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Educação e Pesquisa

Print version ISSN 1517-9702On-line version ISSN 1678-4634

Educ. Pesqui. vol.50  São Paulo  2024  Epub Dec 31, 2024

https://doi.org/10.1590/s1678-4634202450260186por 

ARTICLES

Affiliation of black and/or low-income students to the school of medicine: a literature review *

Yzumi Fukutani1 

Yzumi Fukutani é mestre e doutoranda pelo Programa de Pós-Graduação do Instituto de Psicologia da Universidade Federal da Bahia (UFBA). É membro do grupo de pesquisa Observatório da Vida Estudantil.


http://orcid.org/0000-0002-5654-7641

Sônia Sampaio1 

Sônia Sampaio é professora titular do Instituto de Artes, Humanidades e Ciências Prof. Milton Santos (IHAC) da Universidade Federal da Bahia (UFBA). É coordenadora do grupo de pesquisa Observatório da Vida Estudantil.


http://orcid.org/0000-0001-9893-2321

1Universidade Federal da Bahia, Salvador, Bahia, Brazil


Abstract

This article’s theme is the affiliation of black and/or low-income students to the school of medicine and aims to present a literature review carried out by bibliographical survey in the Catalog of Theses & Dissertations repositories, from the Coordination for the Improvement of Higher Education Personnel (henceforth Capes – Portuguese acronym that stands for Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) portal, Brazilian Digital Library of Theses and Dissertations (henceforth BDTD – Portuguese acronym that stands for Biblioteca Digital Brasileira de Teses e Dissertações), Scientific Electronic Library Online (Scielo) and Google Scholar. The descriptors used were “affiliation (afiliação)”, “black student (estudante negro)”, “low-income student (estudante de camada popular)”, “quota holder (cotista)”, “medicine course” (curso de medicina)” and “Coulon”, combined with the Boolean logical operator “and”. The searches privileged the Portuguese language, as it is the Brazilian university context and, after refinement, considering the temporal delimitation of the last five years and the relevance to the epistemological focus given to the study, 20 productions were selected. The results suggest that black and/or lowincome students are still the first in their families to enter university, which is perceived by them as a space for resignification and social mobility. Racial, social, and economic matters permeate their entire university trajectory. It is perceived that the quality of life of these students is compromised so that they can achieve academic success. Therefore, the relevance of welcoming and the involvement of the university in the process of affiliation of black and/or popular students and the absence of analysis of subalternity relationships in Coulon’s concept of affiliation are considered.

Keywords Affiliation; Black Student; Low-income student; Affirmative action policy; Medicine course

Resumo

O presente artigo tem como tema a afiliação dos estudantes negros e/ou de camada popular ao curso de medicina e objetiva apresentar revisão de literatura realizada por meio de levantamento bibliográfico nos repositórios Catálogo de Teses & Dissertações, do portal da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes), Biblioteca Digital Brasileira de Teses e Dissertações (BDTD), Scientific Electronic Library Online (Scielo) e Google Acadêmico. Foram utilizados os descritores “afiliação”, “estudante negro”, “estudante de camada popular”, “cotista”, “curso de medicina” e “Coulon”, conjugados com o operador lógico booleano “e”. As buscas privilegiaram a língua portuguesa, por se tratar do contexto universitário brasileiro e, após refinamento, considerando a delimitação temporal dos cinco últimos anos e a pertinência ao recorte epistemológico dado ao estudo, foram selecionadas 20 produções. Os resultados sugerem que os estudantes negros e/ou de camada popular ainda são os primeiros de suas famílias a ingressarem na universidade, que é percebida por eles como um espaço de ressignificação e mobilidade social. Questões raciais, sociais e econômicas perpassam por toda sua trajetória estudantil. É percebido um comprometimento da qualidade de vida desses estudantes para que consigam alcançar sucesso acadêmico. Assim sendo, considera-se a pertinência do acolhimento e da implicação da universidade no processo de afiliação do estudante negro e/ou de camada popular e da ausência da análise das relações de subalternidade no conceito de afiliação de Coulon.

