Constructing Professional Identity: The Role of Work and Identity Learning Cycles in the Customization of Identity Among Medical Residents

    Through a six-year qualitative study of medical residents, we build theory about professional identity construction. We found that identity construction was triggered by work-identity integrity violations: an experienced mismatch between what physicians did and who they were. These violations were resolved through identity customization processes (enriching, patching, or splinting), which were part of interrelated identity and work learning cycles. Implications of our findings (e.g., for member identification) for both theory and practice are discussed.

    REFERENCES

    • Abbott A. 1992. Professional work. In Hasenfeld Y. (Ed.), Human services as complex organizations: 145–162. Chicago: University of Chicago Press. Google Scholar
    • Albert S., Whetten D. A. 1985. Organizational identity. In Cummings L. L. & , Staw B. M. (Eds.), Research in organizational behavior, vol. 7: 263–295. Greenwich, CT: JAI Press. Google Scholar
    • Alvesson M. 1994. Talking in organizations: Managing identity and impressions in an advertising agency. Organization Studies, 15: 535–563. Google Scholar
    • Ashforth B. E. 2001. Role transitions in organizational life: An identity-based perspective. Mahwah, NJ: Erlbaum. Google Scholar
    • Ashforth B. E., Mael F. 1989. Social identity theory and the organization. Academy of Management Review, 14: 20–39.LinkGoogle Scholar
    • Ashforth B. E., Saks A.M. 1996. Socialization tactics: Longitudinal effects on newcomer adjustment. Academy of Management Journal, 39: 149–178.LinkGoogle Scholar
    • Baumeister R. F. 1998. The self. In Lindzey G. (Ed.), The handbook of social psychology, (4th ed.): 680–740. New York: Mc-Graw Hill. Google Scholar
    • Becker H. S. 1970. Sociological work: Method and substance. Chicago: Aldine. Google Scholar
    • Becker H., Geer B., Hughes E., Strauss A. 1961. Boys in white: Student culture in medical school. Chicago: University of Chicago Press. Google Scholar
    • Biddle B. J. 1986. Recent developments in role theory. In Turner R. & , Short J. F. (Eds.), Annual review of sociology, vol. 12: 67–92. Palo Alto, CA: Annual Reviews. Google Scholar
    • Blackwell B., Gutmann M. C., Jewell K. E. 1984. Role adoption in residency training. General Hospital Psychiatry, 6: 280–288. Google Scholar
    • Carr-Saunders A. M., Wilson P.A. 1933. The professions. Oxford, U.K.: Clarendon Press. Google Scholar
    • Conrad P. 1988. Learning to doctor: Reflections on recent accounts of the medical school years. Journal of Health and Social Behavior, 29: 323–332. Google Scholar
    • Cote J. E., Levine C. G. 2002. Identity formation, agency, and culture: A social psychological synthesis. Mahwah, NJ: Erlbaum. Google Scholar
    • Deaux K. 1991. Social identities: Thoughts on structure and change. In Curtis R. C. (Ed.), The relational self: Theoretical convergences in psychoanalysis and social psychology: 77–93. New York: Guilford. Google Scholar
    • Dickie V. A. 2003. Establishing worker identity: A study of people in craft work. American Journal of Occupational Therapy, 57: 250–261. Google Scholar
    • Dutton J. E., Dukerich J. M., Harquail C. V. 1994. Organizational images and member identification. Administrative Science Quarterly, 39: 239–263. Google Scholar
    • Eisenhardt K. M. 1989. Building theories from case study research. Academy of Management Review, 14: 532–550.LinkGoogle Scholar
    • Epstein S. 2002. Cognitive-experiential self-theory of personality. In Lerner M. J. (Ed.), Comprehensive handbook of psychology, vol. 5—Personality and social psychology: 159–184. Hoboken, NJ: Wiley. Google Scholar
    • Erez M., Earley C. 1993. Culture, self-identity, and work. New York: Oxford University Press. Google Scholar
    • Erikson E. 1982. The life cycle completed: A review. New York: Norton. Google Scholar
    • Freidson E. 1970. Profession of medicine: A study of the sociology of applied knowledge. New York: Dodd, Mead. Google Scholar
    • Freidson E. 2001. Professionalism: The third logic. Chicago: University of Chicago Press. Google Scholar
    • Gardner H., Csikszentmihalyi M., Damon W. 2001. Good work: When excellence and ethics meet. New York: Basic Books. Google Scholar
    • Gini A. 2000. My job, my self: Work and the creation of the modern individual. New York: Routledge. Google Scholar
    • Glaser B. G., Strauss A. 1967. The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine. Google Scholar
    • Gouldner A. 1957. Cosmopolitans and locals: Towards an analysis of latent social roles-I. Administrative Science Quarterly, 2: 281–306. Google Scholar
