I read an interesting article in a recent MJA (Medical Journal of Australia) which talked about how our professional identities develop in medicine, and some of the ways in which this process can get derailed or cause us some angst. According to the article, professional identities are the cornerstone of professionalism, providing us with ethical frameworks within which we work. Having a strong professional identity enables us to consider our values and how they relate to the behaviours that are expected of us by our profession, our colleagues and patients.
Values vs Identities
I often find myself talking to patients about values, particularly in the context of workplace and interpersonal issues. A mismatch between our own values and those of the people around us is a common cause of emotional distress, but this article gave me a different frame of reference that might be more meaningful for some individuals who struggle with the concept of values.
Our professional identities play out in tangible ways such as our language, clothes and everyday behaviour. Our identity is the external representation of our inner feelings, beliefs, experiences and values. We all have a number of identities – personal, professional, social which reflect our day to day experiences and the environments within which we operate. Different identities can be foregrounded and backgrounded depending on the situation, and also on the degree to which we feel like we fit with those around us.
How do identities develop?
They are essentially formed through a process of socialisation. Our ways of thinking and behaviour are influenced by our relationships, and by the structures and cultures we interface with. We identify with those who we respect or admire, or with whom we feel an affinity. Our identities develop and shift over time but gradually become more solid as we develop confidence and familiarity with our new roles, be it mother, doctor or marathon runner (I wish!!)
So where does it come unstuck?
Just like values, when our personal identities clash with our emerging professional identities, we can feel a sense of disequilibrium. Something isn’t right and we struggle to reconcile who we are personally with who society or our peers are asking us to be professionally. Even when we are comfortable with our professional identities, this can feel threatened in certain situations. Imagine a doctor who identifies with a high degree of competence and professional confidence – what happens when they invariably make a mistake that causes significant harm, or more likely a patient suffers an outcome such as dying by suicide which the doctor could not reasonably have foreseen. These situations challenge our sense of self, and we start to question our professional identity. Indeed others such as regulators and coroners may do so as well. It is easy to see why our patients get into psychological difficulties when faced with work place challenges – it is more than just a stressful event, our professional identity is also under threat!! Reading this article gave me a new way of thinking about values dissonance and how to approach for some of my patients.
Charlotte Rees and Lynn Monrouxe's article can be read here: