Review2020

‘Whispers and shadows’: A critical review of the professional identity literature with respect to minority physicians

Tasha R. Wyatt · Dorene F. Balmer · Nicole Rockich‐Winston · Candace J. Chow · Joslyn Richards · Zareen Zaidi

128 citations0/0 files storedMedical Education

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Diversity and Career in Medicine Innovations in Medical Education Cultural Competency in Health Care

Abstract

OBJECTIVES: Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under-represented in medicine (URM). This meta-ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians. METHODS: Data were gathered using a search of six well-known medical education journals for the term 'professional identit*' in titles, keywords, abstracts and subheadings, delineated with the date range of 2012-2019. All non-relevant abstracts were removed and papers were then further reduced to those that focused only on learners' experiences. This left 67 articles in the final dataset, which were analysed using a collaborative approach among a team of researchers. The team members used their professional expertise as qualitative researchers and personal experiences as minoritised individuals to synthesise and interpret the PIF literature. RESULTS: Four conceptual categories were identified as impacting PIF: Individual versus Sociocultural Influences; the Formal versus the Hidden Curriculum; Institutional versus Societal Values; and Negotiation of Identity versus Dissonance in Identity. However, a major gap was identified; only one study explored experiences of PIF in URM physicians and there was an almost complete absence of critical stances used to study PIF. Combined, these findings suggest that PIF research is building on existing theories without questioning their validity with reference to minoritised physicians. CONCLUSIONS: From a post-colonial perspective, the fact that race and ethnicity have been largely absent, invisible or considered irrelevant within PIF research is problematic. A new line of inquiry is needed, one that uses alternative frameworks, such as critical theory, to account for the ways in which power and domination influence PIF for URM physicians in order to foreground how larger sociohistorical issues influence and shape the identities of minoritised physicians.

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Cited by

2024Manifestations of professional identity work: an integrative review of research in professional identity formation 2022Association Between Resident Race and Ethnicity and Clinical Performance Assessment Scores in Graduate Medical Education 2021The do’s, don’ts and don’t knows of redressing differential attainment related to race/ethnicity in medical schools 2023Intersectionality in Medical Education: A Meta-Narrative Review 2023How Do Academic Medicine Pathways Differ for Underrepresented Trainees and Physicians? A Critical Scoping Review

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