title: The influence of academic discourses on medical students' identification with the discipline of family medicine.
abstract: OBJECTIVE
  To understand the influence of academic discourses about family medicine on medical students' professional identity construction during undergraduate training.
  
  
  METHODS
  The authors used a multiple case study research design involving international medical schools, one each from Canada, France, Spain, and the United Kingdom (UK). The authors completed the fieldwork between 2007 and 2009 by conducting 18 focus groups (with 132 students) and 67 semistructured interviews with educators and by gathering pertinent institutional documents. They carried out discursive thematic analyses of the verbatim transcripts and then performed within- and cross-case analyses.
  
  
  RESULTS
  The most striking finding was the diverging responses between those at the UK school and those at the other schools. In the UK case, family medicine was recognized as a prestigious academic discipline; students and faculty praised the knowledge and skills of family physicians, and students more often indicated their intent to pursue family medicine. In the other cases, family medicine was not well regarded by students or faculty. This was expressed overtly or through a paradoxical academic discourse that stressed the importance of family medicine to the health care system while decrying its lack of innovative technology and the large workload-to-income ratio. Students at these schools were less likely to consider family medicine.
  
  
  CONCLUSIONS
  These results stress the influence of academic discourses on medical students' ability to identify with the practice of family medicine. Educators must consider processes of professional identity formation during undergraduate medical training as they develop and reform medical education.
authors.affiliation: C. Rodríguez is associate professor, Area of Health Services Research, Department of Family Medicine, and director, McGill Family Medicine Educational Research Group (FMER), McGill University, and senior research scholar, Fonds de recherche du Quebec Santé, Montreal, Quebec, Canada. S. López-Roig is associate professor, Department of Health Psychology, Universidad Miguel Hernández, Elche (Alicante), Spain. T. Pawlikowska is professor and director, Health Professions Education Centre, Royal College of Surgeons in Ireland, Dublin, Ireland. F.-X. Schweyer is professor of sociology, École des Hautes Études en Santé Publique, School of Public Health, University of Rennes 1, Rennes, France, and researcher, Équipe de Recherche sur les Inégalités de Santé, Centre Maurice Halbwachs, Paris, France. E. Bélanger is postdoctoral fellow, University of Montreal, and collaborator, McGill Family Medicine Educational Research Group (FMER), Department of Family Medicine, McGill University, Montreal, Quebec, Canada. M.A. Pastor-Mira is associate professor, Department of Health Psychology, Universidad Miguel Hernández, Elche (Alicante), Spain. S. Hugé is maître de conférences associée and chair, Department of General Medicine, University of Rennes 1, Rennes, France. S. Spencer is academic clinical fellow, London School of General Practice, Queen Mary University of London, London, England. G. Lévasseur is emeritus professor, Department of General Medicine, University of Rennes 1, Rennes, France. I. Whitehead is clinical teaching fellow, Freeman Hospital, Newcastle Upon Tyne, England. P.-P. Tellier is associate professor, Department of Family Medicine, and director, Student Health Services, McGill University, Montreal, Quebec, Canada.
authors.forename: Charo
authors.initials: C
authors.lastname: Rodríguez
authors.forename: Sofía
authors.initials: S
authors.lastname: López-Roig
authors.forename: Teresa
authors.initials: T
authors.lastname: Pawlikowska
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Schweyer
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Bélanger
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Pastor-Mira
authors.forename: Sandrine
authors.initials: S
authors.lastname: Hugé
authors.forename: Sarah
authors.initials: S
authors.lastname: Spencer
authors.forename: Gwenola
authors.initials: G
authors.lastname: Lévasseur
authors.forename: Ian
authors.initials: I
authors.lastname: Whitehead
authors.forename: Pierre-Paul
authors.initials: PP
authors.lastname: Tellier
mesh_terms: D002170:Canada; D002321:Career Choice; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005194:Family Practice / Q000193:education*; D017144:Focus Groups; D005602:France; D006801:Humans; D010821:Physicians, Family / Q000193:education*; D012189:Retrospective Studies; D012577:Schools, Medical / Q000592:standards*; D012933:Social Identification; D013030:Spain; D013337:Students, Medical / Q000523:psychology*; D006113:United Kingdom