    • Greil A. L., Rudy D. R. 1983. Conversion to the world view of alcoholics anonymous: A refinement of conversion theory. Qualitative Sociology, 6: 5–28. Google Scholar
    • Greil A. L., Rudy D. R. 1984. Social cocoons: Encapsulation and identity transformation in organizations. Sociological Inquiry, 54: 260–278. Google Scholar
    • Hall D. 1968. Identity changes during the transition from student to professor. School Review, 76: 445–469. Google Scholar
    • Hall D. 1971. A theoretical model of career subidentity development in organizational settings. Organizational Behavior and Human Performance, 6: 50–76. Google Scholar
    • Hall D. 1995. Unplanned executive transitions and the dance of subidentities. Human Resource Management, 34: 71–92. Google Scholar
    • Hogg M. A., Abrams D. 1993. Towards a single-process uncertainty-reduction model of social motivation in groups. In Hogg M. A. & , Abrams D. (Eds.), Motivation—Social psychological perspectives: 173–190. New York: Harvester-Wheatsheaf. Google Scholar
    • Hogg M. A., Mullin B. A. 1999. Joining groups to reduce uncertainty: Subjective uncertainty reduction and group identification. In Abrams D. & , Hogg M. A. (Eds.), Social identity and social cognition: 249–279. Oxford, U.K.: Blackwell. Google Scholar
    • Hughes E. C. 1956. The making of a physician—General statement of ideas and problems. Human Organization, 14(4): 21–25. Google Scholar
    • Ibarra H. 1999. Provisional selves: Experimenting with image and identity in professional adaptation. Administrative Science Quarterly, 44: 764–791. Google Scholar
    • James W. 1890. Principles of psychology (vols. 1 & 2). New York: Holt. Google Scholar
    • Kahn W. A. 1990. Psychological conditions of personal engagement and disengagement at work. Academy of Management Journal, 33: 692–724.LinkGoogle Scholar
    • Kanter R. M. 1972. Commitment and community: Communes and utopias in sociological perspective. Cambridge, MA: Harvard University Press. Google Scholar
    • Kaufmann J., Pratt M. G. 2005. Re-examining the link between organizational image and member attraction: On the positive uses of negative organizational stories in recruiting medical residents. In Elsbach K. (Ed.), Qualitative organizational research: 75–112. Greenwich, CT: Information Age. Google Scholar
    • Knight J. A. 1973. Medical student: Doctor in the making. New York: Appleton-Century-Crofts. Google Scholar
    • Kristof A. 1996. Person-organization fit: An integrative review of its conceptualizations, measurement, and implications. Personnel Psychology, 49: 1–49. Google Scholar
    • Larson M. S. 1977. The rise of professionalism: A sociological analysis. Berkeley: University of California Press. Google Scholar
    • Lee T. W., Mitchell T. R., Sablynski C. 1999. Qualitative research in organizational and vocational psychology, 1970–1999. Journal of Vocational Behavior, 55: 161–187. Google Scholar
    • Lewin K. 1958. Group decision and social change. In Newcomb T. M. & , Hartley E. L. (Eds.), Readings in social psychology: 201–216. New York: Harper & Row. Google Scholar
    • Locke K. 2001. Grounded theory in management research. Thousand Oaks, CA: Sage. Google Scholar
    • Lofland J., Stark R. 1965. Becoming a world-saver: A theory of conversion to a deviant perspective. American Sociological Review, 30: 862–874. Google Scholar
    • Louis M. L. 1980. Surprise and sense making: What newcomers experience in entering unfamiliar organizational settings. Administrative Science Quarterly, 25: 226–251. Google Scholar
    • Macdonald K. M. 1995. The sociology of the professions. London: Sage. Google Scholar
    • Margolis E., Romero M. 1998. “The department is very male, very white, very old, and very conservative”: The functioning of the hidden curriculum in graduate sociology departments. Harvard Educational Review, 68(1): 1–32. Google Scholar
    • Marion R. 1989. Intern blues. NewYork: Fawcett Crest. Google Scholar
    • Marion R. 1991. Learning to play God. Reading, MA: Addison-Wesley. Google Scholar
    • McCall T. B. 1988. The impact of long working hours on resident physicians. New England Journal of Medicine, 318: 775–778. Google Scholar
    • Miles M. B., Huberman A. M. 1994. Qualitative data analysis. Beverly Hills, CA: Sage. Google Scholar
    • Nicholson N. 1984. A theory of work role transitions. Administrative Science Quarterly, 29: 172–191. Google Scholar
    • Pettigrew A. 1990. Longitudinal field research on change: Theory and practice. Organization Science, 1: 267–292. Google Scholar