Palavras-chave Afiliação; Estudante negro; Estudante de camada popular; Política de ação afirmativa; Curso de medicina

Introduction

The present work has as its theme the affiliation of black and/or low-income students to the course of medicine and aims to present a literature review carried out through a bibliographical survey, considering the last five years. The chosen theme finds justification in its social and scientific relevance, due to the significant change in the profile of university students identified in the survey by the National Association of Directors of Federal Higher Education Institutions (henceforth Andifes – Portuguese acronym that stands for Associação Nacional dos Dirigentes das Instituições Federais de Ensino Superior) (2016).

According to Andifes ( 2016), the socioeconomic characteristics of university students at Federal Higher Education Institutions (henceforth IFES – Portuguese acronym that stands for Instituições Federais de Ensino Superior), identified in 2014, reveal a female university, with an average age of 24.5 years, with 47.57% of self-declared black university students and, just over 45%, white. This survey also observed that 51% of students, that is, almost 10 thousand graduates, had a per capita family income of up to three minimum wages. In an equivalent survey, carried out in 2018, Andifes ( 2019) recorded that the university remained female, with a similar average age, darker – with 51.2% of its students self-declared black –, and more socially vulnerable – with 70. 2% of its student body with a per capita monthly family income of up to one and a half minimum wage.

This change in the profile of university students, according to the balance of Secretariat of Higher Education (henceforth SESu – Portuguese acronym that stands for Secretaria de Educação Superior), the implementation of the Support for Restructuring and Expansion Plans of Federal Universities (henceforth Reuni – Portuguese acronym that stands for Programa de Apoio a Planos de Reestruturação e Expansão das Universidades Federais), in 2007, and Law No. 12,711, of August 29, 2012, Quota Law ( Brazil, 2014). The first state mechanism allowed the expansion and internalization of IFES in Brazil, while the second worked to promote social inclusion in higher education. In that context, both derive from the goals – not yet achieved – of the National Education Plan (henceforth PNE – Portuguese acronym that stands for Plano Nacional de Educação - 2001-2010), which provides for the significant increase in demand for higher education of students from popular classes and need to strengthen the public sector to increase and improve education, of research and extension in educational institutions, with expected consequences in technical, scientific and cultural development of the country.

That said, it is worth highlighting the social impact of the Quota Law, which fulfills both the access to higher education policy – by allocating a minimum of 50% of its places to students who have completed high school in public schools –, regarding the affirmative action policy 2 – when promoting racial equality and social inclusion of self-declared black and brown people—, as this policy aims to “[...] restore the equal opportunities between different racial groups, promoting a differentiated and preferential treatment for those historically marginalized” ( Jaccoud; Beghim, 2002, p. 46). With these considerations in mind, and in accordance with the observations of Santos ( 1984) and Jaccoud and Beghim ( 2002) on the inseparability of the categories of race and class in Brazil, we chose to review the phenomenon of the affiliation of black and/or popular students in the course of medicine, for account of the historical constitution of this institution, which continues into the 21st century as the most elite imperial course ( Vargas, 2010) and due to recorded data by Andifes ( 2019).

According to the Andifes survey ( 2019, p. 172), based on the criterion color/race, “emotional problems are more numerous for white people (26.2%)”. When adding, however, the categories quilombo black (12.9%), non-quilombo black (24.7%) and brown (21%), the majority black population of 58.6% becomes evident of students who report the impact of emotional issues on their performance academic. Still considering the color/race criterion, 14.3% of quilombo black students 19.6% of non-quilombo black students and 14.9% of black students mixed race, totaling 48.8% of the student population, report having suffered moral harassment 3 by teachers ( Andifes, 2019). As for the area of knowledge, studies of Andifes ( 2019) highlight the health sector as being the one in which this harassment is most prevalent. manifests itself (20.2%), with the medical course being one of the most notable, concentrating 24.2% of cases.

Therefore, and considering that being at a higher education institution mobilizes the student in their physical, cognitive, social and emotional aspects due to the university’s demand for an ideal student profile endowed with social, intellectual and emotional autonomy ( Paivandi, 2015), both upon arrival and throughout their educational path, it is important to maintain attention to the phenomenon of student affiliation, especially the affiliation of black and/or low-income students, as, according to the studies of Oliveira, A., Cranchi and Pereira ( 2020, p. 154), “[...] Students from historically excluded segments of the university require special attention from the university institution to better adapt to academic tasks”.

