Dear Editor,

I was delighted that a medical student who is first-generation college had sent in an important question to Mama M. about navigating medical school [“First-generation medical student struggles in effort to understand program’s hidden curriculum,” March 5]. While I appreciated Mama M.’s support and encouragement to students to trust themselves and value their unique experiences, I felt the issue of the hidden curriculum was misunderstood and, perhaps unintentionally, minimized.

Philip Jackson (1968) is known to have coined the term “hidden curriculum.” He used this term to refer to the implicit values, dispositions and social behaviors that students were expected to learn in the classroom in order to be successful. At the graduate- and professional-school level, the hidden curriculum is often reflective of the unspoken and implicit cultural norms within a profession. Examples include what to wear at clinic, how to respond when you don’t know the answer to your attending’s question or whether to stick around at the end of your shift while on rotation. Learning about these expectations can make a big difference in one’s academic and professional journey. But access to this kind of information cannot be assumed because it is often passed down informally, and students come from different backgrounds and differential access to a relative, neighbor or community member who talked about such things.

Trusting oneself is important—including one’s sense that one needs more information, resources or help. We don’t do this alone. It takes a village to get a degree for any student. For first-generation college students, populating their village with mentors, trusted professors and supervisors, networks that their peers can introduce them to, fellow travelers with whom to share notes that can be pieced together, etc., can be a helpful way to chip at that barrier of the hidden curriculum while not losing sight of one’s inherent strengths and resources.

Neesha Patel, Ph.D.

Director, First Generation Support Services at UCSF