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Personal, public, and professional identities : conflicts and congruences in medical school

University of British Columbia

Most research on medical professional socialization was conducted when medical students were almost uniformly white, upper- to upper-middle class, young men. Today 50% of medical students in Canada are women, and significant numbers are members of racialized minority groups, come from working class backgrounds, identify as gay or lesbian, and/ or are older. This research examined the impact of such social diversity on processes of corriing to identify as a medical professional, drawing on a survey of medical students in one third-year class, interviews with 25 third-year students, and interviews with 23 medical school faculty members. Almost all of the traits and processes noted by classic studies of medical professional socialization were found to still apply in the late 1990s. Students learn to negotiate complex hierarchies; develop greater self-confidence, but lowered idealism; learn a new language, but lose some of their communication skills with patients. They begin playing a role that becomes more real as responses from others confirm their new identity. Students going through this training process achieve varying degrees of integration between their medical-student selves and the other parts of themselves. There is a strong impetus toward homogeneity in medical education. It emphasizes the production of neutral, undifferentiated physicians - physicians whose gender, 'race/ sexual orientation, and social class background do not make any difference. While there is some recognition that patients bring social baggage with them into doctor-patient encounters, there is very little recognition that doctors do too, and that this may affect the encounter. Instances of blatant racism, sexism, and homophobia are not common. Nonetheless, students describe an overall climate in the medical school in which some women, students from racialized minority groups, gays and lesbians, and students from working class backgrounds seem to 'fif less well. The subtlety of these micro-level experiences of gendering, racialization and so on allows them to co-exist with a prevalent individual and institutional denial that social differences make any difference. I critique this denial as (unintentionally) oppressive, rooted in a liberal individualist notion of equality that demands assimilation or suppression of difference.

Thesis/Dissertation

application/pdf

2009-06-29

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http://hdl.handle.net/2429/9814

Sociology

University of British Columbia

UBCV

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