Conceptualizing Medical Resident’s Journey through Wonderland of Clinical Practice: From transitional shock to role adaptation to independent practice

Objectives: To explore experiences of medical residents about stages and nature of transitional journey from induction into residency program to achievement of consultant title.

Methods: Qualitative phenomenological study was conducted at Sir Gangaram hospital and Fatima Memorial Hospital, Lahore for six months from Feb 2019-July 2019 after IRB/ERC approval from Islamic International Medical College (Ref# Riphah/IIMC/ERC/19/0320). Using purposive criterion sampling, 16 semi-structured interviews in four departments, four strata of junior residents, senior residents, newly-qualified consultants, and supervising consultants with four participants each were conducted till theoretical saturation of data was achieved. After informed consent, audio recorded data was transcribed verbatim & analyzed through Atlas.ti 7 using Interpretive Phenomenological Analysis. After Bracketing and horizontalization, data was coded line by line. Codes (324) were merged to categories (19) for structural and textural description. Composite description of phenomenon was done by abstraction of themes (eight for stages and two for nature of journey).

Results: Eight themes for stages as merriment, anguish, melancholy, acceptance and efforts, intensive learning, burnishing to shine, identity formation and intra-stage oscillations were identified. Two themes for journey’s nature were exponential learning & oscillating journey.

Conclusion: The transitional journey is a multi-stage complex, oscillating journey. An oscillating electron model is presented upon the findings of this study to explain resident transition