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Perceptions of homogeneity reproduction in health sciences academia

Buckup, R. B.; Smith, J. B.; Stadler, G. B.; Buspavanich, P. B.

2026-03-05 health systems and quality improvement
10.64898/2026.03.04.26347665 medRxiv
Show abstract

Academic institutions privilege norms of continuous productivity and uninterrupted availability, creating conformity pressures that systematically disadvantage those who deviate from an implicit template of the ideal academic. This study explores how doctoral students and faculty in the health sciences perceive the reproduction of social homogeneity. Semi-structured interviews were conducted with nine participants at a German university hospital. Data were analysed using reflexive thematic analysis with extended idiographic engagement. Participants perceived homogeneity as reproduced through external exclusion, enacted by others through networks, normative expectations, or institutional arrangements, and self-exclusion, whereby individuals withdrew, reduced visibility, or reshaped identity in anticipation of exclusion ( anticipatory compliance). Across both processes, the tacit norm of the ideal academic organised access and belonging. Supportive supervision and visible role models were perceived as partial buffers but did not structurally alter underlying norms. Interpreted through the social identity threat framework, these findings are consistent with a self-reinforcing cycle: structural homogeneity may generate identity-threatening environments that activate concealment and withdrawal, concentrating homogeneity further. These findings suggest that achieving substantive inclusion requires challenging the structural conditions that naturalise presence, mobility, and availability as measures of academic success.

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