How is transition to medical practice shaped by a novel transitional role? A mixed-methods study

Area of Science:

• Medical Education
• Doctoral Training
• Healthcare Transition

Background:

• The transition from medical school to Foundation Programme (FP) presents challenges for new doctors.
• A novel interim role, FiY1 (interim Foundation Year 1), was piloted to bridge this gap.
• This role was implemented in response to the COVID-19 pandemic but has broader implications.

Purpose of the Study:

• To evaluate the impact of the FiY1 role on doctors' well-being and preparedness.
• To understand the influences on the transition experience for doctors undertaking FiY1.
• To explore the concept of 'institutionalised liminality' in medical training.

Main Methods:

• A sequential mixed-methods study design.
• Two phases of questionnaires assessing preparedness, stress, anxiety, depression, burnout, and identity.
• Semi-structured interviews with a subset of participants to explore experiences in depth.

Main Results:

• Doctors in FiY1 posts reported significantly higher preparedness for FP compared to non-FiY1 colleagues.
• Preparedness advantage persisted throughout the initial months of the Foundation Programme.
• The FiY1 role fostered 'supported autonomy,' enhancing doctors' independence through structural and interpersonal support, with no apparent long-term detriment to well-being.

Conclusions:

• An explicit transitional role like FiY1 can significantly benefit new doctors.
• The concept of 'institutionalised liminality' effectively describes the structured 'betwixt and between' nature of such roles.
• This framework can guide the optimization of transitional training posts for medical graduates.