Symbols and rituals are alive and well in clinical practice in Australia: Perspectives from a longitudinal qualitative professional identity study

Abstract

Purpose Many factors impact an individual’s professional identity on their journey to becoming a doctor, including their experiences, the learning environment, role models, and symbols and rituals. Rituals and symbols associated with the medical profession have historically included wearing a white coat (now rare) and the stethoscope. This study explored two medical students’ perspectives of symbolic identifiers in a six-year longitudinal study in Australia (2012–2017). Methodology A 2012 qualitative cross-sectional qualitative professional identity study in an Australian five-year undergraduate medical programme was extended to a longitudinal study with annual interviews. A conversation about the symbolism of the stethoscope and other identifiers began in Year 1 and concluded when the students were junior doctors. Findings Symbols and rituals remain part of the ‘becoming’ and ‘being’ a doctor. In the context of Australian hospitals, the stethoscope appears to no longer be exclusively associated with the medical profession, with ‘professional attire’ distinguishing medical students and doctors from other team members (uniform). The study identified lanyard colour and design as a symbol and language as a ritual. Conclusions Although symbols and rituals may change over time and across cultural contexts, some forms of treasured material possessions and rituals will persist in medical practice. Practice points On the journey of ‘becoming’ and eventually ‘being’ a doctor, many factors influence the development of an individual’s professional identity, not least symbols and rituals. For a range of reasons, e.g. cultural, contamination, symbols and rituals change but will be replaced. In Australia, and perhaps in other similar contexts, The stethoscope, once seen as an extension of a doctor’s anatomy, may no longer be perceived as such, making way for other identifiers such as lanyards and ‘professional attire.’ COVID-19 may influence some symbols and rituals, but this will depend on the persistence of SARS-CoV-2 variants.