Mixed-Methods Study Finds Two Markets in Turkish English-Medium Medical Education

English-medium medical education in Turkey operates as two distinct markets: one associated with high admission scores, fully funded elite programs and preparation for international careers, and another populated by paid foundation-university programs for students seeking to compensate for lower centralized examination results. An explanatory sequential mixed-methods study reached this conclusion by combining national university admission data from 2023–2025 with interviews involving clinical-year students and university administrators. The findings suggest that the same language of instruction can carry different social, financial and professional meanings depending on where a medical program sits within Turkey’s stratified admissions system.

The quantitative analysis mapped English-medium and Turkish-medium medical programs across four admission-score quartiles, institutional types and funding structures. Upper admission quartiles were dominated by fully funded programs that the study characterized as elite, whereas the lower quartile contained a large concentration of paid foundation programs offering English-medium instruction. The researchers then purposively sampled 40 stakeholders across the four quartiles for semi-structured interviews: 24 clinical-year students and 16 university administrators. Using Braun and Clarke’s thematic-analysis framework, the researchers examined how participants interpreted the distribution of programs. The results identify a dual-market structure in which linguistic branding intersects with financial resources to sort students into differently valued educational pathways.

Students in the upper admission quartiles described English-medium study as an “elite-globalist passport” and as global mobility insurance. For these students, English was associated with preparation for medical careers abroad rather than merely with the delivery of scientific material. Students in the lower quartile interpreted paid English-medium degrees differently, describing them as a status-compensatory mechanism for offsetting lower centralized exam scores. In both settings, students appeared to use English-medium education as a form of currency, but the currency represented different opportunities: overseas mobility for one group and institutional status for the other. The study therefore treats English-medium instruction as a stratified commodity rather than a uniform pedagogical policy, with consequences for the professional identities and clinical competencies that students expect to develop.

The sharpest reported tension emerged in clinical years four through six. Interview participants in English-medium programs described acquiring “global scientific capital,” an advantage they associated with international scientific knowledge, while also reporting significant language barriers when treating local patients. Students in Turkish-medium programs, by comparison, reported stronger communicative competence and clinical resilience. The authors call this a clinical paradox: an educational model that may prepare physicians for international scientific and professional settings can coexist with difficulty communicating in the language and social environment of the patients they serve locally. These are reported experiences among the study’s participants and institutions; the results do not by themselves establish that English-medium instruction causes inferior clinical performance or that Turkish-medium education guarantees better clinical outcomes.

Overall, the study presents English-medium medical education in Turkey as serving contrasting functions within one admissions landscape. For high-scoring students in fully funded programs, it can represent an investment in global mobility. For lower-scoring students in paid foundation programs, it can provide status compensation. At the same time, the qualitative findings show that advantages associated with international scientific exposure may not remove barriers to local patient communication during clinical training. The research combines program-level admission patterns with stakeholder accounts rather than following physicians into practice, so its conclusions are strongest as evidence of perceived stratification and reported clinical experiences, not as a controlled estimate of long-term professional outcomes. Its central implication is that English-medium medical education must be understood not only as a language policy or international credential, but also as a market-shaped educational pathway whose meaning and clinical demands vary with admissions selectivity, institutional type and funding.

Subject of Research: Mixed-methods research on stratification in English-medium medical education in Turkey

Article Title: Global mobility insurance or status compensation? A mixed-methods study of stratification in medical education

Article References: Akay, M. A., Altay, M., Yuksel, B., & Yuksel, D. (2026). Global mobility insurance or status compensation? A mixed-methods study of stratification in medical education. BMC Medical Education. https://doi.org/10.1186/s12909-026-10194-x

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10194-x

Keywords: English-medium instruction, medical education, Turkey, student stratification, clinical communication, global mobility, status compensation, admission scores, foundation universities, mixed-methods research, Global, mobility