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Professional identity formation: creating a longitudinal framework through TIME (Transformation in Medical Education)
Mark D Holden1, Era Buck, John Luk
1M.D. Holden is vice chair, Undergraduate and Continuing Medical Education, and professor and director, General Internal Medicine, University of Texas Medical Branch, Galveston, Texas. E. Buck is senior medical educator, Office of Educational Development, University of Texas Medical Branch, Galveston, Texas. J. Luk is assistant professor of medicine and assistant dean for interprofessional integration, University of Texas Dell Medical School, Austin, and clinical associate professor of pediatrics and assistant dean for regional medical education, University of Texas Medical Branch, Galveston, Texas. F. Ambriz is clinical assistant professor and chair, Physician Assistant Department, University of Texas Pan American, Edinburg, Texas. E.V. Boisaubin is distinguished teaching professor of medicine, University of Texas Medical School at Houston, Houston, Texas. M.A. Clark is visiting scholar, Lincoln Center for Applied Ethics, Arizona State University, Tempe, Arizona. A.P. Mihalic is associate dean for student affairs and professor of pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas. J.Z. Sadler is professor of psychiatry and clinical sciences and Daniel W. Foster, MD Professor of Medical Ethics, University of Texas Southwestern Medical Center, Dallas, Texas. K.J. Sapire is professor of anesthesiology and perioperative medicine, University of Texas MD Anderson Cancer Center, Houston, Texas. J.P. Spike is professor, McGovern Center for Humanities and Ethics, University of Texas Medical School at Houston, Houston, Texas. A. Vince is medical anthropologist and director, University Health Professions Office, University of Texas at San Antonio, San Antonio, Texas. J.L. Dalrymple is assistant dean for clinical integration, and associate professor and division director of gynecologic oncology, Department of Obstetrics and Gynecology, University of Texas Dell Medical School, Austin, Texas.
Abstract:
The University of Texas System established the Transformation in Medical Education (TIME) initiative to reconfigure and shorten medical education from college matriculation through medical school graduation. One of the key changes proposed as part of the TIME initiative was to begin emphasizing professional identity formation (PIF) at the premedical level. The TIME Steering Committee appointed an interdisciplinary task force to explore the fundamentals of PIF and to formulate strategies that would help students develop their professional identity as they transform into physicians. In this article, the authors describe the task force's process for defining PIF and developing a framework, which includes 10 key aspects, 6 domains, and 30 subdomains to characterize the complexity of physician identity. The task force mapped this framework onto three developmental phases of medical education typified by the undergraduate student, the clerkship-level medical student, and the graduating medical student. The task force provided strategies for the promotion and assessment of PIF for each subdomain at each of the three phases, in addition to references and resources. Assessments were suggested for student feedback, curriculum evaluation, and theoretical development. The authors emphasize the importance of longitudinal, formative assessment using a combination of existing assessment methods. Though not unique to the medical profession, PIF is critical to the practice of exemplary medicine and the well-being of patients and physicians.
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