Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

The Lifelong Journey in Professional Identity Formation


We must work toward defining our identities throughout our careers as we strive to give excellent care to every patient.

Huddled on the couch around the computer with my roommates—fellow first year med students—I found a rare moment of connection and respite over Zoom. I was watching a part of the new imperfection series by our Duke School of Medicine wellness committee. The series showcases and demystifies what is so often hidden away in medicine—our imperfections.


Clinicians at every level—residents, attendings, and department chairs—share stories about their fears, mental health struggles, and difficult moments in their career. One thing that struck me during these sessions was how the panelists seemed to still be “figuring it all out.” While they reflected on what they had learned over the years, they also candidly admitted they were still learning how to navigate their challenges. In response, the facilitator, Will Bynum, brought up the concept of identity work.


Identity work describes how we engage in activities to create our identities. This concept comes from the business and organizational psychology world but has obvious applications in medicine. It suggests that identity is an active process, a verb, that requires our effort and attention—that identity is doing rather than just being.


The theory implicates lifelong learning and work—we constantly need to add to, revise, and sustain our identities. As we encounter situations that challenge us, such as taking on a new leadership role at work, we need to intentionally integrate this role into our conception of ourselves to maintain our authenticity.


Formation of identity doesn’t just happen as a med student, intern, or resident, but rather over the course of a career as one continually strives for clinical excellence and growth. Engaging in active reflection on clinical encounters and life’s challenges may help to reconcile how our identity changes in response to these experiences. It can be difficult to find time for reflection on a busy clinic day. But identity work theory also posits that we form our identities in part by how we engage in our daily activities like patient interactions. In other words, our relationships with our patients and colleagues help define who we are. Framing daily tasks in this manner brings me a little more patience and grace on those days when the to-do list never seems to end.


I hope throughout med school I can continue to engage in conversations about our imperfections. Forget mandatory de-stress modules or forced yoga. Shared moments of vulnerability and honesty may be the best step toward wellness in medicine.


The author would like to thank Duke Med Wellness Committee for hosting the imperfection series. You can learn more about the series here.




This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.