Abstract
Equity, diversity, and inclusion remain a prominent focus in medical schools, yet the phenomenon of “belonging” has arguably been overlooked. Little is known regarding how belonging is experienced by medical students from groups that face systemic oppression and exclusion. We employed a sequential explanatory mixed methods design to explore how students from equity-deserving groups (EDGs) experience belonging during medical school, including those who are women, racialized, Indigenous, disabled, and 2SLGBTQIA+. First, we conducted a national cross-sectional survey of medical students (N = 480) measuring four constructs: belonging, imposter syndrome, burnout, and depression. Belonging scores were overall lower for students from EDGs and, more specifically, significantly lowest amongst racialized students. Structural equation models show that poor sense of belonging precedes imposter syndrome and further exacerbates burnout and depression. Next, we sampled and interviewed students (N = 16) from the EDG whose belonging scores were significantly lowest. Participants described the essence of belonging as being able to exist as one’s “true self” while emphasizing feelings of acceptance, comfort, and safety as well as being valued and seen as an equal - yet described how routine experiences of “othering” inhibited a sense of belonging, often due to differences in social identity and structural privilege. Poor sense of belonging negatively affected learners’ well-being and career trajectory. We illuminate the range of psychological and professional consequences associated with diminished sense of belonging and highlight the need to expand traditional notions of equity, diversity, and inclusion to consider structural barriers to belonging.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ahn, M. Y., & Davis, H. H. (2023). Students’ sense of belonging and their socio-economic status in higher education: A quantitative approach. Teaching in Higher Education, 28(1), 136–149. https://doi.org/10.1080/13562517.2020.1778664
Aker, S., & Şahin, M. K. (2022). The relationship between school burnout, sense of school belonging and academic achievement in preclinical medical students | SpringerLink. Advances in Health Sciences Education, 27, 949–963.
Allen, K. A., Kern, M. L., Rozek, C. S., McInerney, D. M., & Slavich, G. M. (2021). Belonging: A review of conceptual issues, an integrative framework, and directions for future research. Australian Journal of Psychology, 73(1), 87–102. https://doi.org/10.1080/00049530.2021.1883409
Blalock, A. E., & Leal, D. R. (2022). Redressing injustices: How women students enact agency in undergraduate medical education. Advances in Health Sciences Education. https://doi.org/10.1007/s10459-022-10183-x
Brown, A., Auguste, E., Omobhude, F., Bakana, N., & Sukhera, J. (2022). Symbolic Solidarity or Virtue Signaling? A critical discourse analysis of the public statements released by Academic Medical Organizations in the wake of the killing of George Floyd. Academic Medicine, 97(6), 867. https://doi.org/10.1097/ACM.0000000000004597
Buckley, A. (2004). Does becoming a Professional Mean I have to become White? Journal of American Indian Education, 43(2), 19–32.
Chandauka, R. E., Russell, J. M., Sandars, J., & Vivekananda-Schmidt, P. (2015). Differing perceptions among ethnic minority and caucasian medical students which may affect their relative academic performance. Education for primary care: An Official Publication of the Association of Course Organisers, National Association of GP Tutors. World Organisation of Family Doctors, 26(1), 11–15. https://doi.org/10.1080/14739879.2015.11494301
Cho, S., Crenshaw, K. W., & McCall, L. (2013). Toward a field of Intersectionality Studies: Theory, Applications, and Praxis. Signs: Journal of Women in Culture and Society, 38(4), 785–810. https://doi.org/10.1086/669608
Clance, P. R. (1985). Clance Impostor Phenomenon Scale. The impostor phenomenon: When success makes you feel like a fake (pp. 20–22). Bantam Books.
Clark, C. R., Mercer, S. H., Zeigler-Hill, V., & Dufrene, B. A. (2012). Barriers to the success of ethnic minority students in School psychology Graduate Programs. School Psychology Review, 41(2), 176–192.
Committee on Accreditation of Canadian Medical Schools (2021). CACMS Standards and Elements: Standards for Accreditation of Medical Education Programs Leading to the M.D. Degree. https://cacms-cafmc.ca/accreditation-documents/
Consolidated federal laws of Canada, Employment Equity Act, Legislative Services Branch (2021). (testimony of Government of Canada). https://laws-lois.justice.gc.ca/eng/acts/e-5.401/
Conway-Hicks, S., & de Groot, J. M. (2019). Living in two worlds: Becoming and being a doctor among those who identify with “not from an advantaged background. Current Problems in Pediatric and Adolescent Health Care, 49(4), 92–101. https://doi.org/10.1016/j.cppeds.2019.03.006
Cornett, M., Palermo, C., & Ash, S. (2022). Professional identity research in the health professions—A scoping review. Advances in Health Sciences Education. https://doi.org/10.1007/s10459-022-10171-1
Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). Sage Publications.
Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2014). Reframing Medical Education to support professional identity formation. Academic Medicine, 89(11), 1446. https://doi.org/10.1097/ACM.0000000000000427
Cruess, R. L., Cruess, S. R., Boudreau, J. D., Snell, L., & Steinert, Y. (2015). A schematic representation of the professional identity formation and socialization of medical students and residents: A guide for medical educators. Academic Medicine: Journal of the Association of American Medical Colleges, 90(6), 718–725. https://doi.org/10.1097/ACM.0000000000000700
Daniels, R., Harding, A., Smith, J. R., & Gomez-Cano, M. (2020). Development and validation of a tool to measure belongingness as a proxy for participation in undergraduate clinical learning. Education for Primary Care, 31(5), 311–317. https://doi.org/10.1080/14739879.2020.1782272
Dolan, E. D., Mohr, D., Lempa, M., Joos, S., Fihn, S. D., Nelson, K. M., & Helfrich, C. D. (2015). Using a single item to measure burnout in primary care staff: A psychometric evaluation. Journal of General Internal Medicine, 30(5), 582–587. https://doi.org/10.1007/s11606-014-3112-6
Frost, H. D., & Regehr, G. (2013). I AM a Doctor”: Negotiating the Discourses of standardization and diversity in Professional Identity Construction. Academic Medicine, 88(10), 1570. https://doi.org/10.1097/ACM.0b013e3182a34b05
Garson, G. D. (2016). Partial least squares: Regression & structural equation models. Statistical Associates Publishing.
Gerull, K. M., Parameswaran, P., Jeffe, D. B., Salles, A., & Cipriano, C. A. (2021). Does medical students’ sense of belonging affect their interest in orthopaedic surgery careers? A qualitative investigation. Clinical Orthopaedics and Related Research, 479(10), 2239–2252. https://doi.org/10.1097/CORR.0000000000001751
Government of Canada (2021, July 14). Task Force on the Employment Equity Act Review. https://www.canada.ca/en/employment-social-development/corporate/portfolio/labour/programs/employment-equity/task-force.html
Government of Canada (2022, August 28). Federal 2SLGBTQI + Action Plan 2022. https://women-gender-equality.canada.ca/en/free-to-be-me/federal-2slgbtqi-plus-action-plan/federal-2slgbtqi-plus-action-plan-2022.html
Guetterman, T., Creswell, J., & Kuckartz, U. (2015). Using Joint Displays and MAXQDA Software to represent the results of mixed methods research. Use of Visual Displays in Research and Testing: Coding, Interpreting, and Reporting Data (pp. 145–175). Information Age Publishing.
Gusa, D. L. (2010). White institutional presence: The impact of whiteness on campus climate. Harvard Educational Review, 80, 464–489. https://doi.org/10.17763/haer.80.4.p5j483825u110002
Haggins, A. N. (2020). To be seen, heard, and valued: Strategies to promote a sense of belonging for women and underrepresented in Medicine Physicians. Academic Medicine, 95(10), 1507–1510. https://doi.org/10.1097/ACM.0000000000003553
Hair, J. F., Matthews, L. M., Matthews, R. L., & Sarstedt, M. (2017). PLS-SEM or CB-SEM: Updated guidelines on which method to use. International Journal of Multivariate Data Analysis, 1(2), 107–123. https://doi.org/10.1504/IJMDA.2017.087624
Hair, J. F., Hult, G. T. M., Ringle, C. M., Sarstedt, M., Danks, N. P., & Ray, S. (2021). An introduction to structural equation modeling. In J. F. Hair Jr., G. T. M. Hult, C. M. Ringle, M. Sarstedt, N. P. Danks, & S. Ray (Eds.), Partial least squares structural equation modeling (PLS-SEM) using R: A workbook (pp. 1–29). Springer International Publishing. https://doi.org/10.1007/978-3-030-80519-7_1
Hiatt, M., & Stockton, C. G. (2003). The impact of the Flexner Report on the fate of medical schools in North America after 1909. Journal of American Physicians and Surgeons, 8(2), 37–40.
