“So I had medicine in my blood. But just because you have medicine in your blood doesn’t mean that it’s always smooth sailing.” —Michael Weinstock, MD

What is “professional identity formation”?

As Abraham Fuks and colleagues once said, “One does not simply learn to be a physician, one becomes a physician.”1 Professional Identity Formation (PIF) is the slow transformative process by which an idealistic pre-medical college student becomes a battle-hardened emergency physician attending. PIF occurs slowly over years of exposure to the culture of medicine. From Day 1 of medical school, we watch how doctors in the world around us think, teach, feel, and act and slowly absorb those lessons over time, often without even being consciously aware of it happening. These lessons can be inspiring or toxic.

Importance of role modeling

We’ve all heard of (or seen) attendings who lose their temper, yell, and throw things in order to prove a point. We’ve seen attendings who roll up their sleeves and go the extra mile to ensure the best possible care for their patients. We’ve also seen residents model the same behavior as their attendings, for better or for worse. There’s a reason that each specialty has a personality—it happens because the accepted behaviors, attitudes, and values are passed down from generation to generation, from attending to medical student. Role modeling has a tremendous impact on PIF.

What does professional identity formation have to do with my wellness?

Thinking about it another way, PIF is the script about ourselves as doctors that we tell ourselves. If you believe that “real” emergency physicians never show weakness, then you run the risk of shame and inadequacy whenever you find yourself struggling. If you believe that the best doctors demonstrate compassion towards both their patients and towards themselves, then you set yourself up with the capacity for self-love in times of distress. Our professional identities can impact our tendency toward burnout and our ability to bounce back from stress.

Interestingly enough, wellness can also reciprocally influence our professional identities. One recent study surveyed faculty responsible for teaching a mind-body medicine course designed to introduce medical student to tools that reduce stress and foster self-awareness.2 In addition to having lower perceived stress when compared to controls, these faculty members also reported positive effects of teaching mindfulness on several aspects of their professional identities including communication, feeling connected to others, demonstrating empathy, active listening, and building self-confidence.

role model and professional identity formation

How do I develop a professional identity that supports my well-being?

Find empathic and compassionate role-models. Make sure that the script or professional identity that you write for yourself is a positive one. Becoming a fully-fledged emergency physician is a long process from medical student to seasoned attending and you can choose your own image of what defines an awesome, happy, and healthy doctor. And then go become that awesome doctor.

Want to take it a step further?

If you are an EM resident, join us on May 15th, 2017 at the 16th annual Essentials of Emergency Medicine (EEM) Experience. Residents from all over the country will gather for the first-ever Resident Wellness Consensus Summit (RWCS) in order to innovate real-world solutions to physician wellness issues just like this one. Stay for the entire EEM conference to learn from all of the excellent faculty speakers, including Dr. Weinstock. The Consensus Summit is jointly sponsored by EEM, Emergency Medicine Residents’ Association (EMRA), and ALiEM.

Featured podcast with Dr. Michael Weinstock

Listen to Dr. Michael Weinstock, famed lecturer and author of the Bouncebacks! series, talk about the 3 key life lessons that he’s learned while transitioning from a medical student to a resident and finally to an attending.

  1. Strive for excellence.
  2. View your clinical care from the lens of Emergency Medicine and not other specialists.
  3. If needed, spend a few more minutes at work, so that you can leave work AT work.
Wald H, Anthony D, Hutchinson T, Liben S, Smilovitch M, Donato A. Professional identity formation in medical education for humanistic, resilient physicians: pedagogic strategies for bridging theory to practice. Acad Med. 2015;90(6):753-760. [PubMed]
Talisman N, Harazduk N, Rush C, Graves K, Haramati A. The impact of mind-body medicine facilitation on affirming and enhancing professional identity in health care professions faculty. Acad Med. 2015;90(6):780-784. [PubMed]
Arlene Chung, MD

Arlene Chung, MD

Chief Strategy Officer,
2016-17 ALiEM Wellness Think Tank
Assistant Professor of Emergency Medicine
Assistant Program Director
Mount Sinai Emergency Medicine Residency
Editor, AKOSMED (EM wellness blog)
Arlene Chung, MD


Residency Director @Maimonides_EM | @NYACEP Board Member | Chair, ACEP Well-Being | EMRA #45under45 | She/her | Intrepid searcher for harmony l Opinions my own