Medical students’ experience of the hidden curriculum around primary care careers: a qualitative exploration of reflective diaries

Objectives Primary healthcare internationally is facing a workforce crisis with fewer junior doctors choosing general practice (GP) as a career. In the UK, a national report on GP careers highlighted adverse influences during medical school on students’ career choices. The authors explored these influences in two urban UK medical schools, both with relatively low numbers of students entering GP training. Design Using a phenomenological approach, the authors thematically analysed the reflective diaries of four medical students who were recruited as ‘participant researchers’ over a period of 10 months. These students made regular reflexive notes about their experiences related to GP career perceptions in their academic and personal environments, aiming to capture both positive and negative perceptions of GP careers. The research team discussed emerging data and iteratively explored and developed themes. Setting Two UK medical schools Participants Undergraduate medical students Results Seven key themes were identified: the lack of visibility and physicality of GP work, the lack of aspirational GP role models, students’ perceptions of a GP career as default, the performativity of student career choice with the perceptions of success linked to specialism, societal perceptions of GP careers, gender stereotyping of career choices and the student perception of life as a GP. Conclusions Students overwhelmingly reflected on negative cues to GP careers, particularly through their experience of the hidden curriculum. Three recommendations are made: the need for increased representation of GP role models in clinical curricula content delivery and senior leadership; ensuring GP clerkships involve an active and authentic student role with patients, enabling students to experience GP’s ‘work’ including managing complexity, uncertainty and risk. Finally, institutions need to consider students’ experiences of the hidden curriculum and the effect this can have on students’ perception of careers, alongside the challenges of rankings and perceived hierarchical positioning of disciplines

Assessing the chemical involvement of limestone powder in sodium carbonate activated slag

This study aims to investigate the effect of limestone powder (LP) on the reaction of sodium carbonate activated slag. The results show that the incorporated LP up to 30% improves the strength development, especially at advanced curing ages. A slightly accelerated reaction is observed for samples containing low amount of LP (≤5%), while mixture with 10% LP shows the optimized results with respect to the heat release and strength development. Chemical effect of incorporating LP is observed at high replacement levels (≥15%), indicated by the formation of a new phase, natron (Na2CO3·10H2O). Besides, relatively high contents of hydrotalcite-like phases are generated when increasing the dosage of limestone powder. The chemical changes, including the volume changes of generating natron and the transformation of natron to calcite, is potentially responsible for the enhanced mechanical properties

Control of structure-specific endonucleases to maintain genome stability

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