Students of Color and the “Doctor Dynasty”: The Dual Realities of Newly-Enrolled Medical School Students’ Socialization and Professional Identity Formation

Abstract

The process of “becoming” a physician is influenced by a variety of factors, including personal histories, experiences with access and opportunities, roles in service, and values formed. How medical professionals are socialized has serious implications for how medicine is practiced. In understanding the professional identity formation process of newly accepted medical students, my research intends to contribute to exploring the gap of and fully understanding the process and role of professional identity formation of this particular group. While literature exists around physician identity, there is very little focus around the identity of those who have been admitted to medical school, and who aspire to practice medicine, as well as their perceptions of how the act of volunteerism impacts their identity, along with their impressions of what qualities define a physician. The research study sought to answer these questions: 1. What comprises the identity of a newly accepted medical student? 2. How does their educational and experiences shape their professional identity development? 3. Specifically, what are the characteristics of professional identity development? 4. How do they negotiate their professional identity and consider their role beyond the clinical aspect? 5. How do they plan to navigate life’s most difficult conversations that come with the territory of being part of a profession that is responsible for the lives of others? 6. Are they prepared for having difficult conversations with patients and their families around poor outcomes? 7. How do they define a “well-prepared” physician, and what qualities encompass a physician? What values are important to them, and what communities to they serve? Do they have a specific emphasis or lens by which they practice medicine? These questions illuminate a gap that I seek to better understand by conducting a series of qualitative interviews with newly accepted medical students in an attempt to further understand their developmental process as well as performing an in-depth review of classic and modern literature informing a contextual framework for ongoing analysis. My findings from the interviews reveal two groups experiencing dual realities as they become members of the same profession. These two groups can be described as a cohort of first-generation students of color. The second, are members of the doctor dynasty, whose parents and/or grandparents are physicians. I will explore this notion of first-generation students of color experiencing disruption to their identity formation process versus continuity of access and privilege within members of the doctor dynasty. While the first group has experienced ongoing rerouting in their process of becoming physicians, members of the doctor dynasty have been given ongoing support, and unlimited resources to succeed in medicine, along with quality mentorship. I will also report on findings around the socialization process prior to medical school that shapes their values, understanding and definition of what being a physician means. This dissertation contributes to prior literature regarding the need for reform around first-generation student of color supports in medical school, more specifically, with positive mentorship. By highlighting the inherent strengths of the group, along with the elements that contribute to the disruption of their professional identity formation, this dissertation challenges an existing medical education model that is failing students that are not part of the doctor dynasty. While literature exists around physician identity, there has been very little focus around the identity of those who have been just admitted to medical school, and who aspire to practice medicine, as well as their perceptions of practicing medicine on an emotional realm from the perspective of a first-generation medical student of color. Implications of my study include fostering awareness around the vulnerabilities of the socialization process. In addition, high quality mentorship, and locating support systems within medicine, and for faculty and administrators to recognize when students may need additional support. Mentorship, fundamentally, is the mechanism for the transmission of both professional and personal values. Ultimately, these gaps in support and mentorship reflect the values of the academy, and the overall culture of the medical profession as one that is built to serve the elite. This study highlights this gap among two very different groups who are entering the same profession with dualities in their socialization process into medicine.