'I don't feel like I'm learning how to be a doctor': early insights regarding the impact of Covid-19 on UK medical student professional identity
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Oct 24, 2022
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Abstract
Introduction
Professional identity formation is a priority of medical training. Covid-19 caused disruption to medical education. We ask how this disruption impacted professional identity formation through the lens of the activities performed – or not performed – by medical students during the first wave of the covid-19 pandemic, and perceptions of conflicts between these activities.
Methods
A pragmatic mixed-methods survey was distributed to medical students in the UK. The survey was active from 2nd May to 15th June 2020, during the height of the first wave of the Covid-19 pandemic in the UK. Operating within the paradigm of constructivism, we conducted a reflexive thematic analysis of qualitative responses to three open questions. Analysis was focused around the disruption to medical education, actions taken by medical students during this disruption, and the tension between student actions (where they existed in conflict).
Results
We analysed 928 responses and constructed three themes:
Status and role as a future doctor
Status and role as a student
Status and role as a member of the wider community
Conflict arose at the intersections between these three themes. Students noted that lack of clinical exposure was detrimental to their education, implicitly recognising that some aspects of professional identity formation require the clinical environment. Participants were keen to volunteer clinically, but struggled to balance this and academic work. Participants worried about risk to their families and the wider community and wanted to ensure their skills added value to the clinical environment. Volunteers felt frustrated when they were unable to perform tasks aligning with their identity as a future doctor. An exception was participants who worked as interim FY1s, aligned with the role of an FY1.
Conclusions
Medical students feel a duty to help during crises. There is conflict when different aspects of their identity demand different actions. Covid-19 heightened issues with developing professional identity for medical students, including lack of a defined role, and perceived undervaluing of their skills by other members of the healthcare team. Care must be taken to nurture professional identity formation even during periods of disruption.
Professional identity formation is a priority of medical training. Covid-19 caused disruption to medical education. We ask how this disruption impacted professional identity formation through the lens of the activities performed – or not performed – by medical students during the first wave of the covid-19 pandemic, and perceptions of conflicts between these activities.
Methods
A pragmatic mixed-methods survey was distributed to medical students in the UK. The survey was active from 2nd May to 15th June 2020, during the height of the first wave of the Covid-19 pandemic in the UK. Operating within the paradigm of constructivism, we conducted a reflexive thematic analysis of qualitative responses to three open questions. Analysis was focused around the disruption to medical education, actions taken by medical students during this disruption, and the tension between student actions (where they existed in conflict).
Results
We analysed 928 responses and constructed three themes:
Status and role as a future doctor
Status and role as a student
Status and role as a member of the wider community
Conflict arose at the intersections between these three themes. Students noted that lack of clinical exposure was detrimental to their education, implicitly recognising that some aspects of professional identity formation require the clinical environment. Participants were keen to volunteer clinically, but struggled to balance this and academic work. Participants worried about risk to their families and the wider community and wanted to ensure their skills added value to the clinical environment. Volunteers felt frustrated when they were unable to perform tasks aligning with their identity as a future doctor. An exception was participants who worked as interim FY1s, aligned with the role of an FY1.
Conclusions
Medical students feel a duty to help during crises. There is conflict when different aspects of their identity demand different actions. Covid-19 heightened issues with developing professional identity for medical students, including lack of a defined role, and perceived undervaluing of their skills by other members of the healthcare team. Care must be taken to nurture professional identity formation even during periods of disruption.
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