This research note evaluates the benefits and pitfalls of unpaid work as an entry route into employment in the creative industries, and investigates the consequences of this practice for those who already work in the sector. Based on a qualitative study of perspectives of stakeholders in unpaid work, this article argues that social capital thesis (Coleman 1988) often used as a rationale for unpaid work, inadequately explains the practice of unpaid work experience, primarily because it does not take cognisance of the consequences of this practice for other people working in the sector. The study also highlights methodological issues that need to be considered in the future. As well as the importance of a plurality of stakeholder perspectives, the study emphasises the need for considering the perspectives of those who are excluded from unpaid work, and those who are potentially displaced by it.

ObjectivesTo explore trainee doctors’ experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors’ successful transition experiences? (3) What is the impact of MMTs on trained doctors?DesignA qualitative longitudinal study underpinned by MMT theory.SettingFour training areas (health boards) in the UK.Participants20 doctors, 19 higher-stage trainees within 6 months of completing their postgraduate training and 1 staff grade, associate specialist or specialty doctor, were recruited to the 9-month longitudinal audio-diary (LAD) study. All completed an entrance interview, 18 completed LADs and 18 completed exit interviews.MethodsData were analysed cross-sectionally and longitudinally using thematic Framework Analysis.ResultsParticipants experienced a multiplicity of expected and unexpected, positive and negative work-related transitions (eg, new roles) and home-related transitions (eg, moving home) during their trainee–trained doctor transition. Factors facilitating or inhibiting successful transitions were identified at various levels: individual (eg, living arrangements), interpersonal (eg, presence of supportive relationships), systemic (eg, mentoring opportunities) and macro (eg, the curriculum provided by Medical Royal Colleges). Various impacts of transitions were also identified at each of these four levels: individual (eg, stress), interpersonal (eg, trainees’ children spending more time in childcare), systemic (eg, spending less time with patients) and macro (eg, delayed start in trainees’ new roles).ConclusionsPriority should be given to developing supportive relationships (both formal and informal) to help trainees transition into their trained doctor roles, as well as providing more opportunities for learning. Further longitudinal qualitative research is now needed with a longer study duration to explore transition journeys for several years into the trained doctor role.

Abstract

Recent literature on hybridity has provided useful insights into how professionals have responded to changing institutional logics. Our focus is on how shifting logics have shaped senior medical professionals’ identity motives and identity work in a qualitative study of hospital consultants in the United Kingdom’s National Health Service. We found a binary divide between a large category of traditionalist doctors who reject shifting logics, and a much smaller category of incorporated consultants who broadly accept shifting logics and advocate change, with little evidence of significant ambivalence or temporary identity ‘fixes’ associated with liminality. By developing a new inductively generated framework, we show how the identity motives and identity work of these two categories of doctors differ significantly. We explore the underlying causes of these differences, and the implications they hold for theory and practice in medical professionalism, medical professional leadership and healthcare reform.