Balancing act—ethnic minority trainees' coping strategies in Dutch GP-specialty training—a qualitative study

Dutch GP-specialty training, like many Western European and U.S. postgraduate medical programs, emphasizes learning from role models and peers through reflection and openness to feedback. However, these methods depend on safe learning environments, which studies have indicated are often undermined for ethnic minority trainees due to microaggressions and exclusion experiences. Understanding their coping strategies and how they impact learning processes is crucial for promoting educational equity. What coping strategies do ethnic minority GP trainees employ to balance the challenges of their educational environment with their personal backgrounds, and how could these strategies affect their ability to comply with learning processes required in GP-specialty training? With the following sub questions: What coping strategies do ethnic minority GP-trainees employ given the interplay between their learning environment and personal backgrounds? A How could utilizing these strategies affect these trainees' these learning processes? We conducted fourteen semi-structured, in-depth interviews with minority GP trainees, using purposive convenience sampling to ensure diversity across various dimensions. Through thematic analysis, we identified participants’ coping strategies and learning processes with which they struggled. While strongly motivated to complete their GP-specialty training, participants faced prejudice and bias, leading them to adopt coping strategies—ranging from emotion-focused (religious support, compliance, detachment) to problem-focused (peer support, adaptation, identity balancing)—which notably shaped their abilities to adhere to learning processes required in their GP-specialty training (Table 3). Ethnic minority GP trainees in the Netherlands face challenges that lead to coping mechanisms. While these strategies offer temporary relief, they can undermine connectedness and reflective thinking—both required in GP-specialty training. Consequently, these trainees often feel inclined to balance educational success with maintaining their well-being. We recommend further research into the challenges that drive these coping strategies among ethnic minority trainees to inform the development of inclusive learning environments.