Method

To prepare this work, searches were carried out in the Catalog of Theses & Dissertations repositories, on the portal of the Coordination for the Improvement of Higher Education Personnel (henceforth Capes – Portuguese acronym that stands for Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), on the Brazilian Digital Library of Theses and Dissertations (henceforth BDTD – Portuguese acronym that stands for Biblioteca Digital Brasileira de Teses e Dissertações), on the Scientific Electronic Library Online (Scielo) and Google Scholar. On the Capes portal, the descriptors “affiliation and student” were used popular class”, “affiliation and quota holder”, “affiliation and black student”, “affiliation and course of medicine” and “Coulon affiliation”. In advanced search, considering the five recent years, with the descriptors “affiliation and low-income student” and “affiliation and course of medicine”, 22 productions related to the areas of health were found public and literature without relevant correspondence with a defined focus for this study. With the descriptors “affiliation and quota holder” and “affiliation and black student”, with based on the same search criteria, no results were found. With the descriptor “Coulon affiliation”, 440 results were found, 278 dissertations and 133 theses. After refinement, considering the categories – master’s and doctorate types; year 2016, 2017 and 2018; major area of applied human and social sciences and area of knowledge education, psychology, social and humanities; education program and psychology – 19 results remained.

In BDTD, searches were carried out considering the descriptors “affiliation and low-income student”, “affiliation and quota holder”, “affiliation and black student”, “affiliation and medical course”. With the descriptor “affiliation and low-income student”, only one result was found. With the descriptors “affiliation and quota holder”, “affiliation and black student” and “affiliation and course of medicine” no results were found. By fragmenting the descriptors and including the terms “ universária” (Portuguese noun that stands for female scholastic) and “Coulon”, the following results were found: with the term “affiliation” alone – 189 results; with the term “university affiliation” – 13 results and with the term “Coulon affiliation” – six results, four of which are dissertations and two theses.

On the Scielo portal, based on the words available in its own index, the terms “university affiliation” and “affiliation” were used. In the second, 11 articles were found, while in the first, no more than one. In turn, in the Google Scholar, the descriptors “affiliation”, “university affiliation”, “Coulon”, “student”, “black student”, “quota student”, “low-income student”, “course of medicine” and “medicine”, combined with the Boolean logical operator “and”. In this search, 19,500 results were found. However, after refinement, considering the criteria “moment” and “relevance”, the results no longer maintained correspondence relevant to the topic of interest in this study from page 15 of the search engine. Because of this, of the total results presented by Google Academic, 54 were considered.

After reading the results collected, based on the selection criteria “correspondence relevant to the epistemological focus of this study” and “studies published up to the year 2016”, 20 productions bordering the theme were selected – three theses, three dissertations and 14 articles, for the preparation of this literature review. The duplicity of productions found in the databases was excluded from the final calculation of the selection, and the searches privileged the mother tongue due to the Brazilian university context, which resulted in the disregard of four studies foreigners of Portuguese origin.

Results and Discussion

This section was divided into three subsections, namely: “Considerations on the concept of affiliation”; “Affiliation of black and/or low-income students”; and “Affiliation to the course of medicine”. The first subsection presents Coulon’s affiliation theory and elaborations by Brazilian authors. The second subsection describes the affiliation of black and popular students, considering the categories of race and class to be inseparable in the national socio-historical context. Finally, the third subsection locates the process of affiliation of black and/or low-income students in the university course of medicine, due to its imperial characteristic.

Considerations about the concept of affiliation

According to Coulon ( 2008), upon entering higher education, the newly arrived student go through an adaptation process marked by three phases: estrangement, learning and affiliation. Even though each of these phases is characterized in their own way, they are not closed in on themselves and can be communicate in an active procedural link, as its boundaries are more like margins that interpenetrate in a fluid, gradual and continuous way rather than steps which suggest separation between stages. Given this understanding of the movement that goes through the student’s adaptation process to the university context, it is possible to describe the times of estrangement, learning and affiliation.

Entry into university life is inaugurated by estrangement, which occurs both due to the student’s lack of knowledge and frustration in the face of what they thought to be the university. This phase can be translated as the discomfort of the student facing this new world, which carries its own codes and discourses that are not yet familiar to them ( Coulon, 2008). This discomfort in the face of the unknown, initially, it is experienced by the student in a solitary and silent way: “[...] entering the university is, in general, losing sight of your best schoolmates, feeling isolated and anonymous among others. It’s staying silent even when in a group, perhaps, especially, when you are in a group” ( Coulon, 2008, p. 174).

