Date of Award


Document Type


Degree Name

Doctor of Education (EdD)


Educational Leadership and Policy Studies

First Advisor

Jill M. Tarule


First year medical school enrollment is projected to reach 21,349 by the 2018 school year, reflecting a 30 percent increase compared to 2002 enrollment numbers (Erikson, Whatley, & Tilton, 2014). In 2006, the Association of American Medical Colleges (AAMC) recommended this increase in enrollment in response to concerns about a physician shortage. Unfortunately, the increase in the number of medical students enrolling in medical school may be good for society, but it may not be good for the health of medical students. A commentary in the journal, Academic Medicine, was titled, “Medical Student Distress: A Call to Action” (Dyrbye & Shanafelt, 2011). There is concern that the structure of medical education may contribute to the lack of wellbeing in medical students beginning in their first year of medical school.

This is an issue of great importance to society as medical students are experiencing distress at a time when more physicians are needed. Medical schools are working to better understand the process of professional identity formation of medical students. The experiences in medical school contribute, both in positive and negative ways to the socialization and creation of a new identity for medical students.

The overall purpose of this study is to explore and analyze the narrative reflections of first year medical students as a rich source of data on the construction of their professional identity formation as a physician. This was a qualitative research study using narrative inquiry. In order to gain a deeper understanding of how first year experiences of medical students influence their professional identity formation, I explored and analyzed 205 reflections of first year medical students from a northeast medical school as a rich source of data on the construction of their professional identity as a physician.

Four themes emerged as important to medical students during their first year of medical school from their narrative reflections: balance, mental health, hidden curriculum and professionalism. The four themes reveal that first year medical students experience varying levels of stress during their first year of medical school. This mirrors the results of a study done more than eighty years ago. Now and then, medical students expressed similar concerns. (Strecker, Appel, Palmer, & Braceland, 1937) asked fourth year medical students questions about their wellness, phrased as neurotic or nervous symptoms. Sixty percent of the students believed their symptoms appeared when they started studying medicine.

These findings support the concerns of the American Association of Medical Colleges (AAMC). In 2016, AAMC held a Leadership Forum in Washington, DC to address what they called a public health crisis. There was significant concern about the wellbeing of those in academic medicine.



Number of Pages

70 p.