Researchers: Orit Karnieli-Miller¹, Keren Michael², Lior Rozental¹

Background: Adequate representation of ethnic minorities in healthcare is essential to ensure equitable, accessible, and culturally sensitive medical care. The Arab society in Israel continues to experience underrepresentation and significant
challenges within medical school and in integrating into the medical profession. These alarming data emphasize the need to identify students' social, educational, and environmental gaps throughout their medical education, allowing for better integration into the profession.

Objectives: To identify and map facilitating and hindering factors affecting the training process of medical students from the social periphery and formulate recommendations.

Method: Qualitative study of 43 semi-structured in-depth interviews with 27 Arab medical and dental students and 16 faculty physician-small-group facilitators' experiences. Data analyzed using Immersion/Crystallization method, vertical and
horizontal thematic analysis.

Findings: Arab medical students face challenges throughout their training, including perceived cultural bias in admissions, social exclusion, and fear of expressing personal or political views, often leading to self-silencing. These difficulties intensified during periods of national tension. Despite this, students identified strengths such as cultural insight and language skills, which allowed them to support minority patients. Faculty noted low participation in group discussions and challenges with reflective writing, but were unclear on how to manage these. Some developed creative approaches to foster safe, inclusive spaces, leading to deeper engagement and communication.

Conclusions: Arab students face challenges, including cultural disconnection, fear of
exposure, and underrepresentation. Many adopt self-censorship. Faculty express
uncertainty in supporting them. Yet, cultural strengths and inclusive environments
promote well-being, emphasizing the need for changes.

Recommendations: To promote equitable integration, medical schools
should adopt multi-level strategies: train faculty in culturally responsive pedagogy,
redesign learning spaces to support diverse identities, review admissions for bias,
minimize isolation, and monitor inclusion. With support, Arab students can
significantly advance equity in Israel’s healthcare system.

Research end date: 08/2025