Professional identity formation of family medicine residents in Singapore: a qualitative study to identify influencing factors.
Professional identity formation in family medicine residents is influenced by psychological senses and socialization, suggesting a need for intentional curriculum support.
Where it sits
this study against the rest of the melanotan 1 corpusSummary and findings
This qualitative study explored the professional identity formation (PIF) of family medicine residents in a hospital-based program in Singapore. Thirteen participants were interviewed to identify factors influencing PIF. The study found that psychological senses and socialization are key to PIF development.
Abstract
<h4>Background</h4>Physician burnout and retention are critical challenges in Family Medicine (FM). Professional Identity Formation (PIF) in family physicians (FP) fosters resilience and job satisfaction but is often overlooked in residency training, particularly in predominantly hospital-based programs where residents are disconnected from the primary care community.<h4>Aim and methods</h4>This qualitative study explored FP PIF in a predominantly hospital-based FM residency program in Singapore and identified factors influencing its development. Individual in-depth semi-structured interviews were conducted with FM residents and post-residency FPs selected through maximum variation purposive sampling. Data was collected and analysed iteratively using Braun and Clarke's reflexive thematic analysis. Cruess et al.'s conceptual model for PIF was used as a sensitising framework, alongside Lankveld et al.'s framework describing psychological processes underlying identity formation.<h4>Results</h4>Thirteen participants were interviewed. Three themes were constructed. First, FP PIF wasunderpinned by four psychological 'senses' of competence, connectedness, appreciation, and career trajectory. Second, reflection and socialization drove development of these senses by enabling meaning-making, learning and belonging within the FM community of practice (CoP). Third, residency program features both enabled and/or constrained PIF; while some components scaffolded PIF, more intentional support was needed.<h4>Discussion and conclusion</h4>PIF is a dynamic, context-dependent psychological process shaped by reflective practice, social participation, and program structure. Intentional support through curriculum design and faculty practices may strengthen PIF. These findings extend existing PIF frameworks and have implications for curriculum design, faculty development, program evaluation, and future research on fostering PIF in hospital-based residency training.
Background
Physician burnout and retention are significant challenges in family medicine, with professional identity formation (PIF) being a crucial factor for resilience and job satisfaction. However, PIF is often overlooked in residency training, especially in hospital-based programs where residents may be disconnected from the primary care community. This study addresses the gap by exploring PIF in family medicine residents in Singapore, aiming to identify factors that influence its development.
Methods
This qualitative study used individual in-depth semi-structured interviews with family medicine residents and post-residency family physicians in Singapore. Participants were selected through maximum variation purposive sampling. Data was collected and analyzed iteratively using Braun and Clarke's reflexive thematic analysis, with Cruess et al.'s model for PIF and Lankveld et al.'s framework on identity formation as guiding frameworks.
Results
The study interviewed thirteen participants and identified three main themes. First, family physician PIF is underpinned by four psychological 'senses': competence, connectedness, appreciation, and career trajectory. Second, reflection and socialization were found to drive the development of these senses by facilitating meaning-making, learning, and belonging within the family medicine community of practice. Third, the features of the residency program both enabled and constrained PIF, highlighting the need for more intentional support.
Interpretation
The findings suggest that PIF is a dynamic and context-dependent process influenced by reflective practice, social participation, and program structure. While the study extends existing PIF frameworks, the small sample size and qualitative design limit the generalizability of the results. The study implies that curriculum design and faculty practices should intentionally support PIF to enhance resilience and job satisfaction among family medicine residents.
Key findings
- Thirteen participants were interviewed.
- Four psychological 'senses' underpin FP PIF: competence, connectedness, appreciation, and career trajectory.
- Reflection and socialization drive development of these senses.
- Residency program features both enabled and constrained PIF.
Limitations
- Small sample size of thirteen participants.
- Qualitative study limits generalizability.
- Focus on a single residency program in Singapore.