Hoyle, R. (2012). Handbook of structural equation modeling. Guilford Press.
Isik, U., Wouters, A., Croiset, G., & Kusurkar, R. A. (2021). What kind of support do I need to be successful as an ethnic minority medical student?” A qualitative study. BMC Medical Education, 21(1), 6. https://doi.org/10.1186/s12909-020-02423-8
Joy-Correll, K., Nevill, E., Bird-Matheson, H., McLennan, H., Quinn, A., Mayer, Y., & Jarus, T. (2022). Barriers and facilitators for indigenous students and staff in health and human services educational programs. Advances in Health Sciences Education, 27(2), 501–520. https://doi.org/10.1007/s10459-022-10099-6
Kalén, S., Ponzer, S., & Silén, C. (2012). The core of mentorship: Medical students’ experiences of one-to-one mentoring in a clinical environment. Advances in Health Sciences Education, 17(3), 389–401. https://doi.org/10.1007/s10459-011-9317-0
Kalifa, A., Okuori, A., Kamdem, O., Abatan, D., Yahya, S., & Brown, A. (2022). This shouldn’t be our job to help you do this”: Exploring the responses of medical schools across Canada to address anti-black racism in 2020. Cmaj, 194(41), E1395–E1403. https://doi.org/10.1503/cmaj.211746
Ko, M., Henderson, M. C., Fancher, T. L., London, M. R., Simon, M., & Hardeman, R. R. (2023). US Medical School admissions leaders’ experiences with barriers to and advancements in Diversity, Equity, and inclusion. JAMA Network Open, 6(2), e2254928. https://doi.org/10.1001/jamanetworkopen.2022.54928
Korpershoek, H., Canrinus, E. T., Fokkens-Bruinsma, M., & de Boer, H. (2020). The relationships between school belonging and students’ motivational, social-emotional, behavioural, and academic outcomes in secondary education: A meta-analytic review. Research Papers in Education, 35(6), 641–680. https://doi.org/10.1080/02671522.2019.1615116
Kroenke, K., Spitzer, R., & Williams, J. (2003). The Patient Health Questionnaire-2: Validity of a two-item Depression Screener. Medical Care, 41(11), 1284–1292.
Kuckartz, U., & Rädiker, S. (2021). Using MAXQDA for mixed methods research. The Routledge reviewer’s guide to mixed methods analysis. Routledge.
Lee, R. M., & Davis, C. (2000). Cultural Orientation, Past Multicultural Experience, and a sense of belonging on campus for asian American College Students. Journal of College Student Development, 41(1), 110–115.
Levett-Jones, T., & Lathlean, J. (2008). Belongingness: A prerequisite for nursing students’ clinical learning. Nurse Education in Practice, 8(2), 103–111. https://doi.org/10.1016/j.nepr.2007.04.003
Levett-Jones, T., & Lathlean, J. (2009). The ascent to competence conceptual framework: An outcome of a study of belongingness. Journal of Clinical Nursing, 18(20), 2870–2879. https://doi.org/10.1111/j.1365-2702.2008.02593.x
Levett-Jones, T., Lathlean, J., Maguire, J., & McMillan, M. (2007a). Belongingness: A critique of the concept and implications for nursing education. Nurse Education Today, 27(3), 210–218. https://doi.org/10.1016/j.nedt.2006.05.001
Levett-Jones, T., Lathlean, J., McMillan, M., & Higgins, I. (2007b). Belongingness: A montage of nursing students’ stories of their clinical placement experiences. Contemporary Nurse, 24(2), 162–174. https://doi.org/10.5172/conu.2007b.24.2.162
Levett-Jones, T., Lathlean, J., Higgins, I., & McMillan, M. (2009). Staff—Student relationships and their impact on nursing students’ belongingness and learning. Journal of Advanced Nursing, 65(2), 316–324. https://doi.org/10.1111/j.1365-2648.2008.04865.x
Lowry, P. B., & Gaskin, J. (2014). Partial least squares (PLS) structural equation modeling (SEM) for building and testing behavioral causal theory: When to choose it and how to use it. IEEE Transactions on Professional Communication, 57(2), 123–146. https://doi.org/10.1109/TPC.2014.2312452
Machado, M. B., Ribeiro, D. L., & de Carvalho Filho, M. A. (2022). Social justice in medical education: Inclusion is not enough—it’s just the first step. Perspectives on Medical Education, 11(4), 187–195. https://doi.org/10.1007/s40037-022-00715-x
Mahoney, M. R., Wilson, E., Odom, K. L., Flowers, L., & Adler, S. R. (2008). Minority Faculty Voices on Diversity in Academic Medicine: Perspectives from one school. Academic Medicine, 83(8), 781. https://doi.org/10.1097/ACM.0b013e31817ec002
Maramba, D. C., & Museus, S. D. (2013). Examining the Effects of campus climate, ethnic Group Cohesion, and Cross-Cultural Interaction on Filipino American Students’ sense of belonging in College. Journal of College Student Retention: Research Theory & Practice, 14(4), 495–522. https://doi.org/10.2190/CS.14.4.d
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52(1), 397–422.
