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Transitions in medical education 

Transitions in medical education
Chapter:
Transitions in medical education
Author(s):

Michiel Westerman

and Pim W. Teunissen

DOI:
10.1093/med/9780199652679.003.0032
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date: 25 September 2021

Medical students or doctors transitioning from one phase of medical education to the next or from one post to another, cope with all sorts of changes in different ways. The transition process reflects an individual’s previous development and current challenges. This makes transitions a lens for the merits and failings of the current medical educational system. This chapter describes three major transitions within the trajectory of becoming a specialist: first, the transition from preclinical to clinical training in medical school, second from medical student to specialty training, and finally from specialty training to working as an independent specialist. Each of these transitions can be highly demanding stage within a medical career and all are characterized by numerous challenging novelties ranging from unknown tasks in a new role with its accompanying responsibilities, to a new context and unfamiliar colleagues. After describing the historic development of transitions within the medical education continuum, an overview of the existing literature on transitions is provided. Within this overview the specific characteristics of each of these transitions is addressed. For instance, how previous training has been a preparation for the subsequent stage within the medical trajectory, and which novel tasks or responsibilities are most prominent within the transitions. Besides this overview of the current literature within medical education, alternative approaches to transitions are presented, stemming from related research areas within psychology and pedagogy. Through synthesizing these varying perspectives on transitions, a different approach to transitions is suggested: one in which transitions are not just threats, but also opportunities for rapid personal and professional development. Furthermore, it is illustrated how transitions are characterized by an intricate interplay between preparation received through training, psychological characteristics such as coping strategies, and contextual factors. This approach contrasts with medical education’s most prevalent approach; to view transitions as threats that should be prevented by creating a better alignment between training and the subsequent phase of the medical career through curriculum alterations. Finally, a future agenda for both research and several possible interventions aimed at supporting individuals in transition are presented.

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