Reflecting on experiences of resident redeployment during the COVID-19 pandemic: Implications for leadership and theory beyond the crisis.

introductionThis study explored medical residents' experiences of redeployment during the COVID-19 pandemic. With the benefit of time and reflection, this study went beyond an 'educational deficit' perspective on redeployment and examined these experiences to better understand enduring tensions in medical education, prepare leaders for ongoing tensions and future crises, and to inform professional identity formation theory.

methodsThis was a qualitative, interpretive study informed by professional identity formation concepts related to work-identity integrity threats. Between April and November 2023, 15 residents from seven specialties at a large urban university in Canada were interviewed about redeployment processes and experiences. An abductive analysis approach was used to examine how residents made meaning of their profession, specialty and workplace in light of these experiences.

resultsThe meaning participants made of redeployment processes depended on their interpretations of fairness, alignments with their perceived identity as a physician, and sense of usefulness during redeployment experiences. While participants noted a lack of socialisation and connection within their specialty as potentially disruptive to professional identity formation, broader sociopolitical dynamics (e.g. anti-vaccine movements) and local microcontexts (e.g. appreciative clinical teams) mattered most in their reflections. Experiences of redeployment elicited reflections on historical relationships between specialties. Some of those reflections were specific to the pandemic context, while others prompted broader reconsiderations of trends towards hyperspecialisation within the profession. DISCUSSION: These results provide insight into how future crises might be best approached, but also how wellness and resilience might be supported in non-crisis situations. This analysis also suggests a potential unfreezing of long-standing interspecialty tensions. The endurance of these shifting dynamics is worth exploring, particularly in light of policy imperatives towards more flexible and responsive systems. Theoretically, this analysis invites considerations of professional identity formation to better account for broader sociopolitical dynamics and the local dynamics of workplaces.