Objective. To identify cultural dimensions and their potential mismatches between attending physicians and their residents and medical students. Methods. We surveyed faculty and students, both undergraduates and postgraduate resident physicians, at the SUNY Downstate College of Medicine, using Hofstede’s VSM-08 questionnaire, and calculated cultural dimensions, including the Power-Distance Index (PDI), Individualism (IDV), Masculinity (MAS), Uncertainty Avoidance Index (UAI), and Long-term Outlook (LTO). Correlations between faculty and student demographic data and cultural dimensions were calculated (SPSS). Results. There were 237 student and resident respondents and 96 faculty respondents. Comparing all faculty and student respondents, significant differences were found in four of five cultural dimensions, with faculty scoring higher in MAS, and lower in PDI, IDV, UAI, and LTO. Conclusions. These differences may be important in the design and implementation of a medical educational curriculum, and, particularly, in the measurement and evaluation of educational outcomes. 1. Introduction The American healthcare system is confronted with numerous quantifiable problems such as rising demand, rapidly evolving technology, and high costs. Despite the potential improvements derived from technological advancement, attention has increasingly focused upon the less easily quantified “culture” of this healthcare system, which has often failed to meet fundamental requirements for accountability, effectiveness, and transparency. We believe that the “tip of the spear” in understanding and shaping the American healthcare “culture” may begin in the training and enculturation of our physicians within medical schools and graduate medical educational programs. During the latter half of the 20th century, American society has become increasingly diverse, as immigrants to the United States have entered the country and integrated to varying degrees into the society. In New York City, nearly 40% of the population is foreign-born [1], and this diversity is reflected in virtually all aspects of urban life, including the healthcare system, where patients, the nonphysician workforce, and the physician workforce are increasingly foreign-born. Many physicians and students enter the United States seeking medical education, and foreign-born physicians now comprise nearly 28% of all residents in ACGME-approved training programs [2]. These physicians in training interact with the largely indigenous American medical education system for physicians and also interact with the culturally
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