The hidden curriculum in undergraduate medical education: qualitative study of medical students' perceptions of teaching.

OBJECTIVE To study medical students' views about the quality of the teaching they receive during their undergraduate training, especially in terms of the hidden curriculum. DESIGN Semistructured interviews with individual students. SETTING One medical school in the United Kingdom. PARTICIPANTS 36 undergraduate medical students, across all stages of their training, selected by random and quota sampling, stratified by sex and ethnicity, with the whole medical school population as a sampling frame. MAIN OUTCOME MEASURES Medical students' experiences and perceptions of the quality of teaching received during their undergraduate training. RESULTS Students reported many examples of positive role models and effective, approachable teachers, with valued characteristics perceived according to traditional gendered stereotypes. They also described a hierarchical and competitive atmosphere in the medical school, in which haphazard instruction and teaching by humiliation occur, especially during the clinical training years. CONCLUSIONS Following on from the recent reforms of the manifest curriculum, the hidden curriculum now needs attention to produce the necessary fundamental changes in the culture of undergraduate medical education.