“It creates a divide”: minoritized medical students’ perceptions of professional identity formation

Abstract

Background: If the task of professional identity formation (PIF) is for the trainee to become acculturated to a specific set of professional values, trainees whose individual identities are already closely aligned with the hegemonic values of medicine might be expected to have an easier PIF process than those trainees who begin their acculturation with individual values that are quite different than the prevailing values in medicine. Method: The present cross-sectional qualitative study examines the PIF experience of 15 medical students who face a range of structural inequalities and cultural constraints in a rural, predominately white medical school setting. Results: Five themes emerged from interviews: 1) participants’ decision to enroll in medical school was substantially influenced by family and broader community; 2) participants' expectations about starting medical school were not met; 3) participants perceived they were different from other medical students and also from the stereotypical physician; 4) participants felt pressure to adjust their personal identity; and 5) participants drew from personal identities to cope with stress. Discussion: These qualitative findings suggest that many participants felt their identity was often an asset in connecting with patients. Concurrently, participants felt a responsibility to return to practice in their home communities, which may represent a uniqueburden. Furthermore, some felt pressure to compromise or change their individual identity to be successful in medical culture. The task for medical schools may be to help students view their identities as a unique advantage, rather than something they need to quell or minimize to be successful.