    • Polzer J. T., Milton L. P., Swann W. B. J. 2002. Capitalizing on diversity: Interpersonal congruence in small work groups. Administrative Science Quarterly, 47: 296–324. Google Scholar
    • Pratt M. G. 1998. To be or not to be: Central questions in organizational identification. In Godfrey P. (Ed.), Identity in organizations: Developing theory through conversations: 171–207. Thousand Oaks, CA: Sage. Google Scholar
    • Pratt M. G. 2000. The good, the bad, and the ambivalent: Managing identification among Amway distributors. Administrative Science Quarterly, 45: 456–493. Google Scholar
    • Pratt M. G., Ashforth B. E. 2003. Fostering meaningfulness in working and at work. In Quinn R. (Ed.), Positive organizational scholarship: 309–327. San Francisco: Berrett-Koehler. Google Scholar
    • Pratt M. G., Rafaeli A. 1997. Organizational dress as a symbol of multilayered social identities. Academy of Management Journal, 40: 862–898.LinkGoogle Scholar
    • Schein E. 1962. Man against man: Brainwashing. Corrective Psychiatry & Journal of Social Therapy, 8(2): 90–97. Google Scholar
    • Schein E. 1987. Process consultation, volume 2: Lessons for managers. Reading, MA: Addison-Wesley. Google Scholar
    • Shulman R., Wilkerson L., Goldman D. A. 1992. Multiple realities: Teaching rounds in an inpatient pediatric service. American Journal of Diseases of Children, 146: 55–60. Google Scholar
    • Snow D. A., Anderson L. 1987. Identity work among the homeless: The verbal construction and avowal of personal identities. American Journal of Sociology, 92: 1336–1371. Google Scholar
    • Snow D. A., Machalek R. 1984. The sociology of conversion. In Turner R. H. & , Short J. F. (Eds.), Annual review of sociology, vol. 10: 167–190. Palo Alto, CA: Annual Reviews. Google Scholar
    • Snow D. A., Phillips C. L. 1980. The Lofland-Stark conversion model: A critical reassessment. Social Problems, 27: 430–447. Google Scholar
    • Spradley J. 1979. The ethnographic interview. New York: Holt, Rinehart & Winston. Google Scholar
    • Stake R. 1995. The art of case study research. Thousand Oaks, CA: Sage. Google Scholar
    • Strauss A., Corbin J. 1990. Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage. Google Scholar
    • Strauss A., Corbin J. 1998. Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Newbury Park, CA: Sage. Google Scholar
    • Sveningsson S., Alvesson M. 2003. Managing managerial identities: Organizational fragmentation, discourse and identity struggle. Human Relations, 56: 1163–1193. Google Scholar
    • Turow S. 1977. 1 L: The turbulent true story of a first year at Harvard Law School. New York: Farrar Straus & Giroux. Google Scholar
    • Van Maanen J. 1997. Identity work: Notes on the personal identity of police officers. Working paper, Massachusetts Institute of Technology, Cambridge. Google Scholar
    • Van Maanen J., Barley S. R. 1984. Occupational communities: Culture and control in organizations. In Staw B. M. & , Cummings L. L. (Eds.), Research in organizational behavior, vol. 6: 287–365. Greenwich, CT: JAI Press. Google Scholar
    • Van Maanen J., Schein E. 1979. Towards a theory of organizational socialization. In Staw B. M. (Ed.), Research in organizational behavior, vol. 1: 209–264. Greenwich, CT: JAI Press. Google Scholar
    • Wallace J. E. 1995. Organizational and professional commitment in professional and nonprofessional organizations. Administrative Science Quarterly, 40: 228–255. Google Scholar
    • Weick K. E. 1995. Sensemaking in organizations. Thousand Oaks, CA: Sage. Google Scholar
    • Weinholtz D. 1991. The socialization of physicians during attending rounds: A study of team learning among medical students. Qualitative Health Research, 1(2): 152–177. Google Scholar
    • West M., Nicholson N., Arnold J. 1987. Identity changes as outcomes of work-role transitions. In Honess T. & , Yardley K. (Eds.), Self and identity: Perspectives across the lifespan: 287–303. New York: Routledge & Kegan Paul. Google Scholar
    • Wrzesniewski A., Dutton J. E. 2001. Crafting a job: Revisioning employees as active crafters of their work. Academy of Management Review, 26: 179–201.LinkGoogle Scholar
    • Wyatt J. F. 1978. Sociological perspectives on socialization into a profession: A study of student nurses and their definition of learning. British Journal of Educational Studies, 26: 263–276. Google Scholar
    • Yin R. K. 2003. Case study research: Design and methods (3rd ed.). Thousand Oaks, CA: Sage. Google Scholar
    Academy of Management
      Academy of Management
      100 Summit Lake Drive, Suite 110
      Valhalla, NY 10595, USA
      Phone: +1 (914) 326-1800
      Fax: +1 (914) 326-1900