Meeuwisse, M., Severiens, S. E., & Born, M. P. (2010). Learning Environment, Interaction, sense of belonging and Study Success in ethnically Diverse Student Groups. Research in Higher Education, 51(6), 528–545. https://doi.org/10.1007/s11162-010-9168-1
Moallem, I. (2013). A Meta-analysis of School Belonging and Academic Success and Persistence. Loyola University Chicago.
Montague, J., Phillips, E., Holland, F., & Archer, S. (2020). Expanding hermeneutic horizons: Working as multiple researchers and with multiple participants. Research Methods in Medicine & Health Sciences, 1(1), 25–30. https://doi.org/10.1177/2632084320947571
Moores, L., & Popadiuk, N. (2011). Positive aspects of International Student Transitions: A qualitative Inquiry. Journal of College Student Development, 52(3), 291–306. https://doi.org/10.1353/csd.2011.0040
Nguemeni Tiako, M. J., Ray, V., & South, E. C. (2022). Medical Schools as Racialized Organizations: How race-neutral structures sustain racial inequality in Medical Education—a narrative review. Journal of General Internal Medicine, 37(9), 2259–2266. https://doi.org/10.1007/s11606-022-07500-w
Nguemeni Tiako, M. J., Wages, J. E., & Perry, S. P. (2023). Black medical students’ sense of belonging and confidence in scholastic abilities at historically black vs predominantly white medical schools: A prospective study. Journal of General Internal Medicine, 38(1), 122–124. https://doi.org/10.1007/s11606-022-07716-w
O’Marr, J. M., Chan, S. M., Crawford, L., Wong, A. H., Samuels, E., & Boatright, D. (2022). Perceptions on Burnout and the Medical School Learning Environment of Medical Students who are underrepresented in Medicine. JAMA Network Open, 5(2), e220115. https://doi.org/10.1001/jamanetworkopen.2022.0115
Pedler, M. L., Willis, R., & Nieuwoudt, J. E. (2022). A sense of belonging at university: Student retention, motivation and enjoyment. Journal of Further and Higher Education, 46(3), 397–408. https://doi.org/10.1080/0309877X.2021.1955844
Puranitee, P., Kaewpila, W., Heeneman, S., van Mook, W. N. K. A., & Busari, J. O. (2022). Promoting a sense of belonging, engagement, and collegiality to reduce burnout: A mixed methods study among undergraduate medical students in a non-western, asian context. BMC Medical Education, 22(1), 327. https://doi.org/10.1186/s12909-022-03380-0
Ray, V. (2019). A theory of Racialized Organizations. American Sociological Review, 84(1), 26–53. https://doi.org/10.1177/0003122418822335
Reinartz, W., Haenlein, M., & Henseler, J. (2009). An empirical comparison of the efficacy of covariance-based and variance-based SEM. International Journal of Research in Marketing, 26(4), 332–344. https://doi.org/10.1016/j.ijresmar.2009.08.001
Rice, J., Rosario-Williams, B., Williams, F., West-Livingston, L., Savage, D., Wilensky, J. A., & Landry, A. (2023). Impostor syndrome among minority medical students who are underrepresented in medicine. Journal of the National Medical Association, 115(2), 191–198. https://doi.org/10.1016/j.jnma.2023.01.012
Ringle, C. M., Wende, S., & Becker, J. M. (2022). SmartPLS (version 3). Boenningstedt. https://www.smartpls.com/
Roberts, L. W. (2020). Belonging, respectful inclusion, and diversity in Medical Education. Academic Medicine, 95(5), 661–664. https://doi.org/10.1097/ACM.0000000000003215
Sánchez, N. F., Kennedy, L., Spigner, S. T., Hartman, A. W., Sánchez, J. P., & Callahan, E. J. (2022). LGBTQ + worker protections: Implications for Academic Medicine Today and in the future. Academic Medicine, 97(11), 1597–1604. https://doi.org/10.1097/ACM.0000000000004672
Sargent, J., Williams, R. A., Hagerty, B., Lynch-Sauer, J., & Hoyle, K. (2002). Sense of belonging as a buffer against depressive symptoms. Journal of the American Psychiatric Nurses Association, 8(4), 120–129. https://doi.org/10.1067/mpn.2002.127290
Savitt, T. (2006). Abraham Flexner and the Black Medical Schools. Journal of the National Medical Association, 98(9), 1415–1424.
