Abstract
To explore factors promoting and hampering a medical resident's journey from residency induction to role adaptation into consultant practice. The qualitative, phenomenological study was conducted at the Fatima Memorial Hospital and Sir Ganga Ram Hospital, Lahore, Pakistan, from February to July 2019, and comprised junior residents, senior residents, newly qualified consultants and supervising consultants from four departments. Semi-structured interviews were conducted to achieve theoretical saturation. The interviews were audio-recorded, transcribed verbatim, and along with nonverbal cues notes by the researchers were analysed using Atlas.ti 7. Using interpretive phenomenological analysis protocol, codes were merged into categories to form main themes. Of the 16 subjects, 4(25%) each were junior residents, senior residents, senior registrars and supervising consultants. There were 7(44%) males and 9(56%) females. The mean age of the residents was 30.9±5.03 years and that of the supervisors was 55.3±0.97 years. Overall, 157 codes were developed which led to 18 categories and subsequently to 2 main themes; intrinsic factors and extrinsic factors. The former encompassed physical and emotional health, personality traits, style, personal skills, core knowledge, attribution training, self-selection of career, and previous life experiences. Extrinsic factors included physical/non-physical environment, economic stability, communication of expectations, structured residency programme, regular programme evaluation, society and culture, family, support system, preparation for transition, psychological assistance, role of supervisor, involvement into communities of practice, time for relaxation, opportunity provision, work-life boundaries, and reflective practices. The resident's transition through residency depended upon the interplay of extrinsic and intrinsic factors. A seven-tier resident support model is proposed to corelate the phases and provide a roadmap for resident's assistance and sustenance planning.
Highlights
157 codes were developed which led to 18 categories and subsequently to 2 main themes; intrinsic factors and extrinsic factors
The qualitative, phenomenological study was conducted at the Fatima Memorial
Data was collected using an interview guide based on evidence and validated by experts, which was pilot-tested before using it for the semistructured interviews in the current study (Figure 1)
Summary
A medical doctor needs to lucratively navigate several transitions across medical education trajectory, from novice undergraduate to postgraduate to consultant to become entitled to the title of expert[1]. This transition of medical residents to consultancy is a challenging journey. Transition from residency to consultancy is drastic and dramatic, like a caterpillar making a transition into a butterfly. It is an avenue for change and harbours rich sources of learning and scholarship, but is puzzling, Pr ov is io na lly
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