Professional identity formation in public health residents: participation in the vast landscape of practice.

backgroundWith the global shift from curative to preventive care, an increasing number of physicians venture in the field of public health (PH), which could entail changes in their scope of practice and professional identity. Professional Identity Formation (PIF) is progressively regarded as a vital part of competency-based medical education. Although it has been extensively studied in clinical settings, less is known about how physicians' PIF unfolds outside of traditional clinical environments and what is required to support this process. This study aims to explore how medical residents' PIF unfolds in the context of PH.

methodsIn this study we used a descriptive qualitative approach, from the perspective of a constructivist paradigm. Cruess's conceptual framework of PIF in medicine served as a sensitizing framework and supported the interpretation of the data. Eleven PH residents and eight recently graduated PH specialists participated in individual interviews or focus groups. Thematic analysis was performed, along with an iterative process of both inductive and deductive coding.

resultsParticipants described the role of a supervisor who is actively involved in the vast landscape of PH and can act as a social catalyzer, as essential in helping them find their professional role. They emphasized the importance of welcoming communities of practice, that give them professional responsibilities to take on tasks aligned with the PH specialty. Participants also expressed the need to reflect on the intersection of personal and professional development. An ambiguous scope of practice and uncertain career perspectives were perceived as inhibiting factors, and could lead to fear of losing legitimacy after residency.

conclusionThis study offers new insights into the role of the supervisor and the sector-specific challenges in PH residency. To counterbalance the negative impact of an unclear scope of practice on PIF, the authors suggest that more attention must be given to the relationship between personal and professional identity and to the complicated participation in the landscape of practice. While this is particularly relevant for PH residents, it may also apply more broadly to all residents who are confronted with the evolving societal and healthcare demands associated with preventive care.