March in this issue

Making entrustment decisions are important actions in medical training that pose risks to trainees and patients if not done well. The authors conducted a realist inquiry to better understand how such decisions are carried out by committees through meeting observations and committee member interviews. Building from a previous model that found entrustment decisions are often not deliberate, the authors found that competence committees often focus deliberately on resident development, just not on resident entrustment. They further found that committees consider bias, equity and fairness with intentionality that ranges from being reactive to being proactive.

Schumacher, D, Martini, A, Michelson, C, Turner, D, Winn, A, Kinnear, B. A realist evaluation of prospective entrustment decisions in pediatric residency clinical competency committees. Med Educ. 2025; 59(3): xx-xx. 10.1111/medu.15530.

Expectations can affect how students interpret and make sense of the support they receive from their medical school. This qualitative study highlights that students expect a strong support system to be provided by the medical school. When these expectations are unmet, students often disengage from formal support systems and instead create their own peer-support networks. A deeper understanding of student expectations can inform the design and development of support systems to more effectively meet student needs.

Tan, E, Driessen, E, Frambach, J, Cleland, J, Kearney, GP. How do medical students' expectations shape their experiences of wellbeing programmes? Med Educ. 2025; 59(3): xx-xx. 10.1111/medu.15543.

Imposter phenomenon (IP) is prevalent across medical professionals, students and trainees. However, the sources of imposter feelings have yet to be explored in medical students. Analysing 233 reflective essays from two institutions, researchers identified imposter feelings in 52% of the essays and generated three themes to describe sources of imposter feelings: self-comparison to idealized images of medical students, self-comparison to physicians and concerns about self-presentation. The findings underscore the need for open dialogue and reflective practices during professional identity formation in medicine.

Kruskie, ME, Frankel, R, Isaacson, J, Mehta, N, Byram, J. Investigating feelings of Imposterism in first-year medical student narratives. Med Educ. 2025; 59(3): xx-xx. 10.1111/medu.15533.

Social connections are important for IMGs' well-being, intercultural competence and performance. This was a large empirical qualitative study where 24 IMGs and 17 UK Medical Graduates were interviewed to understand how IMGs formed their social connections. IMGs were often isolated immediately after migration and developed strategies to overcome this isolation. Challenges arising included segregation behaviours and under-developed intercultural competence by IMGs and UK natives alike. IMGs faced individual, systemic and institutional discrimination. Considering the importance of social connections for IMGs, more emphasis should be placed on providing an environment where these connections can flourish.

Al-Haddad, M, Jamieson, S, Germeni, E. International medical Graduates' social connections: a qualitative study. Med Educ. 2025; 59(3): xx-xx. 10.1111/medu.15542.