Center for Health Professions Education, Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD20814, USA.
Division of General Internal Medicine and Health Services Research, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, USA.
Adv Health Sci Educ Theory Pract. 2024 May;29(2):551-566. doi: 10.1007/s10459-023-10270-7. Epub 2023 Aug 1.
As first generation (FG)/low income (LI) students enter the elite profession of medicine, schools make presumptions about how FGLI students allocate their time. However, their lives are markedly different compared to their peers. This study argues that while all forms of capital are necessary for success, time as a specific form keeps classism in place. Using constructivist grounded theory techniques, we interviewed 48 FGLI students to understand where, why and how they allocated their time, and the perceived impact it had on them. Using open coding and constant comparison, we developed an understanding of FGLI students' relationship to time and then contextualized it within larger conversations on how time is conceptualized in a capitalist system that demands time efficiency, and the activities where time is needed in medical school. When students discussed time, they invoked the concept of 'time famine;' having too much to do and not enough time. In attempting to meet medicine's expectations, they conceptualized time as something that was 'spent' or 'given/taken' as they traversed different marketplaces, using their time as a form of currency to make up for the social capital expected of them. This study shows that because medical education was designed around the social elite, a strata of individuals who have generational resources, time is a critical aspect separating FGLI students from their peers. This study undergirds the idea that time is a hidden organizational framework that helps to maintain classism, thus positioning FGLI students at a disadvantage.
随着第一代（FG）/低收入（LI）学生进入精英医学专业，学校对 FGLI 学生如何分配时间做出了假设。然而，他们的生活与同龄人明显不同。本研究认为，虽然所有形式的资本对于成功都是必要的，但时间作为一种特殊形式，使阶级主义得以维持。我们采用建构主义扎根理论技术，对 48 名 FGLI 学生进行了采访，以了解他们在哪里、为什么以及如何分配时间，以及他们认为这对他们有什么影响。通过开放编码和不断比较，我们了解了 FGLI 学生与时间的关系，然后将其置于关于时间在资本主义系统中是如何被概念化的更大对话中，在这种系统中，时间效率是被要求的，而在医学院中，需要时间的活动也是被要求的。当学生讨论时间时，他们援引了“时间匮乏”的概念；有太多的事情要做，而没有足够的时间。在试图满足医学的期望时，他们将时间概念化为一种“花费”或“给予/占用”，因为他们在不同的市场中穿行，将时间作为一种货币形式来弥补他们所期望的社会资本。本研究表明，由于医学教育是围绕社会精英设计的，而这些精英拥有世代相传的资源，因此时间是将 FGLI 学生与同龄人区分开来的一个关键因素。本研究支持这样一种观点，即时间是一种隐藏的组织框架，有助于维持阶级主义，从而使 FGLI 学生处于不利地位。
