The aim of thisstudy is to determine the adaptation process of international medical schoolstudents to university life in Turkey.The mixed methoddesign study, including all the international students (n=127) studying at EgeUniversity School of Medicine, is employed. Qualitative data were collectedfrom 23 students selected by purposive sampling technique. Two instruments wereutilized for collecting data: Student Adaptation to College Questionnaire(SACQ) and Brief COPE. Focus group interviews were performed for qualitativedata collection.The mean SACQscore of the medical students was found to be 407.44 (SD=68.29). The AcademicAdjustment category included the themes of educational goals, differentstudying habits, accommodation, academic advisor, and scholarship. The SocialAdjustment category included the themes of social interaction and support,differences, longing for family, discrimination and its effects on social life.The Personal/Emotional adjustment category included themes of psychological andphysiological health problems. The Goal Commitment/Institutional Attachmentcategory included themes of academic and social adaptation as well as thestudent’ communication with education management.This studyidentifies to light critical issues in supporting international students withadaptation problems to university life in Turkey. It is clear that revising thecontent of education programs to enable international exchange is notsufficient enough by itself to meet the needs of international students. These efforts include integration to academic and social life at a university, dealing with newfound freedoms, becoming more individualized, and establishing social relations with male and female peers, Higher education is also a time period where cultural adaptation is experienced.Lysgaard’s U curve, Oberg’s seven-step acclimation process, Gullahorn’s W curve, and Peter Adler’s five-step developmental process are among the approaches used to explain cultural adaptation. Lysgaard has stated that the adaptation processes of individuals who have to live in a different culture change in time. This approach, which was the first used to explain cultural adaptation, is called the “U Curve”. The “U Curve” approach has four stages of adaptation; namely the honeymoon, culture shock, adaptation, and double culture.-The phases of cultural adaptation form a special period that requires time and adequate coping strategies to deal with emerging stress. According to previous researches, some students respond positively to such transition problems and increase their level of adaptation. In the cultural adaptation process, the student uses various coping strategies to deal with the stress and problems that may emerge. However, if the student’s coping strategies are not sufficient, adaptation to the new culture would be more difficult.-,The disease-health patterns of different countries affect the content of medical education programs, their languages, and the type of communication between doctor and patient. The undergraduate medical education programs have a different character compared to other college programs in this regard. These differences make cultural adaptation harder especially for international students.-This study adopts a mixed-method approach which combines elements of qualitative and quantitative research approaches.The study consisted of all of the international students (n=127) studying at Ege University School of Medicine. Among the students, 83.46 % (n=106) participated in the study, while 21 students did not agree to participate.The mean age of the students was 23.33±2.86 (min=17–max=35). 68% (n=73) of the students were male, 99% (n=105) were single, 63.20% (n=67) lived in dormitories, 72.60% were accepted to the university via exams, and 51.90% learned Turkish in Turkey. The average duration of study in medical school was 4.35±2.03 years .Students came from seven different regions in the world to study at Ege University School of Medicine.  28% came from Europe, 26% from Central Asia, 20% from the Middle East, 13% from the Caucasus, 9% from Africa, and 1% from either South America or the Mediterranean .The sample of the study was determined according to the most widely used method called ordered quantitative-qualitative technique suggested by Kemper and colleagues.Ethical approval from the Ethics Board of Ege University School of Medicine was obtained prior to this research. The students were also informed on the objective and methods of the study, and they were requested to sign a written consent.-A mixed-method data collection approach using both interview and questionnaire research techniques is adopted to achieve the research aim.The Student Adaptation to College Questionnaire (SACQ), developed by Baker and Siryk, was found to be reliable and valid.The score that can be taken from this subscale changes between 24 and 216. Second, the Social Adjustment subscale consists of 20 items. The items are about success in social activities, the social aspects of the university environment, relations to roommates and opposite sex, and being homesick. The score that can be taken from this subscale changes between 20 and 180. Third, the Personal/Emotional Adjustment subscale consists of 15 items regarding psychological and physical health. Scores vary between 15 and 135. And fourth, the Goal Commitment/Institutional Attachment subscale consists of 15 items. These evaluate emotions and levels of satisfaction regarding university as an institution. Scores vary between 15 and 135.The Brief COPE is the short form of the COPE scale developed by Carver, Scheier, and Weintraub.Moreover, focus group interviews were used for collecting qualitative data. A total of two focus group interviews were conducted, and data collection ceased when saturation was reached. Each focus group interview was carried out with 13to 15 students from diverse genders, nationalities, and years of study. Each interview took approximately 75 minutes. During the interviews, students were asked questions about their experiences regarding academic, social, emotional, and institutional adaptation. All interviews were audio recorded.The students filled out the Student Adaptation to College Questionnaire and the Brief COPE in a single session in March 2015. Self-administered questionnaire technique was used in this study. Focus group interviews’ were conducted in April 2015. Focus groups were audio-recorded, transcribed verbatim, and analysed for content.Descriptive statistics were used to report the findings. In order to make comments on the adaptation process to university, the Maximum Score Approach Rate, the ratio of approximity to the maximum point that can be obtained from the Student Adaptation to College Questionnaire and its subscales, is calculated. In Maximum Score Approach Rate calculation, the formula [(Observed score/expected maximum score) x 100] was used. A higher Maximum Score Approach Rate showed better adaptation.The discussion from focus groups was audio-recorded and transcribed verbatim. Transcripts were independently coded by two of the authors at the early stage of the coding process. Afterwards, the authors compared data and reached an agreement between the identified codes and refined the coding frame. The themes and sub-themes were identified and findings were reported accordingly with the aid of illustrative quotes. The themes were named according to the subscales of The Student Adaptation to College Questionnaire. Qualitative data analysis was performed using the NVivo 10 program. The findings of quantitative and qualitative data were embedded in order to be interpreted. While embedding, qualitative data codes were categorized according to the subscale titles of the Student Adaptation to College Questionnaire and the Brief COPE. Each code was related to one or more categories. The categories were then grouped under certain themes. Thus, the themes stressed by both quantitative and qualitative data have made it possible to interpret data regarding adaptation to university and coping strategies together.The mean Student Adaptation to College Questionnaire score of the students was found to be 407.44 (SD=68.29). The mean subscale score were as follows: Academic Adjustment: 130.59 (SD=26.20); Social Adjustment: 102.14 (SD=20.03); Personal/Emotional Adjustment: 77.31 (SD=21.23); Goal Commitment/Institutional Attachment: 89.29 (SD=17.98). In this study, the items in the social adjustment subscale had the lowest mean score, while the items in the Goal Commitment/Institutional Attachment subscale had the highest mean score.The Maximum Score Approach Rate of the entire scale was 67.57%. The Maximum Score Approach Rate of the subscales were as follows:  