"To Serve My Community Better": Exploring Resistor Identity Formation and Its Impact on Physician Professional...

Area of Science:

• Medical Education
• Professional Identity Formation
• Social Justice in Healthcare

Background:

• Medical training often exposes trainees to systemic social harms like racism and sexism.
• Advocacy and professional resistance are inadequately addressed in U.S. medical education.
• Trainees lack structural support when confronting and resisting social injustice.

Purpose of the Study:

• To explore how medical trainees develop a
• resistor identity.
• To understand how this resistor identity shapes their professional identity as physicians committed to challenging systemic injustices.

Main Methods:

• Qualitative approach utilizing constructivist grounded theory.
• Semi-structured interviews with 18 medical trainees engaged in professional resistance.
• Analysis informed by identity frameworks (Selinger, Syed & McLean) and constant comparative analysis.

Main Results:

• Trainee resistor identities emerge from conflicts between professional roles and the desire to address systemic injustice.
• Three identity relationships identified: Conflict (maintaining distinctness), Intertwining (harmonious coexistence), and Integration (transforming professionalism).
• These interrelations are fluid, allowing trainees to expand professional identity to include advocacy and justice.

Conclusions:

• Medical trainees critically reflect on and expand their professional identities to incorporate advocacy and justice.
• The resistor identity enables trainees to challenge privileged norms while maintaining physician competence.
• Acknowledging advocacy and professional resistance is crucial for future physicians' identity development.