) hidden curriculum model to include the category of "minority tax and burden" which takes into the consideration the additional responsibilities and emotional labor Black women medical students take on as a result of their race and gender.

Conclusion: The results of the study shed light on the unique experiences of Black women medical students in relation to the hidden curriculum and its impact including frustration, exhaustion, and burnout. This group of participants willingly shared their experiences in hopes of sparking meaningful conversations and reducing the burden of the minority tax. However, it is not their burden alone; it is the responsibility of the institutions and organizations they belong to.