Opinion & Special Articles: Examining the Hidden Curriculum of Medical School From a First-Generation Student Perspective.

With the incorporation of pass/fail outcomes into the curricula of many medical schools, a greater premium is being placed on leadership, research, and other extracurricular pursuits. These activities, as well as the cultivation of social capital, represent a "hidden curriculum" which offers significant benefits to career development that are not often explicitly stated. The hidden curriculum benefits students with generational knowledge of the medical school infrastructure and harms first-generation and/or low-income (FGLI) students, who take longer to integrate into the professional environment and experience more challenges along the way. FGLI students show increased persistence, and they offer diverse perspectives, but poor representation and lack of a clear pathway narrow their entry into several medical specialties, including neurology. As neurologists and educators, we play a role during a critical time of medical student professional development and can help bring the hidden curriculum into the light. Recognition of student backgrounds should guide policies to arm all students with knowledge to make the most of the limited timeframe of medical school. To reduce the lag phase of less enfranchised students, several effective practices can be instituted with minimal modification to existing medical school infrastructure. Efforts to support FGLI students by increasing transparency of the hidden curriculum, formalizing FGLI mentorship groups, and centralizing key information and resources will pay dividends with greater realization of promise and increased diversity and inclusion across more specialties.