Schoonenboom, J. (2022). Developing the Meta-Inference in Mixed Methods Research through Successive Integration of Claims. In The Routledge Handbook for Advancing Integration in Mixed Methods Research (1st ed., pp. 55–70). Routledge. https://doi.org/10.4324/9780429432828-6
Schrewe, B., & Martimianakis, M. A. (2022). Re-thinking “I”dentity in medical education: Genealogy and the possibilities of being and becoming. Advances in Health Sciences Education, 27(3), 847–861. https://doi.org/10.1007/s10459-022-10095-w
Sedgwick, M., Oosterbroek, T., & Ponomar, V. (2014). It all depends’: How minority nursing students experience belonging during clinical experiences. Nursing Education Perspectives, 35(2), 89–93. https://doi.org/10.5480/11-707.1
Smith, J. A. (2009). Interpretative phenomenological analysis: Theory, Method and Research. Sage Publications.
Strayhorn, T. L. (2018). College Students’ sense of belonging: A key to Educational Success for all students (2nd ed.). Routledge. https://doi.org/10.4324/9781315297293
Strayhorn, T. L. (2020a). Sense of belonging predicts persistence intentions among diverse dental education students: A multi-institutional investigation. Journal of Dental Education, 84(10), 1136–1142. https://doi.org/10.1002/jdd.12243
Strayhorn, T. L. (2020b). Exploring the role of race in black males’ sense of belonging in Medical School: A qualitative pilot study. Medical Science Educator, 30(4), 1383–1387. https://doi.org/10.1007/s40670-020-01103-y
Sukhera, J., Goez, H., Brown, A., Haddara, W., & Razack, S. (2022). Freedom from discrimination or freedom to discriminate? Discursive tensions within discrimination policies in medical education. Advances in Health Sciences Education, 27, 387–403.
Sukhera, J., Goez, H., Brown, A., Haddara, W., & Razack, S. (In Press). Policy-based solutions to discrimination and harassment in Academic Medicine: An Inclusive Approach. Academic Medicine.
Teshome, B. G., Desai, M. M., Gross, C. P., Hill, K. A., Li, F., Samuels, E. A., Wong, A. H., Xu, Y., & Boatright, D. H. (2022). Marginalized identities, mistreatment, discrimination, and burnout among US medical students: Cross sectional survey and retrospective cohort study. Bmj, e065984. https://doi.org/10.1136/bmj-2021-065984
Tetty, W. (2019, February 25). Inspiring Inclusive Excellence. Installation Address, Toronto, Canada. https://utsc.utoronto.ca/news-events/inspiring-inclusive-excellence-professor-wisdom-tetteys-installation-address
Toubassi, D., Schenker, C., Roberts, M., & Forte, M. (2022). Professional identity formation: Linking meaning to well-being. Advances in Health Sciences Education. https://doi.org/10.1007/s10459-022-10146-2
University of Calgary. (2021). Office of equity, diversity and inclusion. Available from: https://www.ucalgary.ca/equity-diversity-inclusion/
Vaias, L. (1994). Normal white female. Journal of the American Medical Association, 271(9), 716–717.
van Buuren, A., Yaseen, W., Veinot, P., Mylopoulos, M., & Law, M. (2021). Later is too late: Exploring student experiences of diversity and inclusion in medical school orientation. Medical Teacher, 43(5), 538–545. https://doi.org/10.1080/0142159X.2021.1874326
van Manen, M. (1997). From meaning to Method. Qualitative Health Research, 7(3), 345–369.
