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Both within and outside of healthcare, there is a general sense that an internist is different than a surgeon. Despite both being physicians, we understand that certain personality types tend to be attracted to certain specialties, and their distinct training pathways seem to reinforce or foster certain interests and values. Specialties truly are distinct cultures with unique terminology, tools, idols, journals, societies, meetings, training, and often work spaces; yet, exactly how these cultures differ and how this affects patient care is largely underappreciated and studied.
Over the last 3 years with the help of mentors like Robert Vogelzang, MD, FSIR, I have tried to shed some light on how specialty tribalism affects treatment of symptomatic uterine fibroids, endovascular stenting, and cardiovascular imaging. This work led us to also question how certain professional values develop during training, a process that the medical education community has termed “professional identity formation.” Here current literature is also sparse especially in regards to how specific values are cultivated in each specialty. The recent establishment of interventional radiology (IR) as a primary specialty is a unique opportunity to study this process both at an individual and specialty-wide level. How does a new specialty shape its professional identity and change how other clinicians perceive that group? There’s quite a bit of interesting historical context to inform this question, but suffice it to say that the task is rarely easy and without controversy.
To try to understand the current IR professional identity, we interviewed 16 fellows across 4 programs at the beginning and soon after their fellowship. We asked them about their educational journey, recent patient interactions, and views of IR and other specialties. These interviews were then systematically analyzed using a well-validated method from anthropology called constructivist grounded theory. This allowed us to identify central themes and make some interesting conclusions:
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