Destabilized, the student experiences a socio-affective rupture with their core source. Likewise, they also experience pedagogical rupture in their learning process transition from high school to higher education, due to the change in the dynamics of their routine, before school, and the methodology used at university. At this stage, students do not perceive themselves as being led by the teacher towards intellectual production. From this angle, Coulon ( 2008, p. 178) teaches us that: “It is a big change compared to school, where they knew, every day, what they should do, because they wrote it down in a notebook.” Simultaneously with this experience over time of estrangement, the need emerges in the student to appropriate the codes that govern the university space and to recreate a support network. Thus, they launch themselves into the time of learning.

This stage was named by Coulon ( 2008) “learning” to highlight its nature: learning the craft of a student. According to the author, this is the “[...] phase of progressive familiarization with the institution, an adaptation in relation to the local codes and the beginning of intellectual work [...]” ( Coulon, 2008, p. 147). Although this phase stands out for learning, it is also marked by ambiguity that goes through this process, because, during the course of their experience, the student does not yet have consolidated experience at university or mastery of the codes that govern their present. It is precisely this absence of stable references that compromises the student’s ability to plan for their future.

Still insecure and hesitant, the student needs to develop skills that enable them to find a balance between their experience at university and the curriculum requirements, “[...] complex learning must take place quickly as it conditions the continuity of their studies” ( Coulon, 2017, p. 1246). Thus, the student begins to develop strategies in order to adapt to the university, such as: seeking guidance from fellow veterans and the secretariat, understanding the rules of the curriculum, developing a relationship with writing and reading, developing organizational skills considering the time of training ( Coulon, 2008). In this process of learning institutional norms and literacy, appropriations occur that allow the student to reflect on the present and future possibilities, their training time considering their study pace, the credibility of the information obtained and its position in the face of institutional pressures and impositions of the world of work.

In this way, more aware of their present reality, the student can plan a possible future through developing perspectives. The development of perspectives takes place in a complex way and is crossed both by a conscious knowledge of the situation experienced and by the influence of circumstances that are framed by the contexts that make up the student’s life. If the strategies developed are effective and the university becomes a familiar environment to the student, it is possible to consider that they are linked to the institution. It is the birth and formation of this alliance that name the last phase of the student’s adaptation process to university life, that is, affiliation.

Fatigue, delays, lack of motivation and interest, and the risk of abandonment 4 give way to engagement. The student forms a socio-affective network, masters the rules and subtleties of the curriculum and even becomes capable of transgressing it, identifies the implicit guidelines, knows how to identify the tasks to be carried out, adopts reading as a regular practice, develops autonomy to exercise the role of student, discovers the pleasure of thinking and intellectual exploration and can establish a routine for themselves. In this way, the student becomes a competent member of his community and is recognized as such ( Coulon, 2008), that is, “[...] it acquires a new social status” ( Coulon, 2017, p. 1247).

In his criticism of the concept of affiliation, Mendes ( 2020) calls on the university to also be involved in the student’s adaptation process, assuming their epistemological limits and becoming permeable and receptive to another knowledge, highlighting the institutional reception and the empathetic attitude of the teacher throughout the process of student affiliation. The author also makes observations about implicit rules, the normative linearity of times for affiliation and non-observance of what is deviant in this process: “Coulon seems to lack an analysis of how relations of subalternity – among which class, race, gender, nationality – are expressed in the everyday life at the university” ( Mendes, 2020, p. 14).

When observing the importance of the university reformulating its curricular and pedagogical models, as it follows Ferreira ( 2017, p. 306): “[...] these trajectories contribute to a renewal of the academy, in order to force it to produce new languages and new dialogues with popular knowledge that had little circulation in university”. Likewise, through their experience in higher education, the author also reinforces the importance of welcoming through reception activities and inaugural classes, academic guidance and combating hazing as facilitating actions for the affiliation process. Thus, the university’s involvement becomes urgent, as “part of the main difficulties in establishing student identity is related to the precariousness of the university itself in integrating these individuals into their space” ( Ferreira, 2017, p. 296).

