The hidden medical school: a longitudinal study of how social networks form, and how they relate to academic performance

Med Teach. 2012;34(7):577-86. doi: 10.3109/0142159X.2012.669082.


Background: UK medical schools typically have over 300 students per year, making it impossible for students to know all the others well.

Aims: This longitudinal cohort study measured the formation of medical student social networks and their relationship to grades.

Method: In November 2009, 215/317 (68%) Year 2 UCL medical students reported their friendships with others in their year, by questionnaire. Multiple regression assessed the relationship between friendships, exam results and background variables (obtained from student records), with permutation testing to assess statistical significance.

Results: Students of the same sex, the same ethnic group, and in the same tutor and small groups (to which they were randomly assigned at the start of medical school) were socially closer. Taking into account absolute difference in Year 1 grades, Year 2 pairs who were socially closer in November 2009 had more similar May 2010 grades. Individual student variables did not predict similarity in 2010 grades after taking friendships into account.

Conclusions: The results suggest that medical students chose friends of the same sex and ethnic group as themselves; but random allocation of students to tutor groups also influenced friendships. Most importantly, friendships related to subsequent exam performance, suggesting friendship may influence learning.

MeSH terms

  • Education, Medical, Undergraduate / organization & administration
  • Education, Medical, Undergraduate / standards*
  • Educational Measurement / statistics & numerical data*
  • Ethnicity
  • Female
  • Friends / ethnology
  • Friends / psychology*
  • Humans
  • Longitudinal Studies
  • Male
  • Peer Group
  • Regression Analysis
  • Sex Factors
  • Social Support*
  • Sociometric Techniques
  • Students, Medical / psychology*
  • Students, Medical / statistics & numerical data
  • Surveys and Questionnaires
  • United Kingdom