Stigma and the Journey of Extreme Social Mobility: Notes on the Management of Discreditable Identities in a High Status University Degree

  • Erica Southgate
Part of the Palgrave Explorations in Workplace Stigma book series (PAEWS)


Despite significant policy efforts to widen participation, non-traditional students continue to be under-represented in high status university degrees such as medicine. Although this issue is both global and intransigent, relatively little is known about the journeys of non-traditional students who do succeed in gaining access to high status degrees and their associated professions. Theirs is a unique story of extreme social mobility, where students move from humble family of origin into university and the elite organisational contexts of medical education and associated clinical settings. This chapter draws on a qualitative study of first-in-family medical students to explore their experience of extreme social mobility and the overt and subtle forms of stigma they face. Using Goffman’s notion of discreditable identity, the chapter provides a fine grained account of how students negotiate and resist stigma to tactically incorporate aspects of their working-class or cultural selves into emerging professional identities.


  1. Altbach, P. (2013). The international imperative in higher education. Rotterdam, Netherlands: Springer.CrossRefGoogle Scholar
  2. Association of Faculties of Medicine of Canada. (2012). The future of medical education in Canada. Ottawa: AMFC.Google Scholar
  3. Australian Bureau of Statistics. (2013). 2033.0.55.001—Census of population and housing: Socio-economic indexes for areas (SEIFA), Australia, 2011. Canberra: Commonwealth Government of Australia.Google Scholar
  4. Beagan, B. L. (2005). Everyday classism in medical school: Experiencing marginality and resistance. Medical Education, 39(8), 777–784.CrossRefGoogle Scholar
  5. Becker, H. S. (1973). Outsiders: Studies in the sociology of deviance. New York, NY: Macmillan Publishing.Google Scholar
  6. Bergman, M. E., & Chalkley, K. M. (2007). ‘Ex’ marks a spot: The stickiness of dirty work and other removed stigmas. Journal of Occupational Health Psychology, 12(3), 251–265.CrossRefGoogle Scholar
  7. Boelen, C., Dharamsi, S., & Gibbs, T. (2012). The social accountability of medical schools and its indicators. Education for Health, 25(3), 180.CrossRefGoogle Scholar
  8. Bourdieu, P. (1977). Outline of a theory of practice. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  9. British Medical Association. (2009). Equality and diversity in UK medical schools. London: BMA.Google Scholar
  10. Breen, R., & Jonsson, J. (2005). Inequality of opportunity in comparative perspective: Recent research on educational attainment and social mobility. Annual Review of Sociology, 223–243.Google Scholar
  11. Brosnan, C., Southgate, E., Outram, S., Lempp, H., Wright, S., Saxby, T., et al. (2016). Experiences of medical students who are first in family to attend university. Medical Education, 50(8), 842–851.CrossRefGoogle Scholar
  12. Causa, O., Dantan, S., & Johansson, A. (2009). Intergenerational social mobility in European OECD countries, OECD Economics Department Working Papers, No. 709. Retrieved from
  13. Cleland, J., Dowell, J., McLachlan, J., Nicholson, S., & Petterson, F. (2012). Identifying best practice in the selection of medical student. London, UK: General Medical Council.Google Scholar
  14. Cohen, S. (1967). Mods, rockers and the rest: Community reactions to juvenile delinquency. The Howard Journal of Criminal Justice, 12(2), 121–130.CrossRefGoogle Scholar
  15. Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches. Los Angeles, CA: Sage.Google Scholar
  16. Department of Education. (2014). Undergraduate applications, offers and acceptances, 2014 report and appendices. Canberra: Department of Education.Google Scholar
  17. Douglas, M. (1966/2003). Purity and danger: An analysis of concepts of pollution and taboo. London, UK: Routledge.Google Scholar
  18. Duvivier, R. J., & Stull, M. J. (2011). Advocacy training and social accountability of health professionals. The Lancet, 378(9807), e17.CrossRefGoogle Scholar
  19. Fenton, J. J., Fiscella, K., Jerant, A. F., Sousa, F., Henderson, M., Fancher, T., et al. (2016). Reducing medical school admissions disparities in an era of legal restrictions: Adjusting for applicant socioeconomic disadvantage. Journal of Health Care for the Poor and Underserved, 27(1), 22–34.CrossRefGoogle Scholar
  20. Friedman, S. (2013). The price of the ticket: Rethinking the experience of social mobility, Sociology, 0038038513490355.Google Scholar
  21. Friedman, S. (2015). Habitus clivé and the emotional imprint of social mobility. The Sociological Review, 64(1), 129–147.CrossRefGoogle Scholar
  22. Garcia, S. B., & Guerra, P. L. (2004). Deconstructing deficit thinking working with educators to create more equitable learning environments. Education and Urban Society, 36(2), 150–168.CrossRefGoogle Scholar