The purpose of the affirmative action policy is to combat inequalities, allowing young people who have been systematically denied access to higher education to enjoy historically accumulated knowledge and offer, in return, for established science and knowledge, dialogue with the diversity of languages and traditions of their origins, enriching, through mixing, the culture and academic training of all students. Access to higher education is known to be a factor of mobility and sustainability for these populations that demand the right of access and, more than that, of true dialogue. The idea behind this proposal is that young people trained with quality and autonomy help the replication of this experience in their communities of origin, encouraging the continuity of studies.

In this way, Vasconcelos, Santos and Sampaio ( 2017) emphasize the valorization of dialectics In the production of knowledge, recalling Boaventura de Sousa Santos’ concepts of cognitive justice and René Barbier’s sensitive listening as strategies for the inclusion of students from low-income classes , contemplating their knowledge and their history in a lively movement of considering the diversity of knowledge through dialogue and empathy – essential positions for the non-hierarchization of knowledge: “the readings that we can make of the epistemologies of the South cannot make the mistake of considering popular knowledge as a criterion or margin, inaugurating other hierarchies” ( Vasconcelos; Santos; Sampaio, 2017, p. 268).

Given these considerations that invite the university to reflect on its role in the process of affiliating its students, we point out that it welcomed the state provisions that made its expansion and change in the student profile possible. However, due to this change, the university also went – or has been going through – a process of rupture in its secular structure. Given the tensions mentioned, there is a need for its adaptation so that it can sustain itself as a state equipment committed to a free, fair, and supportive society.

Affiliation of black and/or low-income students

Even after almost 25 years since the launch of the PNE 2001-2010 goals, studies by Oliveira, A., Cranchi and Pereira ( 2020) and Oliveira, S. ( 2017) observe that students from low-income segments are generally the first in their families to go to university. Therefore, they often do not find references about this environment in their home nucleus, which can negatively impact their process of affiliation with the university context, at first. As Nery ( 2011, p. 36) states: “[...] the process of student affiliation depends on how the student arrives at the university, a moment in which several simultaneous and immediate ruptures occur [...]”.

Likewise, Sposito and Tarábola ( 2016) also draw attention to the fact that students from the middle or low-income classes still perceive admission to a public university as a challenge that demands great personal investment. With reference to entry into a public higher education institution, the authors also highlight that “[...] these initiatives are marked by conflicts and tensions with the family group and require a degree of personal persistence and self-confidence in order to demonstrate to themselves and their families their capacity” ( Sposito; Tarábola, 2016, p. 1018).

In his studies, Figueiredo ( 2018, p. 12) observes the “[...] relevance of cultural capital [...] shyness, sense of inferiority, difficulty in recognizing academic demands and establishing ways of organizing studies” and the “[...] parents’ difficulty in supporting the academic longevity of their children-students” ( Figueiredo, 2018, p. 14) as obstacles to the low-income class student’s affiliation. However, the author highlights the “[...] need to respond with academic success to parents’ frustration due to the postponement of entry into the job market [...] [as] an important factor to understand the perseverance, dedication and resilience” of many of these students ( Figueiredo, 2018, p. 14).

The study by Freitas and Oliveira, F. ( 2020) identifies that, through an active stance, black quota students seek university as a strategy to gain acceptance, social ascension and break up with the destiny predetermined by their origin. “Admission to university [...] presents itself as a single strategy for changing the family’s life trajectory, a change towards improving financial and quality of life conditions” ( Freitas; Oliveira, F., 2020, p. 39), serving as catalytic example for others.

In turn, Oliveira, G. and Silva, R. ( 2018) contribute significantly to understand the difficulties that go through the student experience coming from the popular layer in their university affiliation process, namely: difficulty in dealing with the disruptions required to be at university, such as change of routine and transportation, which are aggravated by the state of social vulnerability, notably hunger. The authors, however, also record the overcoming of these initial difficulties, especially due to the university’s recognition as a space that promotes the expansion of horizons and the resignification of oneself, others and the world.

Oliveira, G. and Silva, R. ( 2018) also consider the reconciliation of students’ social roles, worker, and caregiver social networks as an obstacle to the university affiliation process. Due to not having enough time to meet the demands of the university, the students compromise their quality of life, start to sleep little and gives up leisure time to study. From this perspective, Oliveira, G. and Silva, R. ( 2018, p. 9) highlight the importance of time: “the more time the student has at their disposal, they will tend to join more easily, taking into account the bond that establish with the institution and mainly with its members [...]”.