Academic Adjustment 60.46%; Social Adjustment 56.75%; Personal/Emotional Adjustment 57.27%; and Goal Commitment/Institutional Attachment 66.14% .Adaptation of the students to the university life was found to be on a satisfactory level (Maximum Score Approach Rate=67.57%).When adaptation to university life was evaluated on a subscale level, they were found to be listed from positive to negative as Goal Commitment/Institutional Attachment, Academic Adjustment, Personal/Emotional Adjustment and Social Adjustment. This may be interpreted as students’ prioritizing their training goals and disregarding social adaptation.On the other hand, the Brief COPE subscale mean scores were as follows; Planning 6.51 (SD=1.28); Acceptance 5.85 (SD=1.28); Active Coping 5.84 (SD=1.35); Positive Reframing 5.67 (SD=1.28); Self-Blame 5.58 (SD=1.51); Self-Distraction 5.58 (SD=1.51); Use of Instrumental Support 5.38 (SD=1.58); Venting 5.11 (SD=1.46); Religion 5.07 (SD=1.84); Use of Emotional Support 4.95 (SD=1.49); Humor 4.69 (SD=1.66); Denial 3.92 (SD=1.52); Behavioral Disengagement 3.87 (SD=1.56); Substance Use 3.06 (SD=1.73) .The highest mean score in the Brief COPE belonged to the Planning subscale 6.51 (SD=1.28), and the lowest belonged to the Substance Use subscale 3.06 (SD=1.73).The students stated that they chose medical school since “being a doctor was an important occupation for human life.” They were admitted to Ege University through the exams they took in their own countries or the International Student Entrance Exam in Turkey.One hundred seventeen codes were extracted in the analysis of qualitative data. When these 117 codes were categorized (15) according to the Student Adaptation to College Questionnaire subscales, 50 were related to Academic Adjustment, 53 to Social Adjustment, 34 to Personal/Emotional Adjustment, and 25 to Goal Commitment/Institutional Attachment. A single code could be included in multiple categories. When the codes were categorized according to the subscales of the Brief COPE, the subscales were related to the following number of codes: Active Coping 11, Planning 23, Use of Emotional Support 17, Acceptance 9, Behavioral Disengagement 2, Substance Use 1, Venting 3, and Positive Reframing 3. The themes related to the categories were determined.The Academic Adjustment Category included the themes of having training goals and being resolute in studying, having different studying habits, accommodation and transportation conditions, not being able to see an academic advisor at school, and scholarship. The Social Adjustment Category included the themes of social interactions and support, differences, missing one’s family, discrimination, and their effects on social life. In addition, The Personal/Emotional Adjustment Category included the themes of psychological and physiological health problems as well as health insurance. And finally, the Goal Commitment/Institutional Attachment Category included the themes of academic and social adaptation as well as the students’ communication with education management.The qualitative data findings, which were embedded into quantitative data, are summarized below by using the determined themes.Students stated that there were positive and negative factors affecting academic adaptation. The factors that positively affected the process can be listed as having education goals for the purpose of becoming a good physician and being resolute in studying.“… of course, we go through hardships, but I think that anyone who leaves his/her country and comes here has a goal and tries to achieve it every day…” When the factors affecting academic adjustment negatively were examined, the prioritized ones were seen to be the Turkish education system being different from their studying habits, of accommodation and transportation, not being able to reach their counselors at school, getting a scholarship with a stipulation of success, and fear of losing the scholarship.The international students face a different education system from that of the country they come from. In the medical school education program for them courses are hard, exams are frequent and different in method, and student success is tied to attendance. These students, who used to be successful in their countries, have to study much harder than their peersto academically adapt to their new school. When the language problem is added to this, adaptation becomes even more difficult. Students stated that they have gotten used to heavy courses and the education system over the years.“… sometimes you go to classes and they are hard so you have to study like we have this system back there where we have to make a transition from” “I think the curriculum is too heavy… We see theoretical courses from 8.30 AM to 5.00 PM… I don’t repeat the daily courses only once, but have to 2 or 3 times to remember so much…” “… I didn’t understand the word but it was Arabic, which is my mother tongue, still it could mean something else…” Most of the students choose to live in an apartment. Apart from creating a free environment, having responsibilities regarding housework affects academic adaptation negatively. Students who stay at dormitories report different problems concerning living conditions. For instance, not having a suitable living and studying environment in crowded dorm rooms is the most important factor in challenging academic adaptation.“Since a house gives more freedom” “I stayed at a dorm for 3 years. We were 6 people in the room, and when it is midnight you want to sleep since you have to wake up the next morning; but people don’t want to sleep, they want to read and they make noises. When I wake up in the morning, I open my wardrobe slowly so that I don’t make a noise since others sleep. We were 6 roommates.” Some students stated that since time lost in transportation shortens studying time, living near the school was vital with regard to academic adjustment.“I prefer the dorm since we need time and living in an apartment is a loss of time since you cook and do everything. Everything is ready for you in the dorm.” “… classes begin at 8.30 AM and they continue until 5.00 PM, and I stay at a dorm, and have to come here every morning from ... We encounter a lot of hardships…” “Other than apartment or dorm, it is important for us to be close to school.” International students also want to meet their academic counselors to solve the problems they face regarding academic adjustment. The students stated that whenever they encounter a problem about courses, they try to reach their counselors but these efforts came fruitless, and that compared to other universities, they couldn’t benefit from their counselors. “… I have never seen him (my counselor). We don’t know who to go to when we have a problem. I need to reach him, and tell him my problem somehow.” “… I couldn’t take my exam this semester… I tried to reach my counselor twice. One time, he went to Istanbul, and I tried to get his phone number… I tried to reach him twice.” “… you e-mail him (the counselor), but there is no answer, you can’t get past his secretary.” Moreover, the stipulation of success attached to scholarships creates pressure for students. In case of academic failure, the students state that their scholarships would be cancelled and they would have to return to their countries. This possibility creates certain anxiety and makes them spend most of their time studying; also damaging their social and personal/emotional adjustment.“… we have to study, if we don’t pass, our scholarships are cut…” “… I want to finish school I don’t want my scholarship to be cut, so I try hard” “If you fail two years in a row, your scholarship is cut; so you have nothing to do, but study more and pass…” Social relationships and support, differences in language, culture, race/color, politics, and the education system, longing for family, and exposure to discrimination and its effect on social life are prominent factors affecting social adjustment. The students reported that they wanted to participate in social activities, but due to the fear of academic failure or losing a scholarship, they chose to study instead of participating in activities. They also stated that they received invitations to social activities from Turkish students and that they received support for compensating for lost time from Turkish students. Moreover, some international students even reported that education goals were more important than their health status and longing for family.   “(Turkish students) sometimes say ‘Come take the study notes from me so it will take less time (to study)’. But, they also say come with us (to various activities).” “In my spare time, I miss (my family). But, during the examination period I do not miss them because of stress, I want to pass the exam. If you fail for two years in a row, they cut the scholarship. I need to study more and pass the exams, there is nothing to do.” “I think of both options if I fail; I want to finish school and I want to keep my scholarship so I put in a lot of effort” “I had a toothache, but I could not visit the dentist because I had to study.” It was observed that students received support both academically and socially from international or Turkish students, which is a positive finding pertaining to the social relations and support domain.“I failed in my first year, than I passed the make-up exams. ….. my friend (said) we’ll study together, I received some help, (my friends) helped, I was studying with them. I was making copies of my Turkish friends’ study notes.” “…… an international friend of mine came and said that “I did not do it, will you help me?” So I thought if I don’t help internationals then who will help me, I should help him, so others will help me too, so I gave.” As to the social relations and support domain, factors that positively affect social adjustment were often related to relationships among students, while factors that negatively affect social adjustment came from lecturers.Another factor affecting social adjustment was the differences. Students suffered from various adjustment problems associated with differences in language, culture, race/color, politics, and the education system.“Language .” “ Culture. Jokes. We do not understand their jokes. I want to make a really good joke but they do not understand.” “ it is color for us, and race. Nothing would change even if you live here for 20-30 years.” “ especially being black in Turkey.” “Politics. We are Arabs. Something happened between Turks and Arabs in the past. You know, in the past. We should not feel like we have to (continue) this. (They say) You Arabs sold us out. Alright, they sold you out. I don’t care. Do I have to continue this?” “ Prejudice, prejudice never disappears.” “Every country has a system; the system here is a new system. I was intimidated (when I first came). (Simulated patient interview) took 30 minutes. I knew nothing (about the system). I forgot to stop the (camera) recording. I knew nothing; I thought that our lecturer was going to stop the camera recording. They did not show us (how to do it). Then we got used to it.” “I did not encounter any hardships in social adjustment. (I did not experience) language related problems. I come from the Balkans. I have relatives here. I even have more relatives than Turkish students. I am more social than most Turkish students.” One of the factors affecting social adjustment was also longing for family. Family is most missed during holidays. Students stated that activities of daily life  increased their longing for family, and that they may not even see their families for years due to financial problems.“ missing my family. A student here would just go (when he misses his family). Bus, plane, it does not matter. Second, if he is short on money, (his family) can send him money. This is not the case for us. Because I call (my father when I need money). My father will go to the bank there, send (money). The process is long; there are problems like that.” In the holidays, everyone goes home, and I stay here. It has been two years (since I last visited home) .“I miss my mother the most when I am cooking. I always had my breakfast and lunch ready when I went to school. Now I go and prepare it myself. It is very difficult.” “During the exams, you are stressful, but you want to study. You cannot. So you think of home more. For me, at least (this is the way it is).” “(Missing the family) happens most during holidays. For me that’s most important. It is not a problem for me, I just want my mother to be happy. My mother gets emotional. I can control myself. She knows I cannot go (for the holiday), and I can control myself when I talk to her, but she cannot.” “During holidays, everyone packs. But, I cannot go anywhere.” “Everyone leaves with luggage and goes to their families during make-ups. I just look!” It was determined that the students were exposed to prejudice and/or discriminating attitudes by lecturers in particular.“In my first year, we were having an exam in the microscopy class. I did not understand one word on the exam. The word was Arabic. Arabic is my mother tongue, but it may have a different meaning. I called the lecturer and said “Does it mean this or does it have another meaning”. The lecturer said “Are you an international? You come here with scholarship (with money)”. (The lecturer said) why my people cannot get education, why are you here?” “… some lecturers are really good. They like internationals. They always understand you when you talk. They explain things to me when I don’t understand them. But, some lecturers are not that interested. There was a lecturer in my first year. I cannot remember his name. but he was male. (During the exam) I saw a question written by him. I went to him and said “I do not understand this, what does it mean?” He gave such a stern answer that I never liked him.” I don’t know how true it is but they don’t like strangers in our university. “You came down with a parachute, taking scholarship from us” they say with prejudice. It’s really sad. I had already gotten the points for medical school back home, and I wouldn’t have come if I hadn’t wanted to… How correct is such a welcome?!” “There was a blood draw skills lesson during the internal diseases internship. The patient said “ (since I was African) I don’t want her to draw blood” I got very sad and demoralized.” It was found that when it came to personal/emotional adjustment, the psychological and physiological health issues encountered by the students, and health insurance coverage in taking care of these problems were important.The international students stated that, psychologically, they experienced exam stress as well as fear of academic failure, scholarship cuts, and having to return to their country.“I don’t get stressed during exams at all, but in the first years I used to get so stressed, I would live with the stress all year.” .“I get affected by stress. I wasn’t overweight, but I lost 5 kilos since starting school, and I can’t gain them back.” “We had a friend who became schizophrenic.” “Two of our friends became schizophrenic, we had to send them back home. One was a senior and one was doing Masters.” “I had to study till morning in the first years a couple of times before I got used to exams. Since I had to study a lot, I would have fatigue.” The students also stated that, besides psychological problems, they have experienced physiological health problems, too; especially because of exam stress.“I can’t eat from stress and get diarrhea during exam weeks.” “Me too, I get diarrhea in exam days. It was more, but it subsided a bit.” “It’s not psychological, but I have acid reflux and can’t eat from stress. I go home in the holidays and never have it for 1,5 months. Here, I get it 3-4 times each week.” “I have migraine. I never had it till I came here.” “Loss of appetite.” In addition to their psychological problems, international students encountered complications due to social security regarding admission to a health service and treatment.“Since we take scholarships, we pay  premiums.” “I have private insurance, but outpatient only.” “Not to be sent from one place to another, I get sick but don’t go (to the physician). I heal myself with natural products.” Goal Commitment/Institutional Attachment is generally considered as a part of academic adjustment or social adjustment. In this section of the findings, examples that contain only goal commitment/institutional attachment are given.International students did not report any positive experiences on the topic. One of the main problems appears to be the lack of communication between the students and the management. Students wanted a mechanism where they are notified and can gain information.“… the school decides on something, and nothing changes whether we object to or not, we have difficulty in being notified. The number  is so low.” “We had a classroom teacher in high school. If we had a problem, we went to him. Here  we have a counselor but we never saw him. We don’t know who to go to. I am a freshman and have friends at 6th year, and they say we didn’t see him yet, how couldn’t you?” The international students also compare universities in providing solutions to their problems. This affects the process of Goal Commitment/Institutional Attachment negatively.   With the effort of easing adjustment, they compare applications in different universities, but become unhappy in the end.