' "Just think of TB and Asians", that's all I ever hear': medical learners' views about training to work in an ethnically diverse society

Introduction The case for being able to respond effectively to cultural and ethnic diversity in health care is attracting increasing debate in medical education. However research exploring the perspectives of learners is lacking. Aims We sought medical learners' perceptions and their perceived training needs in relation to cultural and ethnic diversity in health care. Methods A series of nine focus group interviews was conducted with 55 medical learners, including undergraduate students in a UK medical school and a group of postgraduate general practitioners in training. Interview data were analysed using qualitative methods. Results Participants had a broad but superficial awareness of multicultural issues. This focused upon 'difference' with students emphasizing their need to acquire knowledge of different beliefs and practices. Current teaching was perceived as inadequate and limited largely to ethnic patterns of disease. Most felt a need for greater training. They regarded development of particular communication skills, such as working with interpreters as helpful. Beyond avoiding stereotyping, learners rarely identified reflecting upon their attitudes or the issue of racism as important. Students anticipated a range of potential problems for further training, but sought learning that was relevant, practically oriented and stimulating. Conclusions The study points to learners' experience of inadequate training but suggests a willingness to learn more. The possible predominance of a 'difference' perspective might drive a narrow focus upon learning cultural knowledge at the expense of promoting a balance with self-reflection upon attitudes and developing generic skills. Educators might heed learners' views about how they should be taught successfully.