Trajectories of a doctor’s professional development: a narrative interview. Part 2

BACKGROUND: This article is a continuation of the article by Prisyazhnaya NV, Vyatkina NYu. Trajectories of a doctor's professional development: a narrative interview. Part 1. Sociology of Medicine. 2023;22(2):183–201. DOI: https://doi.org/10.17816/socm632475

The training of personnel resources (specialists) of the health care system is one of the strategic tasks of the state level. At the present stage, there remains a high demand (interest) in obtaining medical education, as one of the most prestigious and socially significant. In turn, this requires serious training of the applicant in specialized disciplines at the stage of pre-university education, and most importantly — motivation to obtain the profession of a doctor and the presence of certain personal qualities — such as empathy, sympathy for patients, responsibility, scrupulousness, high performance. However, young doctors face a number of difficulties at the start of their career (high level of workload and responsibility, difficulties in adapting to working conditions and insufficient remuneration), which may influence their decision to move to a related field of work or not to work in their speciality.

AIM: To study the trajectories of professional development of a young doctor in the Russian health care system in modern conditions.

METHODS: The study of the trajectories of professional development of young doctors was conducted by the method of narrative interview (n=52) in September–December 2022 on the basis of the Institute of Social Sciences of Sechenov University. The study involved young therapists (n=11), pediatricians (n=11), obstetricians and gynecologists (n=10), dentists (n=10), surgeons (n=10). The average age of respondents was 28.2 years (median — 28 years), the average work experience of respondents in the specialty was 2.8 years (median — 3 years).

RESULTS: Analysis of the study data included the identification of key narrative strategies, plot, personalities (respondent, family members, teachers at school, university faculty, colleagues) and temporal characteristics of stories. Analysis of the array of narratives made it possible to identify three key, semantic-semantic data blocks (including seven subgroups), which acted as the empirical basis for the standard plot of narratives. The first two key semantic-semantic blocks (stages) were described earlier: the pre-university stage (“playing the profession” (3–7 years); “premonition” of professional choice (8–11 years old); professional self-determination or formation of professional intentions (12–17 years); university stage (obtaining medical education as the “foundation” of professional socialization (1–2 courses); determination of the desired trajectory of the professional path (3–6 course). This article reveals the third block of the plot of narratives, including the postgraduate stage (debut of professional activity (residency); “challenges of professional autonomy”).

CONCLUSION: The trajectories of professional socialization of a doctor at the present stage receive a new sound due to the transformation of the professional environment and the digitalization of practical healthcare, which determines these changes.