Exploring early community exposure among first-year medical students in a peripheral Indonesian medical school: a qualitative case study

BACKGROUND: Medical education has increasingly emphasized social accountability and community-oriented learning to prepare graduates for complex health system challenges. Early Community Exposure (ECE) introduces medical students to real-world community and primary care contexts early in training, with the potential to foster empathy, professionalism, and contextual understanding of health. While ECE has been widely implemented, evidence remains limited regarding its impact on first-year medical students in newly established medical schools located in peripheral regions of Indonesia. This study explored how novice medical students experienced and interpreted their first exposure to community-based learning. METHODS: This study employed a qualitative exploratory case study design. Participants were first-year medical students who completed the inaugural ECE program at Universitas Borneo Tarakan, a newly established medical school in North Kalimantan, Indonesia. Using purposive and snowball sampling, 15 students participated in in-depth semi-structured interviews conducted between January and March 2025. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically using a hybrid inductive-deductive approach informed by community-based education, experiential learning, and social cognitive theory. Strategies to enhance trustworthiness included member checking, reflexive journaling, and peer debriefing. RESULTS: Seven interrelated themes were identified: (1) meaningful experiences, (2) early learning transformation, (3) bridging theory and practice, (4) professional identity formation, (5) internalization of professional values, (6) adaptation and motivation, and (7) program optimization. Students described ECE as a transformative and humanistic learning experience that enhanced empathy, responsibility, teamwork, and confidence. ECE enabled students to contextualize preclinical knowledge within real community settings while fostering early professional identity formation. Challenges included limited time allocation, scheduling constraints, and accessibility issues for some community participants. CONCLUSIONS: Early Community Exposure provided first-year medical students with a pivotal learning experience that integrated cognitive, affective, and professional development from the outset of training. Embedding structured reflection, mentorship, and institutional support may further strengthen the educational impact of ECE, particularly in peripheral and resource-limited settings. These findings highlight the value of early community-based learning in preparing socially accountable physicians.