Nascent medical students' first view into medical school orients them toward what is considered important in medicine. Based on ethnography conducted over 18 months at a New England medical school, this article explores themes which emerged during a first-year student orientation and examines how these scripts resurface across a four-year curriculum, revealing dynamics of enculturation into an institution and the broader profession. We analyze orientation activities as discursive and embodied fields which serve "practical" purposes of making new social geographies familiar, but which also frame institutional values surrounding "soft" aspects of medicine: professionalism; dynamics of hierarchy and vulnerability; and social difference. By examining orientation and connecting these insights to later, discerning educational moments, we argue that orientation reveals tensions between the overt and hidden curricula within medical education, including what being a good doctor means. Our findings are based on data from semi-structured interviews, focus groups, and participant-observation in didactic and clinical settings. This article answers calls within medical anthropology and medical education literature to recognize implicit values at play in producing physicians, unearthing ethnographically how these values are learned longitudinally via persisting gaps between formal and hidden curricula. Assumptions hidden in plain sight call for ongoing medical education reform.

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BACKGROUND: Mailed stool testing programs increase colorectal cancer (CRC) screening in diverse settings, but whether uptake differs by key demographic characteristics is not well-studied and has health equity implications. OBJECTIVE: To examine the uptake and equity of the first cycle of a mailed stool test program implemented over a 3year period in a Central Texas Federally Qualified Health Center (FQHC) system. DESIGN: Retrospective cohort study within a single-arm intervention. PARTICIPANTS: Patients in an FQHC aged 50-75 at average CRC risk identified through electronic health records (EHR) as not being up to date with screening. INTERVENTIONS: Mailed outreach in English/Spanish included an introductory letter, free-of-charge fecal immunochemical test (FIT), and lab requisition with postage-paid mailer, simple instructions, and a medical records update postcard. Patients were asked to complete the FIT or postcard reporting recent screening. One text and one letter reminded non-responders. A bilingual patient navigator guided those with positive FIT toward colonoscopy. MAIN MEASURES: Proportions of patients completing mailed FIT in response to initial cycle of outreach and proportion of those with positive FIT completing colonoscopy; comparison of whether proportions varied by demographics and insurance status obtained from the EHR. KEY RESULTS: Over 3 years, 33,606 patients received an initial cycle of outreach. Overall, 19.9% (n = 6672) completed at least one mailed FIT, 5.6% (n = 374) tested positive during that initial cycle, and 72.5% (n = 271 of 374) of those with positive FIT completed a colonoscopy. Hispanic/Latinx, Spanish-speaking, and uninsured patients were more likely to complete mailed FIT compared with white, English-speaking, and commercially insured patients. Spanish-speaking patients were more likely to complete colonoscopy after positive FIT compared with English-speaking patients. CONCLUSIONS: Mailed FIT outreach with patient navigation implemented in an FQHC system was effective in equitably reaching patients not up to date for CRC screening.