"Can You Hear Me? Can Anybody Pretty Please Validate [Me]?": The Long Shadow of Separation and Liminality in Military...

Much of the current literature on remediation centers on procedural steps, due process, and the implementation of model programs. However, these studies frequently omit the critical perspective of the learners undergoing the process, which can reveal hidden forces that shape medical students' experiences.

We conducted narrative interviews with 15 practicing physicians who remediated as medical students 5-15 years ago. Data were analyzed by examining plot, characters, and event sequences. Upon identifying a pattern of stages, we applied van Gennep's three-phase framework of rites of passage: separation, liminality, and aggregation.

Remediation remained a vivid, salient experience for participants, characterized by disorientation. Separation was marked by strained community interactions and symbolic "parting." The liminal phase involved isolation and ambiguity while awaiting institutional decisions. Notably, aggregation, reintegration into the medical community, was achieved by few; more than half of the participants still feel excluded or marginalized years later.

Remediation is a harrowing process with long-lasting professional consequences. While all participants experienced separation and liminality, the failure to achieve aggregation highlights the "long shadow" remediation casts over a remediated physicians' career. We suggest that remediation committees consider providing a ritual specific to the reintegration phase to ensure learners feel successfully folded back into the professional community.