Medical students grapple with negotiating their personal and professional identities (1). Whether this negotiation is cultural and context dependent is unknown.

This study explores how undergraduate medical students in two different educational settings, Durham University in the UK and the Mayo Clinic in the USA negotiation their identities.

Year 1 and 2 medical students at each institution participated in semi-structured interviews or focus groups

(Mayo: n= 35, Durham: n= 45)

Data were collected and analysed in accordance with grounded theory; interative cycles, constant comparison, member checking, open, axial and selective coding. 

Similarities in how students negotiated their professional idenitiy formation were: The professionalism bar is always moving – uncertain what’s expected 

Students have multiple facets of self – modulate ‘version of self’ depending on who is present and the environmental context

Virtual context of identity always considered 

Role-modeling- important factor in identity formation, positive and negative examples  

Medicine results in a loss of personal identity

Scruitny of behaviour leads to resentment 

The Hidden Curriculum significantly impacts how students negoitiate their identities- this includes environmental factors too 

Differences were:

USA- stronger organisational culture and thus organisational identity. Identity was validated by dressing the part. 

UK - identity informed, in part, by their own experiences as a patient. Less emphasis on the organisational culture of their Higher Education institution or the NHS. 

There is an ever increasing expectation for medical students to become mini-doctors from day one of medical school. Often, this makes students unable to go through a transitional or developmental period. Subsequently, they struggle to negotiate their personal and professional identities. Despite some cultural differences, medical students in the UK and USA experiences similar scrutiny and thus anxieties.

Despite differing societal expectations, educational settings and cultures, all medical students struggle with identity negotiation and formation. Work needs to be done to aid students in their transition from student to clinician. Examples of positive role-modelling and positive aspects of organisational culture need signposting to students to enable their identities to be positvely reinforced. 

Thanks to Fred Hafferty and Wojciech Pawlina for hosting Gabrielle at the Mayo Clinic. 

Finn, Gabrielle Maria, Garner, Jayne & Sawdon, Marina (2010). "You're judged all the time!" Students' views on professionalism: A multi-centre study. Medical Education 44(8): 814-825.