'Let me through, I'm a Doctor!' Professional Socialization in the Transition from Education to Work

Abstract: Based on four articles, this compilation thesis analyses the demonstrated com-petence defining a medical doctor, to the extent to which he or she acquires a high status and high level of employability in professional practice. Overall, the thesis aimed to describe and analyse professional socialization during doctors' transition from education to work. Questions addressed included how higher education should be understood as preparation for professional practice, how ideals of the future professional were conceived and how these ideals differenti-ated 'good' from 'bad' doctors in professional development and recruitment. The research employed a version of practice theory as its theoretical framework, developed with the aid of work by Pierre Bourdieu, Judith Butler, John Dewey and Theodore Schatzki. Throughout the individual studies, ideals were con-structed and understood as moral imperatives, stating how doctors are expected to perform in professional practice. Article I explored the ideals of academia and higher education practices in a general sense. In this study, the ideals involve the perceived function of higher education in relation to work. Three different and conflicting perspectives were constructed with the aid of a literature study. Arti-cle II was a survey investigation of how two cohorts (n=169) of recent graduates from a Swedish medical programme viewed their competence and the prepara-tion they received for work through the medical programme. The results show that graduates might be overly prepared from a knowledge perspective, while lacking in practical skills and preparation for difficult situations in the work-place. Article III investigated the ideals of the medical programme using an interview study with eight medical students and eight medical teachers. The ideals constructed show how conflicting ideals, such as strength and humility, shape conceptions of the future professional. Finally, Article IV reports an inter-view study with recruiters of medical interns in Sweden's 21 most popular hospi-tals. Results showed that the most attractive candidates balanced two traits: orientation towards performance and orientation towards human relations. They also successfully demonstrated possession of these qualities in their appli-cation and subsequent interview. Overall, the results from the studies indicated that there are great differences between views of proper preparation for work and views of the highly-employable doctor. While medical knowledge and skills were seen as important in preparation for work, they were absent in the views of the highly-competent and employable doctor. Instead, generic attributes, such as drive, curiosity, cooperativeness, warmth, maturity and reflectiveness, char-acterised descriptions of the most accomplished medical professionals. These attributes also were seen primarily as developed before or 'beside' the formal medical education programme.