This data is also corroborated by the study by Nery ( 2011) on emotional affiliation, which considers the importance of recognizing time to acquire intellectual maturity. When analyzing the relevance of time for the adaptation process from the student to the university context, it is important to draw attention to the need for university to innovate in its academic calendar to allow the combination of exercise of the social roles that its student needs to play.

An important obstacle to the affiliation process for black quota students is camouflaged racial discrimination in the university environment ( Freitas; Oliveira, F., 2020):

Whether through looks and even in the small number of black students compared to white ones or when teachers at evoking themes such as black consciousness and quotas in their classes, humiliate and embarrass black students and quota students.

( Freitas; Oliveira, F., 2020, p. 46).

However, despite the strangeness due to the “[...] absence of black people and by socioeconomic differences” ( Freitas; Oliveira, F., 2020, p. 41) and political and ideological tensions crossed by racism, Freitas and Oliveira, F. ( 2020) record the affiliation of the black quota student to the university through their participation in study groups, research and extension activities, social movements, collectives, and religious groups.

This data also appears in the studies by Oliveira, G. and Silva, R. ( 2018) and Sposito and Tarábola ( 2016) as strategies developed by students from the lower classes to join. Oliveira, G. and Silva, R. ( 2018) specifically highlight the relationship with colleagues, participation in monitoring and research groups. In turn, Sposito and Tarábola ( 2016) observe organizations in collectives and social movements as strategies for university affiliation. According to them, students from the middle or low-income classes introduce their previous social and political experience of organization and engagement in collectives and social movements into the university context:

The first figure that emerges from the narratives of some of the young people interviewed stems from the experience of participation and engagement in collectives and movements prior to entering university. Thus, the discovery of public and political life precedes upon entering university, and these young people enter higher education with this background inscribed in their trajectories. This group brings together the narratives of young men and women who participated in the creation of collectives in popular neighborhoods, their places of residence, through cultural activities, study groups, among others. [...] Local groups with cultural activities, small study collectives guided by dedicated teachers from public schools, can be present in these forms of engagement.

( Sposito; Tarábola, 2016, p. 1017).

It is worth noting that the university, as a house that embrace knowledge and its production, can also be understood as a political institution with relevant social impact with the purpose of guaranteeing collective well-being, as thinking and acting towards modifying its surroundings is a political act. This finding by Sposito and Tarábola ( 2016) signals the arrival of a youth whose political disposition is in harmony with the spirit of the university, and which finds in the group the strengthening of their identity: “these collectives understand the processes of affirmation and recognition of denied individual identities that express important dimensions aspects of the subjectivity of girls and boys at this point in their lives” ( Sposito; Tarábola, 2016, p. 1019). In this logic, Silva, L. ( 2016, p. 113) also notes that “[...] education is a process of humanization, and it is fundamental that the institution also takes care of the cultural, political, ethical and aesthetic aspects constitutive of the subjects” in its affiliation process.

More specifically about research, it is appropriate to bring the results of Souza ( 2016), according to which, scientific initiation can be considered as a facilitating resource for the process of student affiliation with the university context, as it allows them to appropriate knowledge, skills and attitudes requested by the academy. In this work, Souza ( 2016) highlights the importance of scientific initiation as a strategy for students from working-class backgrounds to remain at the university, both due to the bonds formed in research groups and the value received through the scientific initiation scholarship.

The study by Lacerda ( 2019) brings self-analysis as a strategy for affiliation of students’ school trajectories and university experiences. According to the author, based on reflections on their experiences at university, students from the lower classes realize that being there represents a great achievement and that the socio-affective networks built are important for their permanence. However, Lacerda ( 2019) draws attention to the feeling of not belonging that accompanies them: “[...] the distance from their origins, when they enter the public university, produces the experience of tearing apart and the feeling of being alone in the world” ( Lacerda, 2019, p. 574). Likewise, Silva, L. ( 2016) points to emotions in the affiliation process. Emotional problems can also arise during learning and, because of this, “[...] the institution needs to be aware of the difficulties that may be expressed by students and offer them support and guide them with the appropriate steps that may be necessary” (Silva, L., 2016, p. 113).

