What is medicine and what is a doctor? Medical students' perceptions and expectations of their academic and professional career

Background: Research was conducted at the University of Cape Town in South Africa where a new medical curriculum was introduced in 2002. This curriculum is largely problem-based and primary health care (PHC) driven. Aim: To qualitatively explore medical students' perceptions of medicine and doctors and their expectations of studying medicine and practising as a doctor. Methods: A questionnaire was administered to all first-year students (n = 193) that assessed their perceptions of doctors, and their expectations of studying medicine and practising as a doctor. Interviews and focus groups were conducted with purposively selected first-, second-, third- and fourth- year students. Results: Medical students at the University of Cape Town were found to have generally positive perceptions of medicine and doctors, and depicted the medical profession as one that is very significant because of its influence within society, to the point of being perceived as almost noble. Some of the more challenging and difficult aspects of a career in medicine were mentioned, but these seem to be minor compared to the positive aspects. Some students regarded the medical profession as having a biomedical and curative emphasis, although there seemed to be a strong move towards a more holistic view. However, students expected their degree to concentrate on the biomedical aspects of medicine, and therefore did not expect particular components of their degree, such as the psychosocial component. Conclusions: Unmet expectations regarding their curriculum seem to be a very significant issue for students. It is therefore important for educators who deliver the curriculum to be aware of and to understand medical students' perceptions and expectations of medicine and doctors, in order to detect and deal with conflict between these perceptions and expectations and what may be an educational institution's 'hidden curriculum'.