Medical identity; perspectives of students from two countries

Abstract

Background The development of professional identity is a fundamental element of medical education. There is evidence that in Germany, students’ perceptions of the ideal and real doctor differ, and that of themselves as physicians falls between these constructs. We sought to compare students’ perceptions of themselves, the ideal doctor, and the ‘real’ doctor and investigate differences from first to final year in the relationships between these constructs, as well as differences between Australian and German cohorts. Method Students in the first and final years of their medical program at one Australian and one German university were invited to complete the Osgood and Hofstatter polarity profile, involving the description of their mental image of the ideal and real doctor, and the doctor they hope to become, with adjectives provided. Results One hundred sixty-seven students completed the survey in Australia (121 year 1, 46 year 5) and 188 in Germany (164 year 1, 24 year 6). The perception of the ideal doctor was consistent across all respondents, but that of the real doctor and self-image differed between country and year. Differences existed between country cohorts in perceptions of ‘confidence’, ‘strength’, ‘capability’ and ‘security’. Conclusions The pattern previously reported among German students was maintained, but a different pattern emerged among Australian students. Differences between countries could reflect cultural differences or variations in the overt and hidden curricula of medical schools. Some of the constructs within the profiles are amenable to educational interventions to improve students’ confidence and sense of capability.

Insights into discrepancies in professional identities and role models in undergraduate medical education in the context of affective burden

“…Gilligan et al. ( 58 ) conducted a similar study on professional role models amongst medical students in their first semester and final year of medical school in Germany and Australia. Those authors found that perceptions of the ideal physician were common to all respondents, whereas perceptions of real physicians and self-image differed by country and cohort, particularly in perceptions of “confidence”, “strength”, “skills” and “safety”.…”

Adaptations of Clinical Teaching During the COVID-19 Pandemic: Perspectives of Medical Students and Faculty Members

“…Perspectives of medical students from two countries (Germany and Australia) were found to be different, thus, differences between countries could reflect cultural differences or variations in the overt and hidden satisfaction of medical students, hence educational interventions may be needed to improve students’ confidence and sense of competence. 14 …”

“…13 Perspectives of medical students from two countries (Germany and Australia) were found to be different, thus, differences between countries could reflect cultural differences or variations in the overt and hidden satisfaction of medical students, hence educational interventions may be needed to improve students' confidence and sense of competence. 14 The situation is more complex for some clerkships or final year medical students who are in the process of sitting their final assessments. Some medical schools have reduced clinical exposure in the weeks coming up to their final exams to reduce the risk of contracting the virus.…”

Author's reply

“…2 The pandemic aside, interestingly, it has been demonstrated that students' beliefs about certain positive 'medical self' attributes, including empathy and idealism, become diminished throughout medical school training. 3 As students progress and spend more time observing the behaviour of doctors, and perhaps gain more insight into the reality of the job, the perception of an 'ideal doctor' changes to align much more with that of a 'real doctor'. The 'real doctor' is not as hardened as one may think.…”