  23. Garlick, P. B., & Brown, G. (2008). Widening participation in medicine. British Medical Journal, 336(7653), 1111.CrossRefGoogle Scholar
  24. Gibson, C. (2013). Welcome to Bogan-ville: Reframing class and place through humour. Journal of Australian Studies, 37(1), 62–75.CrossRefGoogle Scholar
  25. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York, NY: Simon and Schuster.Google Scholar
  26. Greenhalgh, T., Russell, J., Boynton, P., Lefford, F., Chopra, N., & Dunkley, L. (2006). ‘We are treated like adults’—Development of a pre-medicine summer school for 16 year olds from deprived socioeconomic backgrounds: Action research study. British Medical Journal, 332, 762–767.CrossRefGoogle Scholar
  27. Greenhalgh, T., Seyan, K., & Boynton, P. (2004). ‘Not a university type’: Focus group study of social class, ethnic, and sex differences in school pupils’ perceptions about medical school. British Medical Journal, 328(7455), 1541.CrossRefGoogle Scholar
  28. Grumbach, K., & Chen, E. (2006). Effectiveness of University of California postbaccalaureate premedical programs in increasing medical school matriculation for minority and disadvantaged students. Jama, 296(9), 1079–1085.CrossRefGoogle Scholar
  29. Hughes, E. C. (1958). Men and their work. Glencoe, IL: Free Press.Google Scholar
  30. Jones, M., Humphreys, J., & Prideaux, D. (2009). Predicting medical students’ intentions to take up rural practice after graduation. Medical Education, 43(10), 1001–1009.CrossRefGoogle Scholar
  31. Klein, M. (2015). Educational expansion, occupational closure and the relation between educational attainment and occupational prestige over time. Sociology, 0038038514560602.Google Scholar
  32. Loughnan, S., Haslam, N., Sutton, R. M., & Spencer, B. (2014). Dehumanization and social class. Social Psychology, 45(1), 54–61.CrossRefGoogle Scholar
  33. Mathers, J., & Parry, J. (2009). Why are there so few working-class applicants to medical schools? Learning from the success stories. Medical Education, 43(3), 219–228.CrossRefGoogle Scholar
  34. McMillan, J., Beavis, A., & Jones, F. (2009). The AUSEI06: A new socioeconomic index for Australia. Journal of Sociology, 45(2), 123–149.CrossRefGoogle Scholar
  35. Mills, C. Wright. (1959/2000). The sociological imagination. Oxford, UK: Oxford University Press.Google Scholar
  36. Murray, R. B., Larkins, S., Russell, H., Ewen, S., & Prideaux, D. (2012). Medical schools as agents of change: Socially accountable medical education. Medical Journal of Australia, 196(10), 653.CrossRefGoogle Scholar
  37. Reay, D., Crozier, G., & Clayton, J. (2009). ‘Strangers in paradise’? Working-class students in elite universities. Sociology, 43(6), 1103–1121.CrossRefGoogle Scholar
  38. Reay, D., Crozier, G., & Clayton, J. (2010). ‘Fitting in’ or ‘standing out’: Working-class students in UK higher education. British Educational Research Journal, 36(1), 107–124.CrossRefGoogle Scholar
  39. Robb, N., Dunkley, L., Boynton, P., & Greenhalgh, T. (2007). Looking for a better future: Identity construction in socio-economically deprived 16-year olds considering a career in medicine. Social Science & Medicine, 65(4), 738–754.CrossRefGoogle Scholar
  40. Schuetze, H. G., & Slowey, M. (2002). Participation and exclusion: A comparative analysis of non-traditional students and lifelong learners in higher education. Higher Education, 44(3–4), 309–327.CrossRefGoogle Scholar
  41. Sennett, R., & Cobb, J. (1972). The hidden injuries of class. Cambridge, UK: Cambridge University Press.Google Scholar
  42. Shapiro, J. (2008). Walking a mile in their patients’ shoes: Empathy and othering in medical students’ education. Philosophy, Ethics, and Humanities in Medicine, 3(1), 1.CrossRefGoogle Scholar
  43. Skeggs, B. (2004). Class, self, culture. London, UK: Routledge.Google Scholar
  44. Southgate, E., & Bennett, A. (2014). Excavating widening participation policy in Australian higher education: Subject positions, representational effects, emotion. Creative Approaches to Research, 7(1), 21–45.Google Scholar
  45. Southgate, E., Kelly, B. J., & Symonds, I. M. (2015). Navigating towards medicine: The ‘capacity to aspire’ for diverse groups of Australian school students. Medical Education, 49(1), 73–83.CrossRefGoogle Scholar
  46. Sullivan, L., & Mittman, I. (2010). The state of diversity in the health professions a century after Flexner. Academic Medicine, 85(2), 246–253.CrossRefGoogle Scholar
  47. Turner, R., Shulruf, B., Li, M., & Yuan, J. (2012). University admission models that address quality and equity. Asia Pacific Journal of Education, 32(2), 225–239.CrossRefGoogle Scholar
  48. Valencia, R. R. (Ed.). (2012). The evolution of deficit thinking: Educational thought and practice. London, UK: Routledge.Google Scholar
  49. Wear, D., & Kuczewski, M. G. (2008). Perspective: Medical students’ perceptions of the poor: What impact can medical education have? Academic Medicine, 83(7), 639–645.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Erica Southgate
    • 1
  1. 1.University of NewcastleCallaghanAustralia

Personalised recommendations