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Abstract Number: 1738

How Do Resident Physicians Choose a Career in Rheumatology?A Qualitative Analysis of Journey Maps

Rachael Hart1 and Bharat Kumar2, 1University of Iowa Carver College of Medicine, Iowa City, 2University of Iowa Hospitals and Clinics, Iowa City, IA

Meeting: ACR Convergence 2024

Keywords: Education, Work Force

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Session Information

Date: Sunday, November 17, 2024

Title: Abstracts: Professional Education

Session Type: Abstract Session

Session Time: 3:00PM-4:30PM

Background/Purpose: Professional Identity Formation (PIF) refers to the process by which individuals internalize knowledge, skills, values and beliefs, resulting in an individual embracing a sense of belonging as a member of a professional community.  Despite its centrality to concepts of professionalism, little is known about the PIF during the course of graduate medical education for rheumatologists.  Characterizing the process by which PIF occurs prior to rheumatology fellowship is essential to designing educational interventions to promote specialization of physicians into the field and enhance activities to advance PIF during fellowship.

Methods: Purposive sampling was used to recruit rheumatology fellow physicians and Internal Medicine resident physicians accepted into rheumatology fellowship within the past year.  Semi-structured interviews were conducted, and data was recorded via a standardized intake form.  Hamilton’s method of rapid qualitative analysis was employed to facilitate analysis of templated information, yielding a 5-stage journey map for each individual participant (Figure 1).  Research team members compared and contrasted journey maps to yield themes describing the process by which resident physicians choose to specialize in rheumatology.

Results: 5 rheumatology fellow physicians and 7 Internal Medicine resident physicians were interviewed.  Six physicians (50%) identified as female, 8 physicians were international medical graduates (50%), and 4 physicians (33%) identified as being from marginalized communities.  Four themes were identified: (1) early experiences and exposure prior to medical education ‘prime’ selection for fellowship, (2) mentorship and sponsorship during residency facilitates specialty selection, (3) self-reflection is often a prolonged process with doubt and uncertainty that slowly reveals clarity and purpose, and (4) physicians often ascribe important milestones in their journeys to luck and chance. Based on these themes, research team members recommend: (1) robust pathway initiatives co-designed with interested early career physicians to catalyze exposure to research and clinical opportunities, and (2) development of virtual communities to share resources and experiences to enable PIF.

Conclusion: Selection of rheumatology for specialization is a complex process that begins prior to formal medical education and training.  There appears to be widespread diversity in rationale and timeframes for specialty selection but also similarities that unite experiences throughout their journeys.  Multiple actionable opportunities exist for fostering PIF at the resident level to increase the likelihood of attracting interested physicians, broadening the workforce, and advancing a sense of belonging to the larger rheumatology community throughout one’s professional career.

Supporting image 1

Example of a templated journey map


Disclosures: R. Hart: None; B. Kumar: None.

To cite this abstract in AMA style:

Hart R, Kumar B. How Do Resident Physicians Choose a Career in Rheumatology?A Qualitative Analysis of Journey Maps [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/how-do-resident-physicians-choose-a-career-in-rheumatologya-qualitative-analysis-of-journey-maps/. Accessed .
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All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

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