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Table 3 Quotations from semi-structured interviews with subgroup of students

From: Motives, experiences and psychological strain in medical students engaged in refugee care in a reception center– a mixed-methods approach

Quotations from pre-interviews
 Category A: Prior experiences with refugees or flight (36 codes)
“In the hospital I already had some encounters with refugees, which I found very positive (…) I found it a little bit difficult that there were certain expectations (from the refugees)” (B)
“My grandparents arrived as refugees in Germany after the Second World War” (H)
“If there’s something in the news, once again everybody talks about it. It is an issue which divides (the opinions of) everybody. I mean, it is okay now; we are here at the university in Heidelberg and here we have a (common) opinion. But what about other communities? (…) I do try not to discuss too much, because you know, there won’t be an easy solution. I don’t think this is the aim of the Patrick Henry Village. You don’t try to solve the problem, but somehow try to give aid to those, who are there, who need medical help.” (C)
 Category B: Motivations for voluntary assignment (55 codes)
“(I want to get) a more realistic perspective on the whole refugee issue; and perhaps I can learn from it some modesty and gratitude for the life conditions in which I grew up and in which I live now.” (B)
“I think everybody can contribute a little bit (…) and then certain things may be realized, which would not have been possible otherwise.”(G)
“I (consider) us, as a community, as well as me, as an individual, to have a duty (to give aid)” (M).
 Category C: Expectations prior to the assignment (119 codes)
“In fact, I expect a range of diseases that are not typically taught in medical curriculum. (…) and I also think that (…) a lot of them (refugees) come to Germany with traumatic experiences, so that giving aid is very difficult.” (B)
“I just don’t know what I’ll be confronted with. I think when there are severe issues, it won’t just simply pass me by.” (G)
“What about infectious diseases? (…) tuberculosis is very frequent in those countries.” (D)
Quotations from post-interviews
 Category D: Subjective experiences during the assignment (248 codes)
“(I communicated) with general practitioners, if they had issues; or someone from the university called me with an issue. (It was important) to communicate and solve problems within the team.” (R)
“And then something happens or a doctor doesn’t make progress (in examining a patient) and everybody has to wait. Consequently the atmosphere (in the waiting room) can rapidly become stressed.” (R)
“(For example, when) they (refugees) just didn’t understand what kind of pills they had to take. Due to the language barrier it (the issue) was magnified and sometimes it got very loud.” (W)
 Category E: Subjective experiences after the assignment (31 codes)
“(It is) fascinating to switch from the lives in which those people (refugees) are captured, back to my own, normal life. A life (of refugees), in which the most important role is played by where you are and where you can stay and in which other people decide if you are allowed to move along or not. This is quite interesting (…) to deal with it, to listen to what the media and others report. It was quite distressing for me, even dominating my everyday life for a time (…) so I talked and read a lot about it and even dreamed that I was in a war.”(Y)
“That means I can’t really detach (the experiences in PHV) from what happens later on. But in fact, I felt well mostly. So, I ride my bicycle for half an hour. Then I have some time to focus on the rest or the other world, so to speak. And then it is usually OK again.” (R)
“I can state, except for the last shift, I really felt well the other shifts. I felt I was efficient, because I accomplished something on this day.” (O)
 Category F: Reappraisal (31codes)
“(I learned) that you can’t just consider them (refugees) overall to be a homogenous mass; instead there are arriving as very, very diverse human beings.” (Y)
“At the beginning I thought ‘The refugees need help, every one of them is kind and grateful’. Of course, there are such friendly patients among the people. But working in PHV, I recognized that some others are quite unkind. In fact, you have a naive idea in your head that everybody is really happy and everybody is kind. Well, in fact we are kind. However, as I said before, there was that one (refugee) screaming so loud. Sometimes, situations weren’t quite friendly.” (Q)
“Since then, I consider medicine to be a more political issue. The basic right for medical provision is in fact supreme; it is the supreme human right. I’m so aware of this now.” (Ö)
 Category G: Meaningfulness (57 codes)
“(I had the feeling) that I was doing something, without which it wouldn’t have worked out as well as it did. Till then I had the feeling of affecting something, even if it was marginal. But when I sat in the doctor’s office, looking over his shoulders, like in a usual traineeship and taking blood samples means constraining (of the procedures), then you have to be clear about what you are doing and who’s benefiting from this.” (Z)
“(I think) that it was and still is worth going there (PHV). That this is a kind of work which I, being intrinsically motivated, enjoy performing and which gives something back to me. And that it is nice, to give aid to people in need.” (Ä)
“In any case, I learned a lot. Not only on a medical level, but I also became aware of a lot of organizational stuff and about the procedures which you perform in such a medical center.” (S)