title: Discourses of student orientation to medical education programs.
abstract: BACKGROUND
  Although medical students' initial orientation is an important point of transition in medical education, there is a paucity of literature on the subject and major variations in the ways that different institutions orient incoming medical students to their programs.
  
  
  METHODS
  We conducted a discourse analysis of medical education orientation in the literature and on data from a survey of peer institutions' approaches to orientation.
  
  
  RESULTS
  These two discourses of orientation had clear similarities, in particular, the critical role of ceremony and symbols, and the focus on developing professionalism and physician identities. There were also differences between them, in particular, in the way that the discourse in the literature focused on the symbolic and professional aspects of orientation; something we have called 'cultural orientation'. Meanwhile, those who were responsible for orientation in their own institutions tended to focus on the practical and social dimensions.
  
  
  CONCLUSIONS
  By examining how orientation has been described and discussed, we identify three domains of orientation: cultural, social, and practical. These domains are relatively distinct in terms of the activities associated with them, and in terms of who is involved in organizing and running these activities. We also describe orientation as a liminal activity system on the threshold of medical school where incoming students initially cross into the profession. Interestingly, this state of ambiguity also extends to the scholarship of orientation with only some of its aspects attracting formal enquiry, even though there is a growing interest in transitions in medical education as a whole. We hope, therefore, that this study can help to legitimize enquiry into orientation in all its forms and that it can begin to situate the role of orientation more firmly within the firmament of medical education practice and research.
authors.affiliation: Undergraduate Medical Education, Northern Ontario School of Medicine, Greater Sudbury, ON, Canada; rachel.ellaway@nosm.ca.
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Ellaway
authors.affiliation: Undergraduate Medical Education, Northern Ontario School of Medicine, Greater Sudbury, ON, Canada; Schulich School of Medicine & Dentistry - Windsor Program, Western University, Windsor, ON, Canada.
authors.forename: Gerry
authors.initials: G
authors.lastname: Cooper
authors.affiliation: Undergraduate Medical Education, Northern Ontario School of Medicine, Greater Sudbury, ON, Canada; Office of the Registrar, Trent University, Peterborough, ON, Canada.
authors.forename: Tracy
authors.initials: T
authors.lastname: Al-Idrissi
authors.affiliation: Undergraduate Medical Education, Northern Ontario School of Medicine, Greater Sudbury, ON, Canada.
authors.forename: Tim
authors.initials: T
authors.lastname: Dubé
authors.affiliation: Undergraduate Medical Education, Northern Ontario School of Medicine, Greater Sudbury, ON, Canada; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Graves
mesh_terms: D004501:Education, Medical / Q000458:organization & administration*; D004777:Environment; D006801:Humans; D007398:Interpersonal Relations; D009949:Orientation; D010819:Physician's Role; D011057:Politics; D013337:Students, Medical
keywords: identity development; medical culture; medical student orientation; professionalism; transition; white coat ceremony