Verbi (2021). MAXQDA (Version 2022). VERBI Software. www.maxqda.com
Violato, C., & Hecker, K. G. (2007). How to use structural equation modeling in medical education research: A brief guide. Teaching and Learning in Medicine, 19(4), 362–371. https://doi.org/10.1080/10401330701542685
Vivekananda-Schmidt, P., & Sandars, J. (2018). Belongingness and its implications for undergraduate health professions education: A scoping review. Education for Primary Care, 29(5), 268–275. https://doi.org/10.1080/14739879.2018.1478677
Volpe, R. L., Hopkins, M., Haidet, P., Wolpaw, D. R., & Adams, N. E. (2019). Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis. Medical Education, 53(2), 119–132. https://doi.org/10.1111/medu.13781
Walton, G. M., & Cohen, G. L. (2007). A question of belonging: Race, social fit, and achievement. Journal of Personality and Social Psychology, 92(1), 82–96. https://doi.org/10.1037/0022-3514.92.1.82
Walton, G. M., & Cohen, G. L. (2011). A brief social-belonging intervention improves academic and Health Outcomes of Minority Students. Science, 331(6023), 1447–1451. https://doi.org/10.1126/science.1198364
Wyatt, T. R., Rockich-Winston, N., Taylor, T. R., & White, D. (2020). What does Context have to do with anything? A study of professional identity formation in physician-trainees considered underrepresented in Medicine. Academic Medicine, 95(10), 1587. https://doi.org/10.1097/ACM.0000000000003192
Wyatt, T. R., Balmer, D., Rockich-Winston, N., Chow, C. J., Richards, J., & Zaidi, Z. (2021a). Whispers and shadows’: A critical review of the professional identity literature with respect to minority physicians. Medical Education, 55(2), 148–158. https://doi.org/10.1111/medu.14295
Wyatt, T. R., Rockich-Winston, N., White, D., & Taylor, T. R. (2021b). Changing the narrative”: A study on professional identity formation among Black/African american physicians in the U.S. Advances in Health Sciences Education, 26(1), 183–198. https://doi.org/10.1007/s10459-020-09978-7
Acknowledgements
This project was funded by the Canadian Association for Medical Education Foundation through the 2022 Learner Health Professions Education Grant, and by the Office of Health and Medical Education at the University of Calgary through the 2021 Equity, Diversity & Inclusion Scholarship in Health and Medical Education Funding Competition. The authors also wish to thank the following medical students who pilot tested and translated the survey instrument: Santanna Hernandez, Tyler Warnock, Whitney Ereyi-Osas, Claire Connors, Ines Zuna, Jeremy Moreau.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. All statistical analysis and modelling were conducted by Allison Brown. Interviews were conducted by Priatharsini Sivananthajothy, Adibba Adel, Shima Afhami and Nina Castrogiovanni. Adibba Adel reviewed all transcripts for accuracy and to remove identifiable information. Initial analysis of qualitative data was conducted by Priatharsini Sivananthajothy, Adibba Adel, Shima Afhami, Nina Castrogiovanni, and Allison Brown. Subsequent analysis of qualitative data was led by Priatharsini Sivananthajothy, Adibba Adel, and Allison Brown. Figure 1 was prepared by AB. Figure 2 was prepared by PS. The first draft of the manuscript was written by Priatharsini Sivananthajothy and Allison Brown, and all authors reviewed and commented on draft manuscripts. All authors read and approved the final manuscript. All authors meet the ICMJE criteria for authorship.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethics approval
Ethics approval was granted by the University of Calgary Conjoint Health Research Ethics Board [CHREB ID: 21-1076]. This study was performed in line with the principles of the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study.
Other disclosures
The authors recognize how language can be a tool to reclaim power and did their best to use inclusive language practices as they understood them at the time of writing this article. We use “equity-deserving groups” as a central term throughout to refer to medical students who share social identities and lived experiences with groups that are recognized in the Federal Employment Act of Canada.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Sivananthajothy, P., Adel, A., Afhami, S. et al. Equity, diversity, and…exclusion? A national mixed methods study of “belonging” in Canadian undergraduate medical education. Adv in Health Sci Educ (2023). https://doi.org/10.1007/s10459-023-10265-4
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10459-023-10265-4