“I don’t know how true it is, but they don’t like strangers in our university. (A friend of mine) studies at the Faculty of Dentistry at the X University. (According to him) the international students easily go to the tutors. The tutors even ask if they have a problem when they meet.” “… I had a friend in X University. He had a counselor… he (the counselor) would always come by and ask. (the counselor) would call him to see if he had any trouble. When I came to Ege, I heard there was a counselor, but never met such a thing. No one asks (about me) and I don’t even know who he/she is.” Another area of problems negatively affecting Goal Commitment/Institutional Attachment is the issue of social security for international students. When the students encounter a health problem, despite studying at a medical school, they cannot find institutional solutions.I got the flu and couldn’t stand. I went to student affairs and  told them I wanted to be examined as a member of the personnel. They told me to write a petition. Then they asked me for a student card. Despite being a student, since I wasn’t a part of the Turkish social security system, they sent me from one place to another. I couldn’t stand, so I gave up and returned home .As a result, the students were found to use the coping strategies of acceptance, self-blame, use of instrumental and emotional support, active coping, positive reframing, behavioral disengagement, self-distraction, and substance use regardless of adjustment areas. For this reason, the use of qualitative data categories were (adjustment areas and coping strategies) interpreted together. In cases where they had a potential to cause change, the students were found to use functional coping strategies ; and in cases where they didn’t have such potential, students were found to prefer goal-oriented reinterpretation strategies .In this study, the adaptation and coping strategies of undergraduate international medical students to university life in Turkey were examined. The problems encountered by the students during the adaptation process were determined, and various suggestions were introduced to solve these problems.Study findings have shown that international medical students have come to Ege University School of Medicine from seven different regions of the world. Turkey, being a transitory country between Europe and Asia, has become a conscious choice for international students for her geographical location to pursue their educational goals. In addition to this, the education programs of the universities in Turkey being compliant especially with that of European universities (due to the Bologna process) also appears as a determining factor in their choice of university.Qualitative and quantitative data on academic adjustment have shown that international students aiming to be proficient doctors, came to Turkey with a focus on education, and determined to complete their education despite all difficulties. The fact that the students couldn’t reach anticipated academic success was because of their academic and cultural differences despite studying hard. This seems to be in compliance with the Habitus concept of Bourdieu. Their departure from their own habitus and encounter with a new one also supports the “Les Rites the passage” concept of Gennep.-To illustrate, students experience the stage of separation from their families and culture in their freshman year, the threshold in the second and third years, and the integration into the new culture stage in their fourth, fifth, and sixth years. The integration stage, which the students termed as “we got used to it”, is the stage defined as an adjustment by Gennep and Lysgaard.---,The quantitative and qualitative data regarding Academic Adjustment showed that students wanted to be good physicians, came to Turkey for this reason, and they want to complete the education against all hardships. Despite a lot of effort, they cannot achieve the academic success they expect due to hardships brought about by differences. Nevertheless, language barriers remain some of the most reported hindrances that physicians need to overcome in a healthcare setting.It was also found that Social Adjustment is the subscale of the Student Adaptation to College Questionnaire with the lowest mean score. International students are willing to participate in social activities that could positively affect social adjustment. The fact that the students prioritize academic success and not prefer to participate in social activities supports Maslow’s theory.-Moreover, prejudiced and discriminatory attitudes were found to have an effect on social adjustment. The Queer theory explains some of the problems experienced by international students.  Being the other, especially in their interactions with academic advisors, students point out that discriminatory attitudes come to the forefront. In studies by Dunne and McGarvey, the most difficult form of adjustment was stated to be a social adjustment. In Dunne’s study, it was stated that there were difficulties in social adjustment in a manner similar to our study.Hence, in this study, the physiological adjustment of the students was found to be better than their psychological adjustment. In Personal/Emotional Adjustment, the fear of not reaching education goals increases the visibility of its psychological effects on students. While students make an effort to solve their physiological problems, they use nonfunctional coping strategies such as acceptance when it comes to psychological issues. The problems encountered during Personal/Emotional adjustment can be explained via two theories. The psychological and physiological health problems can be thought to emerge from the habitus change of the students. The fact that the students had no local health insurance and couldn’t benefit from health services can be explained by being queer.As to Goal Commitment/Institutional Attachment, it is not termed alone and is generally considered as a part of Academic Adjustment or Social Adjustment. Although a student comes to the institution to fulfill a specific academic goal, various situations regarding the institution can affect his/her overall adjustment process . Although international students choose to come to Ege University School of Medicine, there are no institutional mechanisms to ease Social Adjustment  for them. Thus, the expectations of the students from education management cannot be met, and the students again use nonfunctional coping strategies.According to the social model, exhibiting differences between students is performed not to point out the other but to determine needs. Therefore, it could be possible for individuals who have needs that differ from one another to live together in the same society. According to the social model, management power has a determining role in the formation of a social structure appropriate for the social model. Interventions such as education managements establishing a bureau specific to international students or meeting their health service needs on campus are critical in combating the students’ adjustment problems.-,-With the lack of such mechanisms, international students were observed to use the coping strategies of acceptance, self-blame, use of instrumental and emotional support, active coping, positive reframing, behavioral disengagement, self-distraction, and substance use all of which were mentioned in the Brief COPE – as supported by previous research findings.International students’ not being able to use Turkish effectively has caused the transcript consist of many short and inverted sentences. Self-administered questionnaire technique was used in this study. Social desirability bias is yet another limitation in this study.In this study, the university adaptation of undergraduate international medical students were evaluated. It can be said that for the individual  to be healthy and happy, and for the faculty to be productive, different cultures should co-exist in harmony. According to the findings of this study, in order to increase and ease the adaptation of international medical students to university life, and to minimize problems, the following suggestions were developed: first, before international medical students start their education, their needs potentially affecting their adaptation process should be determined. For this purpose, feedback mechanisms should be established and used effectively. Second, orientation training should be planned and implemented for international medical students. Third, language problems encountered by students should also be analyzed in a detailed manner. Especially when planning exams, culturally variable idioms , terms, and synonyms should be considered concerning