In their studies, Carneiro and Soares ( 2019) propose the support group as a facilitating strategy for affiliation, as it is a resource capable of favoring the formation and strengthening of new bonds – which could allow the escape from loneliness and identification and creation of a new perspective on the problems experienced throughout the university career. For the authors, “[...] the creativity workshop is configured as an empowering tool, as it provides a space for students to listen and can awaken other senses for their academic trajectory [...]” ( Carneiro; Soares, 2019, p. 19486).

Carneiro and Soares ( 2019) also state that the support group allowed students to establish a new perspective of themselves, develop and strengthen self-esteem, become more active members in the university context, with greater engagement in extracurricular activities and the student movement. Despite the time gap between the works, Sposito and Tarábola ( 2016, p. 1021) point in the same direction:

[...] the importance of sociability is further highlighted beyond the collegial relationships that exist in classes for this path of building oneself, as a student and as a person, within the university. In other words, it is about seeking an activity, a form of participation in some group, association or collective (sports, political, academic, etc.) to be inserted into the logic of the university itself, towards overcoming the indeterminacy and indefiniteness of the first moments of studies and the formation of a university identity far from a merely liberal stance of everyone for themselves.

Finally, we bring the study by Sousa ( 2020) on the issue of student housing. Although living in the housing provided by the institutions helps the student to bond with the university, strengthening ties, there is also the compromising compliance with the regular course completion time, prolonging their university career. The quality of relationships from the Coexistence in student housing allows the construction of a socio-affective network capable of assisting the student in their process of affiliation with the university context, especially considering the reconfiguration of the self for the construction of the identity of student during learning time ( Nery, 2011).

Affiliation to the course of medicine

Regarding the affiliation of quota and non-quota university students to the course of medicine, the study by Oliveira, S. ( 2017) points out that the affiliation process of the quota student is crossed by racial, social, and economic issues. Regarding the time of estrangement, issues related to reception, the pedagogical aspects of the course, social origin and its impact on the university context, housing and support and monitoring from the family and the university were observed ( Oliveira, S., 2017).

Economic difficulties are felt immediately upon entering the course. Whether in the acquisition of material for study or the way of dressing and the tensions marked by the reflection of who is the majority in that space, accompanied by the perception that their presence in that environment is part of a minority.

( Oliveira, S., 2017, p. 80).

Unlike the study by Oliveira, S. ( 2017), the study by Martins ( 2017) records the support of the quota student’s family regarding the extension of schooling even at the time of estrangement, as the university is perceived as promoting social mobility. According to the author, the families of these students help them financially, even if this support still needs to be supplemented by the institution through scholarships.

In contrast to the time of estrangement experienced by the quota student on the course of medicine, the work of Oliveira, S. ( 2017) brings the time of estrangement experienced by the non-quota student on the same course. According to the author, non-quota students find a welcoming environment conducive to the formation of a socio-affective network when entering university. This student also does not face financial difficulties, as they have family support ( Oliveira, S., 2017). Regarding the family, the non-quota student recognizes their influence in the process of professional choice, including living with medical relatives.

Regarding the time of learning and affiliation, the study by Oliveira, S. ( 2017) observes that the process of appropriation of the elements that make up the university context by the quota student is continually crossed by racial, social, and economic issues. Due to the delay in academic training, the difficulty in coordinating the demands of academia with those of everyday life, especially due to the time spent commuting between home and university, the lack of adequate space to study at home and the insufficiency of library collection, the quota student developed the formation of groups as a strategy ( Oliveira, S., 2017; Martins, 2017).

According to Oliveira, S. ( 2017) and Martins ( 2017), quota students perceive themselves as excluded from the university context and find support for their permanence in other quota students, especially those who participate in the student movement. Students engaged in the student movement guide newly arrived students on the notices to receive aid. Other strategies developed by the quota student are: complementary group studies, search for suitable places to study; and sharing materials. In this sense, the actions of the student movement and activism function as a network of socio-affective support and racial empowerment.

Still on the socio-affective support network, the study by Oliveira, S. ( 2017) records family support, with a determining force in the learning time for the continuity of this segment of students in the course – with special emphasis on the intervention of mothers, which, in their entirety, do not have higher education. However, the lack of support and monitoring from the university remains.

