Identification with the role of doctor at the end of medical school: a nationwide longitudinal study.

OBJECTIVE

Given the sparse literature on the topic, there is a need to know more about student identification with the role of doctor, particularly with respect to the possible impact of pre-existing and medical school factors.

DESIGN AND PARTICIPANTS

Medical students at all 4 Norwegian universities (n = 421) were mailed questionnaires on entry to their medical course (T1). Respondents were surveyed again halfway through (T2) and at the end (T3) of their 6-year courses. The study sample comprised the 236 students who responded on all 3 occasions.

RESULTS

No significant variation occurred between medical schools in the level of student identification with the role of doctor, except for a significant gender difference at 1 university. Among pre-existing factors, interpersonal problems and confidence in one's own knowledge had independent impact on role identification controlled for gender, age, parental relationships, personality and mental health. This impact was mediated through perceived stress and perceived recording skills, while confidence in knowledge also maintained impact in the final model. Women had a lower level of role identification, with the strongest impact coming from pre-existing factors like interpersonal problems, fear of encountering demanding work, and confidence in own knowledge. For men, change in perceived medical school stress from T2 to T3 and perceived recording/clinical skills had significant impact on the level of role identification.

CONCLUSION

Pre-existing factors, partly mediated through skill acquisition and stressful medical school experiences, influenced role identification. In women, pre-existing factors had a significant impact upon role identification, contrasting with men, whose role identification was more influenced by medical school factors.