the academic success and reading speed of an international student. Fourth, an international student bureau should be established on the campus and should take an active role in solving bureaucratic problems international students might face. And finally, the University Counseling and Guidance Service and peer support systems should be used more effectively. International students should be encouraged to participate in activities designed to help them mingle with domestic students.To conclude, this study has pointed out the critical issues in supporting international students in adapting to university life in Turkey. Globalization, the Bologna Process, and similar developments have increased the desire to receive high-quality education beyond borders and work under better conditions. The influence of globalization may remain insufficient in resolving the issues that arise when different cultures meet. The problems encountered by international students as a whole may be considered as an example of this. Revising the content of education programs to enable international exchange is also not sufficient enough by itself to meet the needs of international students. Future studies should be planned to resolve the cultural issues as well as the issues of adaptation to university life in Turkey.We thank Hanife Ankara, an employee at the Medical Education Department, whose help and valuable input made the project possible. We also thank our international students who participated in the study, and showed their support sincerely.The authors declare that they have no conflicts of interest.


African irregular migrants risk their lives crossing the Mediterranean Sea in small boats hoping to reach Europe. Women irregular migrants (WIMs) are an especially vulnerable group that suffer from violence and sexual aggression, but little is known about their actual experiences. The objective of our study is to describe and understand the violence against WIMs who arrive in Spain in small boats. A qualitative study based on Gadamer’s phenomenology was used. The data collection included twenty-six in-depth interviews with WIMs. Three main themes arose: “Poverty and discrimination push WIMs into migrating”; “WIMs as a paradigm of extreme vulnerability”, and “WIMs in small boats should raise the alarm”. WIMs who arrive to Europe in small boats have a history of violence, rape, prostitution, forced pregnancy, and human trafficking. Emergency care must include gynecological examinations and must make detecting sexual violence and human trafficking of WIMs part of their care protocols. Migrant and refugee movement is considered to be a political, social, and public health challenge around the world . The EurThe fight against unwanted sea migration in Southern Europe has transformed borders as we know them, as well as the relationship between countries ,14. DespWIMs may suffer from violence throughout all the stages of the migratory process, from recruitment, transit, and finally, during integration in the place they land . While eA qualitative design based on Gadamer’s hermeneutic phenomenology was used in the data interpretation and analysis . HermeneA purposive sample was used to recruit WIMs. The inclusion criteria for the WIMs was to have crossed the Mediterranean Sea in a small boat in the last 5 years. The exclusion criteria were to refuse to participate in the study and to be <18 years old.In-depth interviews were carried out with twenty-six WIMs, with an average duration of thirty four minutes. In-depth interviews (Dis) were completed between February 2017 and April 2018 . The DIsA modified version of the stages developed by Valerie Fleming was used . In the Approval was gained from the Spanish Red Cross Ethics and Research Committee (protocol number: CR-1501). The participants were informed of the purpose of the study. Permission was requested to record the conversations, participants signed an informed consent form, and their anonymity has been maintained at all times.Twenty-six WIMs, originating from eight African countries, participated in the study. Their average age was 28.8 years old (SD = 6.09). Of the WIMs, 42.3% traveled alone, 23.07% while pregnant, 23.07% with children, 7.7% while pregnant and with children, and 3.85% with siblings. Participants’ individual demographic characteristics are presented in This theme describes the motives behind taking on an extremely risky journey for WIMs. In migrants’ countries of origin, a culture of emigration as a means to escape discrimination and improve living conditions has arisen in recent years. The media offer images of a European paradise, which pushes women to risk their lives on the journey to escape from war, poverty, violence, or discrimination.“I want to come to Europe so we can all live a better life, because women are equal to men here.”(WIM-6)The majority of the women are from countries that have economic and social inequality with few resources for survival. This situation makes accessing education and escaping poverty or social exclusion nearly impossible. In addition to violence and gender discrimination, imagining an idealized life in Europe with equal opportunities drives them to go on a high-risk migration journey.“My father died, and he had a debt that we could not pay. So it would be forgiven, I was forced to get married against my will at 16 years old. My mother begged me for forgiveness every day, ... but she also begged me not to run away, because (husband’s name) could retaliate against the whole family.”(WIM-11)The WIMs we interviewed lacked prospects for the future in their countries of origin and coming to Europe seemed like the only option to improve their living situation. Sometimes, the loss of a male figure leaves the family unprotected, in social and economic vulnerability, women are responsible for their families, which they pay for with their freedom. As one WIM comments, this can be the trigger to finally make the journey.“My first daughter died because of genital mutilation. I refused to continue that practice and I was publicly punished by my husband, closed in a room for a week. People assaulted me and gave me food through a window.”(WIM-24)Along with arranged or forced marriage, sexual and physical abuse and violence may be present even within their own families. Many WIMs come from countries where they suffer genital mutilation as young girls as a way of following tradition and religion or controlling their sexuality. As some of our participants say, they flee from these practices.“I was with my partner for 4 years, and I suffered from physical and psychological abuse. My ex mother-in-law didn’t help me, ... she said it was normal, that all men did it.”(WIM-12)WIMs flee from practices and customs focused on the control and reinforcement of the inferiority of women. In their cultures and countries of origin, domestic violence usually comes from someone close to them, that they know well. As one WIM says, some have been hit by their parents or husbands.“Four months after my husband died, I refused to get married again, and I was harassed and abused by my husband’s family... I had no choice but to flee!”(WIM-14)There are certain ethnicities with deep-rooted traditions that violate women’s rights. As one participant, who is of the “Tsimni” race, informed us, when a woman and a man are married, if he dies, she must marry one of his brothers to ensure the continuation of the family lineage. If she refuses, her life may be at risk:“I asked my grandfather’s brother for money, I spoke with him and he organized it, … then I worked to repay him the money he had lent me.”(WIM-3)On some occasions, people with power in their communities of origin, or even families of the victims themselves, contribute to the process of recruitment. There is a type of social coverage that protects these practices, and sending a daughter to a foreign country can imply gaining a position of higher status within the community. As one WIM says, the family often actively participates in financing and organizing at least one part of the dangerous journey:“A Nigerian woman (madame) told me, ‘You are a very pretty woman and I can help you find work in Europe,’ She took care of my passport and the trip. She also made me do voodoo rituals: she took a blood sample from me, my hair, pubic hair and fingernails, and made me drink it. She said it would protect me, but if I didn’t obey, the spirits that were summoned would turn against my family and me.”