A Schematic Representation of the Professional Identity Formation and Socialization of Medical Students and Residents

Abstract

Recent calls to focus on identity formation in medicine propose that educators establish as a goal of medical education the support and guidance of students and residents as they develop their professional identity. Those entering medical school arrive with a personal identity formed since birth. As they proceed through the educational continuum, they successively develop the identity of a medical student, a resident, and a physician. Each individual's journey from layperson to skilled professional is unique and is affected by "who they are" at the beginning and "who they wish to become."Identity formation is a dynamic process achieved through socialization; it results in individuals joining the medical community of practice. Multiple factors within and outside of the educational system affect the formation of an individual's professional identity. Each learner reacts to different factors in her or his own fashion, with the anticipated outcome being the emergence of a professional identity. However, the inherent logic in the related processes of professional identity formation and socialization may be obscured by their complexity and the large number of factors involved.Drawing on the identity formation and socialization literature, as well as experience gained in teaching professionalism, the authors developed schematic representations of these processes. They adapted them to the medical context to guide educators as they initiate educational interventions, which aim to explicitly support professional identity formation and the ultimate goal of medical education-to ensure that medical students and residents come to "think, act, and feel like a physician."

Social support in the workplace for physicians in specialization training

“…In the context of medical workplace learning, however, both identity and relational functions are important, because they work toward the objectives of specialization training, toward professional identity formation [32]. Every senior is an important role model in the identity formation process [36], and it is extremely important to be aware that every professional encounter may reinforce or hinder the process of professional identity formation. Every supportive encounter also enhances resources to manage stress and that way it enhances learning.…”

“…This phase of medical studies calls for reflection, which is a central process in professional identity formation [35]. Thus, learning through service is an important arena for one’s professional identity formation, and role models and mentors have a crucial role in the process [36]. However, the medical workplace is a demanding organizational and interpersonal environment.…”

Trustingly bewildered. How first-year medical students make sense of their learning experience in a traditional, preclinical curriculum

“…Participation in this ‘community of practice’ [10] fosters a dynamic student identity that evolves over the years. This identity is influenced by the cognitive input of explicit teaching practices, but even more by each individual’s largely unconscious internalizations of the behaviors, language, and conceptions of knowledge and quality inherent in medical teaching, clinical practice, and the informal aspects of academic and student environments [3,8,11–13]. The evolving medical student identity is the stem from which develops the future physicians’ full-fledged professional identity, capability and outlook, embodying the tacit norms of physicianship [14,15], of good and right medical actions [16,17], of what it means to be ‘a real doctor’ [18,19].…”

Core Entrustable Professional Activities for Entering Residency Pilot Group Update: Considerations for Medical Science Educators

“…The need for professional, trustworthy behaviors in early educational activities can be framed around preparation for intern duties. This reminder of one's future responsibility for patients may shift student focus from scores and grades, providing an alternate perspective that facilitates professional identity formation [9].…”