Student portfolios and the hidden curriculum on gender: Mapping exclusion

Context The hidden curriculum - the norms, values and practices that are transmitted to students through modelling by preceptors and teachers, and decisions about curricular exclusions and inclusions - can be profoundly important in the socialising of trainee doctors. However, tracking the hidden curriculum as it evolves can be challenging for medical schools. Objectives This study aimed to explore the content of student e-portfolios on gender issues, a key perspective often taught through a hidden curriculum. Methods Online posts for a gender and medicine e-portfolio task completed by two cohorts of students in Year 3 of a 4-year medical course (n = 167, 66% female) were analysed using a grounded theory approach. Results A process of gendered 'othering' was applied to both men and women in the medical school using different pedagogical strategies. Curricular emphases on women's health and lack of support for male students to acquire gynaecological examination skills were seen as explicit ways of excluding males. For female medical students, exclusion tended to be implicit, operating through modelling and aphoristic comments about so-called 'female-friendly' career choices and the negative impact of motherhood on career. Discussion E-portfolios can be a useful way of tracking the hidden curriculum as it evolves. Responses to gendered exclusion may be developed more readily for the explicit processes impacting on male students than for the implicit processes impacting on female students, which often reflect structural issues related to training and employment.