(WIM-16)On other occasions, it is the trafficking network that recruits the victims directly, scamming them by promising them a bright future in Europe with a steady job as a hairdresser or taking care of children. In some communities, the agreement with the network of traffickers is sealed by a ceremony (juju or voodoo), which exercises control over the women. Juju is sometimes used to enforce a contract or ensure compliance. Coerced by magic rituals  they believe that if they do not obey the trafficking network, their family will be in danger. As one participant explained:“I didn’t know anything, nobody informed me, my brother paid a friend of Abiyán, who spoke with someone from Morocco who managed all the other things.”(WIM-6)The trafficking network organizes the trip and the economic conditions. One man, from Morocco or Algeria, manages the payment with a friend or a relative of the woman. With the collusion of their families, these women often pawn the few personal or family belongings they have in order to pay for the journey. WIMs are excluded from taking part in these decisions:“When I paid him (the trafficking network), he told me: “We’ll pick you up in a parking lot”. When I got in the car, I saw that there were two other girls in the trunk.”(WIM-8)In addition, the human trafficking ring can act directly by kidnapping these women. WIMs can be tricked, kidnapped, forced to hide to avoid being discovered, transported secretly, and sexually exploited. As one participant told us:During the migratory journey from sub-Saharan countries to the Maghreb, WIMs are exposed to xenophobia, physical violence, and sexual exploitation. Consequently, as they wait to embark towards Spain, WIMs stay hidden in areas near the coast of Morocco or Algeria, where they survive in precarious conditions, trying to avoid being detained or deported.“From Senegal to Morocco, they were constantly asking us for money and they threatened to make me go back. They made us dress in Arabic clothing, they made me wear a hijab, we always traveled hidden among suitcases.”(WIM-9)Once the conditions are negotiated, WIMs are moved throughout different countries using the routes with the laxest migratory controls. The traffickers know how and where to go to avoid hitting border control, although there are always cities where they have to stop; these are known as “hot spots”. The journey is done on foot, or by bus, truck, taxi, or private cars. As one WIM says, threats are used as a way to control women throughout the trip:“I stayed hidden with my son in the forest outside Nador for three and a half months until we could leave on a small boat. It was so hard! I had to beg for food just to eat!”(WIM-12)The women do not travel alone and are always accompanied by a woman or man who is in charge of their transportation, managing the payments and controlling the victims. Border crossing is one of the most traumatic moments for WIMs because the trafficking network may use them as bartering currency to bribe the police. In Morocco, WIMs stay half-hidden for long periods in flats in unsanitary conditions or in the forest (near the Spanish border) waiting to cross the Mediterranean in small boats. As one WIM says, they are obligated to beg or are exploited as domestic servants or prostitutes:“Yes, a woman is in charge, she threatens you, ... you have to obey. I was abused! I had to pay back my stay.”(WIM-18)At this point, WIMs already belong to a human trafficking network that makes all the decisions for them, including their sexual and reproductive health. They decide where the WIM will be prostituted and if she will use any contraceptive methods. If the WIM is pregnant, the human trafficking network will decide whether she will abort or carry the baby to term. As one WIM tells us, the trafficking network designates women to be in charge of controlling WIMs:“My husband stayed in the forest, he said for me to go first because I am pregnant and that I should have the baby in Europe. I don’t know when he’ll get here, he hasn’t said anything!”(WIM-5)In the case that the pregnancy comes to full term, the baby would become property of the trafficking network. These children are usually the result of rapes and sexual abuse and usually go on the journey by small boat with the mother.“I was so hungry, I went weeks without eating, sleeping in the streets! They treated us like animals, I don’t want to remember the time I spent there!”(WIM-20)Before leaving for Spain, WIMs survive in wooded areas in improvised camps made up of shelters built from branches and plastic tarps where they stay hidden for months on end. In these places, women suffer from racial discrimination, sexual harassment, and rape at the hands of the local population. As one WIM describes:“In the forest I suffered from violence and sexual assault at the hands of a man, ... I had to say yes to anything so they would help me make the crossing in small boat.”(WIM-22)The wait becomes unbearable, WIMs remain detained, isolated, and without any chance of getting help. These camps are places where fear and anxiety run deep and WIMs are controlled by men who do not let them speak to their families. As one participant said, they are required to comply with any request the men make:“In the forest, the police caught me. They left me beyond Casablanca and I walked for days to get to where the boat left.”(WIM-1)WIMs live in constant threat of police raids that force them to flee and disperse. If they are detained, WIMs report that the Moroccan police makes deportations without guarantees to other cities or the country border.“When I got to Casablanca, there was a man waiting for me who took me to a house where there were more girls. They took my passport and they forced us into prostitution, always under their close watch, abuse ... it was horrible!”(WIM-16)WIMs may also live in small apartments or flats on the cities’ outskirts, in very poor hygienic and sanitary conditions. They may remain detained in those crowded spaces for days or even years in semi-freedom while saving up money in order to pay back their debt.“I moved into the house and the owner and I agreed I could do the housework and cooking. I left after a month because I was under a lot of pressure to get into prostitution.”(WIM-12)WIMs find themselves obligated to beg and hustle in order to survive and pay back their debt to the trafficking network. As one WIM says, they go into homes of Moroccans to work. They say they work as cleaners but you can sense that they are being sexually exploited:“I met this man, I got pregnant, I had the boy but this man disappeared. My “journey husband” organized the trip. I gave him 4000 Dirham (Moroccan currency) that I earned and he took care of everything...”(WIM-7)During the first stage of the journey, the figure of the “journey husband” arises. This is a man with whom the WIM establishes an emotional attachment. He protects the WIM and gets her pregnant. These men, chosen by the network to control the women throughout the journey, monitor their stay in Morocco, preparing them for their journey by small boat to Spain.“It was a very hard journey, as the water came into the small boat. My friend’s son fell into the sea and I was able to get him out, but he wasn’t breathing … I still feel panic and anxiety from it!”(WIM-10)This is an extremely dangerous journey done in small, substandard boats with hardly any water or food for the journey and surrounded by gasoline tanks and, sometimes, drugs. Without prior warning, the trafficking network puts between 35 and 60 men, women, and children on one small boat, all piled up and huddled together without space. They embark without life jackets despite the majority not knowing how to swim:“You get on the boat with what you have on, they don’t want you to take anything. It’s scary just to look, … they threaten us, hit us, frisk us, and rob us.”(WIM-4)On the outskirts of the city and in the forest there are men and women who prepare and negotiate the trip. Their “journey husbands” stay in Morocco to continue their job within the human trafficking ring. The women do not know anything related to the organization, the payment, and the conditions of the journey. The small boats are very low-quality, they do not have compasses and they are not tested to see if they work prior to the journey. As one WIM says, they fit as many people as possible on the boat and they are obligated to stay still, to cover themselves with a blue tarp if they see police helicopters, and to not give up the identity of the operator of the boat:“There were 33 of us in the boat and you have to sit on the floor or on someone else’s legs. We arrived tired, in pain, with our limbs numb, and with burns.”(WIM-7)The small boats lack space and the migrants cannot move, they suffer from headaches, dizziness, and vomiting. The small children sit on their laps the whole time, which causes them to arrive completely exhausted. As one WIM describes:“We didn’t eat anything, were dehydrated and you can’t urinate. The men could just pull their pants down, but the women couldn’t…you soil yourself!”