Reproducing Privilege or Hippocratic Habitus: A Critical Discourse Analysis of Personal Statements and the use of Capital to Facilitate Matriculation into Medical School

A national physician shortage has prompted calls to diversify the demographics of medical school student bodies to address the social determinants of health plaguing underrepresented minority communities. Moreover, the Association of American Medical Colleges predicts a deficit of 104,900 physicians by 2030. Despite this, admission into medical school remains competitive, homogenous, and lacking “underrepresented in medicine” (URM) students. Underrepresented groups historically absent from medical education show that the medical degree and overall pursuit of a medical career are tacitly affiliated with a dominant social group acting as a power agent in the reproduction of an economic class. Considering the admissions process, one could question the ability to extend existing cultural-based inequalities into medical education. This dissertation examines how discourse in an applicant’s personal statement shapes the actions of medical-school admissions committees oblivious to hidden influences of power. Inspired by Pierre Bourdieu’s economic notion of capital, I used his theories to examine how applicants use available cultural and social capital in personal statement to obtain in-person interviews. The research questions are: (1) How are forms of capital expressed in URM and non-URM applicants’ medical school personal statements? (2) Do the expressed forms of capital differ in the personal statements of applicants accepted and rejected for in-person interviews? A critical discourse analysis highlights cultural and social capital among accepted and rejected URM and non-URM applicants with similar academic scores. Key findings revealed URM students lacked expressive values of cultural capital and are were less likely to be invited to for interview due to the lack of URM physician mentors evident through cultural relational values. Additionally, non-URM applicants’ evolving interpretation of the medical field influenced their motivation to demonstrate cultural capital at the macro level, presenting the likelihood of an interview. The macro level also revealed how non-URM students used celebrity-status relationships and disproportionality larger social networks related to the field of medicine. Implications are related to executing a formal inventory of pipeline programs through institutional representation at the national level, reforming admissions priorities to leverage applicants’ personal qualities and potential, and redefining the disadvantaged status in the medical school application process