"As an ethnic minority, you just have to work twice as hard." Experiences and motivation of ethnic minority students in medical education

INTRODUCTION: Adequate representation of ethnic minority groups in the medical workforce is crucial for ensuring equitable healthcare to diverse patient groups. This requires recruiting ethnic minority medical students and taking measures that enable them to complete their medical studies successfully. Grounded in self-determination theory and intersectionality, this paper explores the experiences of ethnic minority medical students across intersections with gender and other categories of difference and how these relate to students' motivation.

METHODS: An explorative, qualitative study was designed. Six focus groups were conducted with 26 ethnic minority students between December 2016 and May 2017. Thematic analysis was performed to identify, analyse and report themes within the data.

RESULTS: The findings were categorized into three main themes: the role of autonomy in the formation of motivation, including students' own study choice and the role of their family; interactions/'othering' in the learning environment, including feelings of not belonging; and intersection of ethnic minority background and gender with being 'the other', based on ethnicity.

DISCUSSION: Ethnic minority students generally do not have a prior medical network and need role models to whom they can relate. Ensuring or even appointing more ethnic minority role models throughout the medical educational continuum-for example, specialists from ethnic minorities in teaching and/or mentoring roles in the education-and making them more visible to students is recommended. Moreover, a culture needs to be created in the educational environment in which students and staff can discuss their ethnicity-related differences.