(WIM-2)During the journey, WIMs experience hunger, thirst, extreme cold (they do not travel with adequate clothing), and sometimes can get sexually abused. In addition, WIMs cannot urinate and they arrive on land with excessive urine retention.WIMs are a very vulnerable group that requires specialized emergency care upon their arrival.“There are more opportunities for them to do bad things to a woman, … I would never do this trip by small boat again.”(WIM-5)When a small boat arrives to the Spanish coast, IMs receive emergency care. WIMs arrive exhausted from a long migratory journey full of violence, abuse, and discrimination. For our participants, being black and a WIM makes the journey especially perilous:“I arrived pregnant, they took me to the hospital and examined me, ... I was HIV positive. My daughter and I are now taking pills as treatment.”(WIM-22)IMs require evaluation of their physical health, nutrition, hydration, waste elimination, injuries, burns, and wounds. In addition, WIMs also need a gynecological examination focused on the detection of sexually transmitted diseases, clandestine abortion practices, female genital mutilation, and signs of abuse. As one WIM points out:“A man helped me to cross without charging me anything, I know I have a debt to pay, ... someday he’ll find me and I’ll have to pay.”(WIM-18)Detecting human trafficking victims is key in the provision of emergency care. Being controlled by the trafficking network, in conjunction with feeling fearful, deters WIMs from reporting their situation and seeking protection.“My parents died and I was left in charge of my 4 siblings, and clothing sales were not doing well. Helen (the madame) urged me to come to Europe, saying, ‘There you’ll earn money, you can feed your siblings!’ She organized the journey to Morocco, but then she disappeared.”(WIM-25)WIMs may be accompanied by a woman who ensures that they follow the orders of the network. Although during triage they remain in silence, healthcare providers can observe if WIMs lower their head upon making eye contact with another woman; the latter may be the “leader” of the group.“My daughter did the journey by small boat with my niece, and they wouldn’t let me get on. When she arrived in Spain she lied and said it was her daughter, ... later that her parents were in Morocco. My daughter is now in a center for inmigrant children.”(WIM-11)Some WIMs travel with their children, but when they go to board the boat, they may be separated by the organizers. As one participant said, some children may end up traveling alone, with another family member, or with strangers.“I arrived with my little son, my other daughter had gone ahead in small boat a few weeks before. She had to travel with a stranger …”(WIM-26)When any minor arrives to the coast, it is important to detect the family relationship they have with the adult that accompanies them. Detecting this vulnerability is important for the safety and protection of the family, especially of women and children. As one WIM explains:“The Red Cross Emergency Response Team interviewed me upon arrival, the first thing I told them was that my other young daughter had arrived in Spain a few weeks prior, ... I don’t know where she is! They said they would look for her, that they would help me.”(WIM-26)Small boats of sub-Saharan Africans with women and children aboard need specific treatment. During triage, the organizations that provide emergency care to WIMs carry out specific protocols for detecting human trafficking, gender violence, or family separation. They carry out immediate interventions, involving the WIMs themselves.The objective of our study is to describe and understand the violence against WIMs who arrive in Spain in small boats. The framework developed by Zimmerman et al.  has alloSeveral women refused to participate in the study out of fear of speaking out or retaliation from human trafficking networks. The sample of WIMs is nonhomogenous, as their economic, political, and sociocultural characteristics vary according to their country of origin.Many WIMs live in a culture of oppression, discrimination, and inequality that drives them to emigrate to Europe from their home countries in search of a better life. Although they are familiar with the risks and encouraged by false promises, they are still recruited by the trafficking network to migrate to Europe. During this dangerous journey, they suffer from hunger, dehydration, or injuries. Additionally, they also incur a huge debt that exposes them to sexual abuse and rape. WIMs are abandoned in Morocco or Algeria; they live in conditions of semi-slavery and prostitution and their bodies act as currency to be traded with local people and police. The trafficking network controls their sexual and reproductive rights, their pregnancy and their abortions. After a long wait, WIMs cross the Mediterranean Sea in small boats. Upon their arrival in Spain, WIMs require emergency care with a special focus on nutrition, hydration, hypothermia, and injuries. In addition, healthcare providers must provide gynecological examinations, detect human trafficking victims and guarantee their safety. The development of joint protocols between governments, NGOs, and police and healthcare providers, along with the observation of the relationship between WIMs and children are crucial steps to improving emergency care. These results may serve to better administer care to WIMs who reach Europe by sea from the north of Africa.


In Bohmian mechanics, particles follow continuous trajectories, so two-time position correlations have been well defined. However, Bohmian mechanics predicts the violation of Bell inequalities. Motivated by this fact, we investigate position measurements in Bohmian mechanics by coupling the particles to macroscopic pointers. This explains the violation of Bell inequalities despite two-time position correlations. We relate this fact to so-called surrealistic trajectories that, in our model, correspond to slowly moving pointers. Next, we emphasize that Bohmian mechanics, which does not distinguish between microscopic and macroscopic systems, implies that the quantum weirdness of quantum physics also shows up at the macro-scale. Finally, we discuss the fact that Bohmian mechanics is attractive to philosophers but not so much to physicists and argue that the Bohmian community is responsible for the latter. Bohmian mechanics differs deeply from standard quantum mechanics. In particular, in Bohmian mechanics, particles, here called Bohmian particles, follow continuous trajectories; hence, in Bohmian mechanics, there is a natural concept of time-correlation for particles’ positions. This led M. Correggi and G. Morchio  and moreHere, we clarify this debate. First, we recall why two-time position correlation is at a tension with Bell inequality violation. Next, we show that this is actually not at odds with standard quantum mechanics because of certain subtleties. For this purpose, we do not go for full generality but illustrate our point with an explicit and rather simple example based on a two-particle interferometers, partly already experimentally demonstrated and certainly entirely experimentally feasible . The subtleties are illustrated by explicitly coupling the particles to macroscopic systems, called pointers, that measure the particles’ positions. Finally, we raise questions about Bohmian positions, about macroscopic systems, and about the large differences in appreciation of Bohmian mechanics between philosophers and physicists.Bohmian particles have, at all times, well defined positions in our three-dimensional space. However, for the purpose of my analysis, I need only to specify in which mode the Bohmian particle is. Here I use “mode” as is usually done in optics, including atomic optics. For example, if a particle in Mode 1 encounters a beam splitter (BS) with Output Modes 1 and 2, then the Bohmian particle exits the beam splitter either in Mode 1 or in Mode 2, see H:Assumption Position measurements merely reveal in which  mode the Bohmian particle actually is.Part of the attraction of Bohmian mechanics lies then in the following assumption:Accordingly, if Modes 1 and 2 after the beam splitter are connected to two single-particle detectors, then, if the Bohmian particle is in Mode 1, the corresponding detector clicks, and the case of Mode 2 is similar, see x and y to Modes 1 and 4, respectively, and combine their modes on a beam splitter, see Let’s consider a two-particle experiment with 4 modes, labeled 1, 2, 3, and 4, as illustrated in If Modes 1, 2, 