Making Work Glorious: Primary Care Residents and Social Justice Schema

• In Event: 322 - Section on Medical Sociology Roundtable Session
  In Refereed Roundtable: Table 14. Medical Education II

Abstract

Primary care is vitally important to the foundation and efficiency of our health care system, yet primary care struggles to secure an adequate supply of recruits. Primary care specialties can be unattractive to medical students for a number of reasons, including its general low status and the disparagement of primary care during medical training. In this paper, I examine resident biosketches, short biographical statements that residents write to describe themselves and their career trajectory, in order to consider how residents who choose primary care construct value in their work and explain their commitment to a devalued specialty. Biosketches of residents in three other specialties serve as comparison groups for a total of 2,150 biosketches coded. This paper first shows how residents construct the meaning of their work to be glorious, focusing on two dimensions of care: patient relationships and variety in work. This article then examines the presence of service in biosketches, identifying three types of pathways between service and specialty choice. The presence of a social justice schema emerges, that, when embraced, renders primary care a desirable specialty and diminishes the weight of the dominant narratives of disparagement, empowering individuals to withstand negativity. Findings suggest an innovative avenue for increasing the supply of primary care residents and also enhance our understanding of how individuals within medicine, and professionals more generally, think about their work and make sense of their choices.

Author

• Joanna Veazey Brooks, Harvard University