Why Your Doctor Didn’t Go to Class: Student Culture, High-Stakes Testing, and Novel Coupling Configurations in an Allopathic Medical School

Abstract

A clear pattern has emerged in allopathic medical schools across the United States: Most medical students have stopped going to class. While this trend among students is well known in medical education, few studies to date have examined the underlying sociological mechanisms driving this collective behavior or how these dynamics are related to institutional change in medical education. Drawing on 33 in-depth interviews with medical students in an allopathic medical school, we examine medical student culture and its role in shaping how medical students make sense of the institutionalized licensing requirement of the United States Medical Licensing Exam. We find that medical students learn to rely on digital recordings of their course content and third-party digital resources for Step 1 prep and stop attending their academic courses in person altogether. We argue that medical students create novel coupling configurations between local interaction and institutionalized licensure rules via their student cultures.

Learning to Think Like an Economist without Becoming One: Ambivalent Reproduction and Policy Couplings in a Masters of Public Affairs Program

“…This does not mean ambivalent and interpretive reproduction do not happen, but conditions are different. Medical and law school are longer, allowing for deeper learning (although, surprisingly, new research finds that medical students often skip classes, preferring to spend that time studying for Board exams while referring to course recordings [Everitt, Johnson, and Burr 2023]). Here the problem is "the fate of idealism" (Becker and Geer 1958;Dingwall and Lewis 1983), where students must overcome the realization that the profession does not fit their idealized visions, threatening their morals (Clair and Hunt 2023).…”