Elsevier

Social Science & Medicine

Volume 186, August 2017, Pages 70-77
Social Science & Medicine

‘You do not cross them’: Hierarchy and emotion in doctors' narratives of power relations in specialist training

https://doi.org/10.1016/j.socscimed.2017.05.048Get rights and content
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Highlights

  • Affective relations in specialist training are patterned on the medical hierarchy.

  • Anger, fear and intimidation characterised trainee-trainer relationships.

  • The emotional roles accessible to trainees impact learning and patient outcomes.

Abstract

Studies of medical education often focus on experiences and socialisation processes among undergraduate students, with fewer examining emotionality among postgraduate trainees. This article explores the relationship between power and emotion, questioning how affective relations between senior and junior doctors are patterned on the hierarchical structure of medicine. The study employs qualitative methods of in-depth, face-to-face and telephone interviews with fifty doctors at initial and advanced stages of specialist postgraduate training in teaching hospitals across Ireland, conducted between May and July, 2015. The study found that respect for hierarchy, anger and fear, intimidation, and disillusion were key themes in participants' narratives of relationships with senior staff who oversaw their postgraduate training. The implications of these emotional subjectivities for quality of training, patient care and willingness of junior doctors to pursue careers in Ireland, are discussed and recommendations and areas for further research proposed.

Keywords

Ireland
Emotion
Hierarchy
Medical education
Power
Qualitative research

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