A framework to understand the needs of the medical students of the future.

Medical education is undergoing curricular reform driven by internal needs and external pressures. Concurrently, medical students are changing. More diverse student bodies, particularly those from underrepresented minorities, bring different skill sets, needs and priorities to their medical school education. Here we present their voices. In order to explore the stories, needs and motivations of future physicians, we conducted a small-scale study of students from diverse backgrounds in US medical schools. Our interviews revealed two core themes about medical school: (1) that medical school is an extreme physical and emotional challenge for all students, and (2) that medical school education consists of multiple conflicting goals. Combining the two themes provides a descriptive topology of student's motivations and strategies for getting through medical school. Using this framework, we deconstruct the experience of medical school to reveal the gaps and misalignments between the traditional system of medical education and what medical students want, expect and need to be successful. We discuss the implications of our research and this framework for curricula and the learning environment with a particular focus on (1) cooperative learning and social interdependence theory and (2) an expanded understanding of diversity and the needs of under-represented students.