Many students obtained support from the university, in the sense of assistance with transportation, food, among others, only from the third and fourth semester onwards, that is, they passed decisive moments for continuing the course without actually being able to receive this necessary support from the institution of which they are a part of and in which they are seeking affiliation.

( Oliveira, S., 2017, p. 115).

The studies by Oliveira, S. ( 2017) and Martins ( 2017) draw attention to the high workload of the course and the impact on students’ quality of life. Both quota and non-quota students highlight the competitiveness of the course, recognition from colleagues through grades and the impairment of mental health:

The stress caused by the overload of activities in the medical course has caused serious psychological problems for students who, in some cases, seek professional support from the university, or privately. However, others experience these sufferings in their academic career in isolation and without seeking help.

( Oliveira, S., 2017, p. 100).

Due to the need for rest, the quota student chooses to live alone, giving up student housing ( Martins, 2017). Still according to the author, the student recognizes the importance of the affirmative action policy in their trajectory as a mechanism that promotes equity and expresses the intention to work in the Unified Health System (henceforth SUS – Portuguese acronym that stands for Sistema Único de Saúde) as a form of social retribution.

Regarding the learning time and affiliation of the non-quota student, the study by Oliveira, S. ( 2017) reveals that access to information is facilitated by their social relationship network and highlights the importance of the family, both in conducting the student throughout their training and in their maintenance through support and financial support. Finally, the author observes that quota students tend to engage, mostly, in the student movement and extension groups, as they do not meet the criteria required in the selection to join research groups. Non-quota students actively participate in research groups and do not suffer significant disruptions in their affiliation process ( Oliveira, S., 2017).

Final considerations

The results indicate that black and/or popular students are still the first in their family to enter university, which is experienced as a space of resignification and understood as a possibility for social mobility. Racial, social, and economic issues permeate the entire university trajectory of these students, whose quality of life is compromised to achieve academic success. To overcome obstacles to affiliation, students develop adaptive strategies such as participation in study groups, tutoring, extension activities, social and collective movements.

The creation and provision of spaces intended for listening and elaborating on experiences lived at the university, welcoming, the involvement of the university in the student affiliation process and the valorization of dialectics in the production of knowledge and non-hierarchization of knowledge were also highlighted as necessary strategies for the process of affiliation of black and/or popular students to the university context.

Despite carrying out searches in repositories of recognized scale and importance, few scientific productions on the topic of student affiliation were found in the last five years. This work also finds limits on issues of ethnicity, gender, and inclusion of people with disabilities. However, the results of this study can contribute to improving the implementation of affirmative action policy.

That said, we reiterate the relevance of Mendes’ ( 2020) criticism regarding the lack of analysis of subalternity relationships in Coulon’s concept of affiliation, which calls for investigation, especially considering the historical process of establishing the university in Brazil, its organizational models and the elite education policy versus the affirmative action policy, which generated a paradox involving the massification of access to higher education and the non-democratization of knowledge.

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*English version by João Vitor de Carvalho Madureira. The authors take full responsibility for the translation of the text, including titles of books/articles and the quotations originally published in Portuguese.

2-According to Munanga ( 2020, p. 62), “in an immemorial march held in Brasília on the 20th of November of that year [1995] by the Brazilian Black Movement, called Zumbi dos Palmares March against Racism, for Citizenship and Life, the expression ‘affirmative action’ was verbatim stated for the first time in the manifesto delivered to the then President of the Republic, Fernando Henrique Cardoso. Five years passed between the Zumbi dos Palmares March and the III World Conference against Racism, Racial Discrimination, Xenophobia and Related Intolerance, organized by the Organization of the United Nations (UN) in Durban, South Africa, in August/September 2001. The final report, under the responsibility of the State Secretariat for Human Rights (henceforth SEDH – Portuguese acronym that stands for Secretaria de Estado dos Direitos Humanos), contained proposals for quotas for black, indigenous, and other minorities”.

3-Definition of moral harassment, according to a study by Andifes ( 2019, p. 173): “a situation of embarrassment, belittlement or humiliation to which the student was subjected by a teacher”.

4-Due to the vulnerability in which the student find themselves upon arrival at the university, Coulon ( 2017) considers the first year of the course as the “time of all dangers”, as this is where the Breaking ties that are still fragile may result in abandonment.

Received: January 19, 2022; Accepted: April 24, 2023; Revised: April 13, 2023

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