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Exploring sense of belonging in medical students: A scoping review
Stephanie Bull1, Lynelle Govender2, Agalya Ramanathan1,3
1Medical Education Innovation and Research Centre, School of Public Health, Imperial College London, London, UK.
Background:
Sense of belonging is increasingly discussed in health professions education and predominantly recognised as a necessary state for students' success. This study aims to synthesise the evidence and consider what it means to belong as a medical student, what impact it has on students and what influences its development.
Methods:
A scoping review using the Arskey and O'Malley's five-step framework was conducted. MEDLINE, EMBASE, PsychINFO, GlobalHealth, LILACS and Sabinet were searched for research articles relating to sense of belonging in medical students until 12 December 2025.
Results:
Three hundred ten articles were identified. One hundred sixty-two used the term belonging and 148 a closely related term. One hundred thirty-six of these did not provide a definition. The number of articles from authors in high-income countries was 25-fold and 50-fold higher than that of authors from lower-middle income and low-income countries, respectively. Well-being was the most cited effect of belonging (130 articles), followed by increased learning and professional identity formation. Only 10 articles considered the impact of sense of belonging on student attainment. Demographic factors such as ethnicity and socio-economic background influenced students' sense of belonging. Features of the learning environment were also important, including inclusive practice, diversity and representation, student support, facilitating student connection and meaningful involvement in clinical practice. Recommendations made to promote belonging mirrored the influencing factors. Only 26 articles presented initiatives designed to promote sense of belonging among medical students.
Discussion:
When considering the influences, impacts of and recommendations for developing sense of belonging, the collated evidence supports some commonly held narratives but is also lacking in some areas, with lack of definitions of belonging also creating ambiguity. The deficit of study participants from lower-middle and low-income countries means that care needs to be taken when applying these findings to those settings.
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