Becoming a practitioner: workplace learning during the junior doctor's first year

Newly qualified doctors (interns) report that they learn a great deal in the first year of practice, but exactly what is learnt is not well understood.

To document the reflections and perceptions of first year junior doctors in order to reveal and chronicle their informal and often tacit learning in the workplace within a practice methodology framework.

New Zealand interns, from three sites, participated in group interviews modelled on a conversation and joint enquiry style.

We found that learning in the first year after graduation falls into three broad themes: (1) concrete tasks, (2) project management and (3) identity formation. Identity formation appeared the most challenging and included getting used to being seen by others as a doctor.

All themes have implications for curriculum development and clinical supervision in both undergraduate programmes and during internship. The third theme (identify formation) is the most complex. We draw on a model from management literature, to describe intern education as a process of becoming: as an unfolding and as a transformation of the self over time. We argue that reconfiguring internship as a period of identity formation, and as a self-determined, active process of 'becoming a doctor' provides a wider perspective than enculturation or socialisation theories to understand this significant transition.