3, and 4, after the beam splitter, encounter four single-particle detectors, also labeled 1, 2, 3, and 4, then the probabilities for coincidence detection areIn Bohmian mechanics, this experiment is easily described. Denote the two particles’ positions Equation ), the paH, one does not need to actually measure the positions of the particles; it suffices to know that each is in one specific mode. Hence, one can undo Alice’s measurement as illustrated in x′ and a third beam splitter, see Now, according to Bohmian mechanics and Assumption Equation . Alice cr′H, if r′There is no doubt that, according to Bohmian mechanics, there is a well-defined joint probability distribution for Alice’s particle at two times and Bob’s particle: aimed in .Let’s have a closer look at the probability distribution that lies at the bottom of our puzzle: a′, i.e., traces out Alice’s second measurement, then one recovers the quantum prediction equations ))a′, i.e.x′, as one would expect. Similarly, if one traces out Alice’s first measurement,It is important is to notice that quations  and 4)..P is signa, a′, and b in the natural way,Consequently, defining a joint probability for the measurement outcomes H, so Assumption H is wrong. Every introduction to Bohmian mechanics should emphasize this. Indeed, Assumption H is very intuitive and appealing, but wrong and confusing.In summary, it is the identification in Equation  that conx′ on To elaborate on this, let’s add an explicit position measurement after the first beam splitter on the Alice side. The fact is that, according to both standard quantum theory and Bohmian mechanics, this position measurement perturbs the quantum state (hence the pilot wave) in such a way that the second measurement, labeled x , by an extra system, called here the pointer, initially at rest in a Gaussian state, see p large enough so that the two quantum states of the pointer Let’s model Alice’s first position measurement, labeled p is large enough for the pointer to have moved by more than its spread by the time Alice’s particle hits the second BS, then the pointer acts like a standard measurement, and the second position measurement x′ of Alice’s particle is perturbed by measurement x, as discussed in the previous paragraph. However, if p is small enough, then, by the time the second measurement x′ takes place, the pointer barely moves. In this case, the second position measurement is not affected [x′ that perturbs the “first” one, i.e., perturbs measurement x. Indeed, because of the entanglement between Alice’s particle and the pointer, if one waits long enough for the pointer to move by more than its spread and then reads the result of the “first” measurement out of this pointer, then one will not find the expected result: the second measurement perturbed the “first” one. I put “first” in quotes because, in such a slow measurement, the result is actually read out of the pointer after the “second” measurement took place.Accordingly, if affected ,5,6, seeThis is very similar to the so-called surrealistic trajectories, see ,5,6. In So far so good. But let’s now consider, not single particles, but elephants. One of the advantages of Bohmian mechanics is that whether systems are microscopic and macroscopic makes no difference: all systems are treated alike. The price to pay, as we illustrate below, is that all the strangeness of quantum physics at the microscopic level has to show up also at the macroscopic level.Let’s consider two elephants in the state of Equation  correspoNote that the above deeply differs from the standard BS, which corresponds to The story of the single particles described above remains the same. In Bohmian mechanics, the elephants’ positions are also hidden, or at least not fully accessible. However, this is puzzling, as it means that, when one “looks slowly”  evolves. Hence, not all measurements that, according to quantum theory, are position measurements, are also Bohmian-position measurements: some quantum-position measurements do not reveal where the Bohmian particle is.Assumption The first point above is very familiar to quantum physicists. However, it may take away some of the appeal of Bohmian mechanics. Indeed, the naive picture of particles with always well-defined positions is obscured by the fact that these positions cannot be “seen”—in fact, one can not “merely see” in which mode a Bohmian particle is. At the end of the day, Bohmian mechanics is not simpler than quantum theory. The promise of a continuously well-defined position and the associated intuition is deceptive.quantum-position and Bohmian-position measurements. The latter refers to measurements that provide information about the position of Bohmian particles. It would be interesting to figure out how to characterize such Bohmian-position measurements without the need to fully compute all the Bohmian trajectories.The second point listed above is interesting: One should distinguish between From all we have seen so far, one should, first of all, recognize that Bohmian mechanics is deeply consistent and provides a nice and explicit existence proof of a deterministic non-local hidden variables model. Moreover, the ontology of Bohmian mechanics is pretty straightforward: the set of Bohmian positions is the real stuff. This is especially attractive to philosophers. Understandably so. But what about physicists mostly interested in research? What new physics did Bohmian mechanics teach us in the last 60 years? Here, I believe it is fair to answer: Not enough! Understandably disappointing.It is deeply disappointing that an alternative theory to quantum mechanics, a theory that John Bell thought should be taught in parallel to standard textbook quantum mechanics , did notLet me suggest some possible, albeit only partial, answers to the above puzzle. I am afraid that almost all the research on Bohmian mechanics over the last several decades remained trapped within an exceedingly narrow viewpoint and worked only on problems of interest that were highly specific to their Bohmian community. I believe this is especially disappointing, as there were several interesting open problems that Bohmian-inspired ideas could have addressed. The positive side is there are likely still interesting open problems that open-minded researchers can explore.Let me illustrate some of the ideas I believe Bohmian mechanics should have triggered. This list is obviously subjective—it is only important that it is not empty. Bohmian mechanics, like quantum theory, is in deep tension with relativity theory. I know of Bohmians who claim that it is obvious that any non-local theory, Bohmian or not, requires a privileged universal reference frame. I also know of Bohmians who claim that it is obvious that Bohmian mechanics can be generalized to a relativistic theory . However, I know of no Bohmians who are inspired by their theory and its tension with relativity to try to go beyond Bohmian mechanics, as illustrated in the next two paragraphs.choice-devices [According to Bohmian mechanics, particles “make decisions” at beam splitters in the sense that, after a beam splitter, the particle is definitively in one of the output modes. Admittedly, this is not a real decision as everything is determined by the initial state of the particle and of all other systems entangled with the particle. However, let me continue using this inspiring terminology. Accordingly, and following Suarez, we call such beam splitters -devices . Such ch-devices . This ha-devices .Another Bohmian-inspired idea follows directly from an observation by Hiley and Bohm : “it is I am confident that Bohmian mechanics and other alternative views on quantum mechanics will inspire further ideas that will lead to experiments that might work to extend quantum theory. The real question is whether the Bohmian community will pursue such ideas.H is wrong. Still, Bohmian mechanics is deeply consistent. Position measurements perturb the system, even in Bohmian mechanics. Hence, the existence of two-time position correlations is not in contradiction with possible violations of Bell inequalities.Naive Bohmian mechanics that assumes Assumption Generally, position measurements sometimes reveal information about Bohmian positions, but never full information and sometimes none at all. Simple and handy criteria for determining when the Bohmian position measurements of a particle under test highly correlate with the position of the center of mass of some large pointer are still missing.Bohmian mechanics is attractive to philosophers because it provides a clear ontology. However, it is not as attractive to researchers in physics. This is unfortunate because it could inspire brave new ideas that challenge quantum physics.