Students of Color and the “Doctor Dynasty”: The Dual Realities of Newly-Enrolled Medical School Students’ Socialization and Professional Identity Formation

The process of “becoming” a physician is influenced by a variety of factors, including personal histories, experiences with access and opportunities, roles in service, and values formed. How medical professionals are socialized has serious implications for how medicine is practiced. In understanding the professional identity formation process of newly accepted medical students, my research intends to contribute to exploring the gap of and fully understanding the process and role of professional identity formation of this particular group. While literature exists around physician identity, there is very little focus around the identity of those who have been admitted to medical school, and who aspire to practice medicine, as well as their perceptions of how the act of volunteerism impacts their identity, along with their impressions of what qualities define a physician. The research study sought to answer these questions: 1. What comprises the identity of a newly accepted medical student? 2. How does their educational and experiences shape their professional identity development? 3. Specifically, what are the characteristics of professional identity development? 4. How do they negotiate their professional identity and consider their role beyond the clinical aspect? 5. How do they plan to navigate life’s most difficult conversations that come with the territory of being part of a profession that is responsible for the lives of others? 6. Are they prepared for having difficult conversations with patients and their families around poor outcomes? 7. How do they define a “well-prepared” physician, and what qualities encompass a physician? What values are important to them, and what communities to they serve? Do they have a specific emphasis or lens by which they practice medicine? These questions illuminate a gap that I seek to better understand by conducting a series of qualitative interviews with newly accepted medical students in an attempt to further understand their developmental process as well as performing an in-depth review of classic and modern literature informing a contextual framework for ongoing analysis. My findings from the interviews reveal two groups experiencing dual realities as they become members of the same profession. These two groups can be described as a cohort of first-generation students of color. The second, are members of the doctor dynasty, whose parents and/or grandparents are physicians. I will explore this notion of first-generation students of color experiencing disruption to their identity formation process versus continuity of access and privilege within members of the doctor dynasty. While the first group has experienced ongoing rerouting in their process of becoming physicians, members of the doctor dynasty have been given ongoing support, and unlimited resources to succeed in medicine, along with quality mentorship. I will also report on findings around the socialization process prior to medical school that shapes their values, understanding and definition of what being a physician means. This dissertation contributes to prior literature regarding the need for reform around first-generation student of color supports in medical school, more specifically, with positive mentorship. By highlighting the inherent strengths of the group, along with the elements that contribute to the disruption of their professional identity formation, this dissertation challenges an existing medical education model that is failing students that are not part of the doctor dynasty. While literature exists around physician identity, there has been very little focus around the identity of those who have been just admitted to medical school, and who aspire to practice medicine, as well as their perceptions of practicing medicine on an emotional realm from the perspective of a first-generation medical student of color. Implications of my study include fostering awareness around the vulnerabilities of the socialization process. In addition, high quality mentorship, and locating support systems within medicine, and for faculty and administrators to recognize when students may need additional support. Mentorship, fundamentally, is the mechanism for the transmission of both professional and personal values. Ultimately, these gaps in support and mentorship reflect the values of the academy, and the overall culture of the medical profession as one that is built to serve the elite. This study highlights this gap among two very different groups who are entering the same profession with dualities in their socialization process into medicine

Stratified University Strategies: The Shaping of Institutional Legitimacy in a Global Perspective

Globalizing forces have both transformed the higher education sector and made it increasingly homogenous. Growing similarities among universities have been attributed to isomorphic pressures to ensure and/or enhance legitimacy by imitating higher education institutions that are perceived as successful internationally, particularly universities that are highly ranked globally (Cantwell & Kauppinen, 2014; DiMaggio and Powell, 1983). In this study, we compared the strategic plans of 78 high-ranked, low-ranked, and unranked universities in 33 countries in 9 regions of the world. In analyzing the plans of these 78 universities, the study explored patterns of similarity and difference in universities' strategic positioning according to Suchman's (1995) 3 types of legitimacy: cognitive, pragmatic, and moral. We found evidence of stratified university strategies in a global higher education landscape that varied by institutional status. In offering a corrective to neoinstitutional theory, we suggest that patterns of globalization are mediated by status-based differences in aspirational behavior (Riesman, 1958) and "old institutional" forces (Stinchcombe, 1997) that contribute to differently situated universities pursuing new paths in seeking to build external legitimacy.18 month embargo; published online: 13 Sep 2018This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

White Matter Plasticity in the Adult Brain

The study of brain plasticity has tended to focus on the synapse, where well-described activity-dependent mechanisms are known to play a key role in learning and memory. However, it is becoming increasingly clear that plasticity occurs beyond the synapse. This review focuses on the emerging concept of white matter plasticity. For example, there is growing evidence, both from animal studies and from human neuroimaging, that activity-dependent regulation of myelin may play a role in learning. This previously overlooked phenomenon may provide a complementary but powerful route through which experience shapes the brain

Statement in Support of: “Virology under the Microscope—a Call for Rational Discourse”

[Extract] We, members of the Australasian Virology Society, agree with and support the statement entitled “Virology under the Microscope—a Call for Rational Discourse” (1). Like virologists everywhere, we have worked with scientist and clinician colleagues worldwide to develop knowledge, tests, and interventions which collectively have reduced the number of deaths due to COVID-19 and curtailed its economic impact. Such work adds to the extraordinary achievements resulting from virology research that have delivered vaccines and/or antivirals against a long list of diseases and global scourges, including AIDS, smallpox, and polio (1). We believe the question of the origin of SARS-CoV-2 should be approached with an open mind and in consideration of the best scientific evidence available. We concur with the view that the zoonosis hypothesis has the strongest supporting evidence (2–4), and this is a scenario that has been observed repeatedly in the past (5), including in Australia (6). Recent data strongly support the zoonosis hypothesis (7). We share the concern that emotive and fear-based dialogues in this area add to public confusion and can lead to ill-informed condemnation of virology research