Supporting doctors' professional identity development through specialist training

Anatomy-centric specialties such as surgery, radiology, and anatomical pathology (AP) have workforce shortages, with attrition during the training phase proposed as a contributing factor. Current understanding of the reasons behind trainee attrition is limited, and there have been calls to increase the depth and richness of research in this area. Exploring trainees' professional identity (PI) development may deepen our understanding of why trainees resign and inform development of appropriate interventions. This study seeks to address this by exploring the field of AP as a model for specialist PI development and asks what factors affirm and/or challenge AP trainees' PI development? A qualitative research approach was undertaken using narrative inquiry. Interviews with AP trainees and consultants in Australia and New Zealand were interpreted as stories through a 're-storying' process. Story data of doctors' AP training experiences were thematically analyzed using framework analysis. Three themes were identified related to anatomy-centric specialist training PI: What trainees do ('learning opportunities'), where trainees learn ('learning environment and context'), and who trainees learn from ('people influencing learning'). 'Learning opportunities' appeared to be a dominant influence on trainees' PI development. Prominent PI challenges included perceptions of incompetence and dependence during the transition to specialist training and perceptions of disconnectedness throughout training. This study extends existing research to suggest ways educators could support trainees navigating perceptions of incompetence and dependence. Our study highlights how disconnectedness may be a factor in trainee attrition-suggesting that future research into this underexplored theme is warranted.