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Garrett CC, Robinson H, David J, Utz B, Azimov MB. Gaining Respect and Mitigating Risk: A Qualitative Exploration of How New Attendings Navigate Interpersonal Relationships with Recent Resident Peers. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:460-468. [PMID: 39372232 PMCID: PMC11451548 DOI: 10.5334/pme.1396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 09/19/2024] [Indexed: 10/08/2024]
Abstract
Background Physicians moving through training experience changes in personal and professional relationships, which can increase stress, uncertainty, and burnout. Social connection can be an important resource but can introduce complexity and conflict. This study aimed to explore how early-career attendings navigate and manage changing organizational and friendship roles with recent resident peers (near-peers) through this critical transition. Methods We conducted a reflexive thematic analysis of interviews with early-career attendings working with near-peers from the same institution where they trained. Twenty three of 27 (85%) eligible attendings from two United States health systems participated in semi-structured interviews between April and June 2023. Results Familiarity from working at the same institution where new attendings completed training made it more difficult to command authority. Early-career attendings at times struggled with insecurities about their ability to fulfill their new role and challenges from others in recognizing their new attending identity. These tensions could heighten emotions in the clinical setting and spill over into relationships with residents outside the workplace, impacting social lives and well-being. Early-career attendings engaged in strategies to manage the social realm of their transition with near-peers, including prioritizing their organizational role in the clinical setting and mitigating risks to their professional reputation by creating stronger boundaries between their personal and professional lives. Conclusions This study provides new insight into how attendings navigate changing personal and professional relationships with recent resident peers and offers strategies on how to manage the social realm of this liminal transition.
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Affiliation(s)
- Cameryn C. Garrett
- Department of Graduate Medical Education at Community Memorial Healthcare in Ventura, California, USA
| | - Hannah Robinson
- Internal Medicine Residency Program at Community Memorial Healthcare in Ventura, California, USA
| | - Jacob David
- Family Medicine Residency Program at Ventura County Medical Center in Ventura, California, USA
| | - Brian Utz
- Family Medicine Residency Program at Community Memorial Healthcare in Ventura, California, USA
| | - Michelle B. Azimov
- Department of Graduate Medical Education at Community Memorial Healthcare in Ventura, California, USA
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den Bakker CR, Ommering BWC, de Beaufort AJ, Dekker FW, Bustraan J. The bumpy ride to a medical PhD degree: a qualitative study on factors influencing motivation. BMC MEDICAL EDUCATION 2024; 24:159. [PMID: 38373938 PMCID: PMC10875841 DOI: 10.1186/s12909-023-04973-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 12/13/2023] [Indexed: 02/21/2024]
Abstract
INTRODUCTION In parallel with a tremendous increase in medical PhD enrolments, concerns have risen about PhD candidates' poor well-being, increasing attrition rates for PhD programmes, and, eventually, a decline in clinician-scientists. According to the Self-Determination Theory, autonomous motivation is strongly linked to positive aspects of well-being and other positive outcomes such as study completion and success. In this way, motivation has a pivotal role in successful completion of medical doctoral programmes. In this study we explored factors affecting motivation during the PhD journey and aimed to contribute to engaging doctoral education environments, and, eventually, a sustainable clinician-scientist workforce. METHODS This constructivist qualitative interview study was conducted among ten medical PhD candidates in the final phase of their PhD. We used timeline assisted interviews to identify meaningful experiences throughout their PhD journey. Thematic analyses as an iterative process resulted in overarching themes. RESULTS We identified six themes influencing autonomous and controlled motivation along the challenging PhD journey: (1) Initial motivation to start a PhD matters; (2) Autonomy as a matter of the right dose at the right time; (3) PhD as proof of competence and/or learning trajectory?; (4) It takes two to tango; (5) Peers can make or break your PhD; (6) Strategies to stay or get back on track. CONCLUSION This study revealed factors that contribute positively and/or negatively to autonomous and controlled motivation. Some factors impacted motivation differently depending on the PhD phase and individual strategies. Additionally, some factors could coincide and change from positive to negative and vice versa, showing that a successful journey cannot simply be reduced to an absence of negative experiences.
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Affiliation(s)
- C R den Bakker
- Center for Innovation in Medical Education, Leiden University Medical Center, Hippocratespad 23, Zone V7-P, PO Box 9600, 2333 ZD, Leiden, The Netherlands.
| | - B W C Ommering
- Research Centre for Learning and Innovation, Research Group On Research Competence, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - A J de Beaufort
- Center for Innovation in Medical Education, Leiden University Medical Center, Hippocratespad 23, Zone V7-P, PO Box 9600, 2333 ZD, Leiden, The Netherlands
| | - F W Dekker
- Center for Innovation in Medical Education, Leiden University Medical Center, Hippocratespad 23, Zone V7-P, PO Box 9600, 2333 ZD, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - J Bustraan
- Center for Innovation in Medical Education, Leiden University Medical Center, Hippocratespad 23, Zone V7-P, PO Box 9600, 2333 ZD, Leiden, The Netherlands
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Farha N, Bhama A, Tizzano A, Asfaw S, Kim MK, Burke CA. Impostor Phenomenon and Microaggressions in Gastroenterology: Exposing the Tip of the Iceberg. Gastroenterology 2024; 166:11-15.e1. [PMID: 38128970 DOI: 10.1053/j.gastro.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Natalie Farha
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Anuradha Bhama
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Anthony Tizzano
- Department of Surgery, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Sofya Asfaw
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Michelle Kang Kim
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Carol A Burke
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
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Farha N, Bhama A, Tizzano A, Asfaw S, Kim MK, Burke CA. Impostor Phenomenon and Microaggressions in Gastroenterology: Exposing the Tip of the Iceberg. Clin Gastroenterol Hepatol 2024; 22:3-8.e1. [PMID: 38135356 DOI: 10.1016/j.cgh.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Natalie Farha
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Anuradha Bhama
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Anthony Tizzano
- Department of Surgery, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Sofya Asfaw
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Michelle Kang Kim
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Carol A Burke
- Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio
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Cole R, Williamson SS, Hughes JR, Rudinsky SL. The Military Medical Officer's Current-Day Professional Identity: An Enhanced Model. Mil Med 2023; 188:e3667-e3674. [PMID: 37002610 DOI: 10.1093/milmed/usad094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/28/2023] [Accepted: 03/15/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND As the landscapes of war have evolved, so too has the role of the military medical officer (MMO). Colonel (Retired) Barry Wolcott developed a "vector" model in the 1990s, illustrating the dual professional role of the MMO. Since then, propelled by the War on Terror, MMOs have adapted to treating patients in volatile, uncertain, complex, and ambiguous operational environments. This study, therefore, aimed to explore modern-day aspects of the MMO's role in order to enhance Wolcott's depiction of the MMO's professional identity in contemporary operational environments. MATERIALS AND METHODS We used the qualitative phenomenological tradition to design our study. We interviewed military physicians from a variety of specialties in order to explore their experiences and professional identity as MMOs. Our research team then coded each of these interview transcripts. We organized these codes into categories, which served as the themes of our study. RESULTS The following themes emerged from our data regarding the role of the MMO in the operational environment: Primary roles (officer, physician, educator, and diplomat) and aptitudes (innovation, advocacy, cultural competency, and leadership). The MMO's roles as officer and physician often intersect, with dual foci on the mission and the patient. The MMO also serves as an educator to medics and line officers. In addition, they act as diplomats both outside and within the military. Within each of these primary roles, the MMO innovatively prepares for future landscapes of war and advocates for both the individual warfighter and the unit/command. Finally, the MMO navigates both foreign and internal cultural differences and demonstrates leadership in enabling the military's mission. CONCLUSIONS The role of the MMO is complex and multifaceted. The recognition of the contemporary MMO's unique skill set is essential for the effective education and training of future military health care leaders. The value of capitalizing on this unique skill set has been demonstrated in recent civ-mil responses. Because their intricate skill set is specialized for the operational environment, long-term retention of MMOs is key to force readiness.
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Affiliation(s)
- Rebekah Cole
- Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | | | - Joshua R Hughes
- School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Sherri L Rudinsky
- Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD 20814, USA
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Gottlieb M. When I say … imposter syndrome. MEDICAL EDUCATION 2023; 57:1008-1009. [PMID: 37392164 DOI: 10.1111/medu.15160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/03/2023]
Affiliation(s)
- Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
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Mezuk B, Zhong C, Firestone M. Integrative approaches to methods training for early-career scientists: Rationale and process evaluation of the first cohort of the Michigan Integrative Well-Being and Inequality Training Program. J Clin Transl Sci 2023; 7:e169. [PMID: 37588674 PMCID: PMC10425869 DOI: 10.1017/cts.2023.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/10/2023] [Accepted: 07/12/2023] [Indexed: 08/18/2023] Open
Abstract
Background The Michigan Integrative Well-Being and Inequality (MIWI) Training Program aims to provide state-of-the-art, interdisciplinary training to enhance the methodological skills of early-career scientists interested in integrative approaches to understanding health disparities. The goals of this paper are to describe the scientific rationale and core design elements of MIWI, and to conduct a process evaluation of the first cohort of trainees (called "scholars") to complete this program. Methods Mixed methods process evaluation of program components and assessment of trainee skills and network development of the first cohort (n = 15 scholars). Results The program drew 57 applicants from a wide range of disciplines. Of the 15 scholars in the first cohort, 53% (n = 8) identified as an underrepresented minority, 60% (n = 9) were within 2 years of completing their terminal degree, and most (n = 11, 73%) were from a social/behavioral science discipline (e.g., social work, public health). In the post-program evaluation, scholars rated their improvement in a variety of skills on a one (not at all) to five (greatly improved) scale. Areas of greatest growth included being an interdisciplinary researcher (mean = 4.47), developing new research collaborations (mean = 4.53), and designing a research study related to integrative health (mean = 4.27). The qualitative process evaluation indicated that scholars reported a strong sense of community and that the program broadened their research networks. Conclusions These findings have implications for National Institutes of Health (NIH) efforts to train early-career scientists, particularly from underrepresented groups, working at the intersection of multiple disciplines and efforts to support the formation of research networks.
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Affiliation(s)
- Briana Mezuk
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Center for Research Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Chuwen Zhong
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Monica Firestone
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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