title: Reimagining the self at late-career transitions: how identity threat influences academic physicians' retirement considerations.
abstract: OBJECTIVE
  There is scant empirical work exploring academic physicians' psychosocial adjustment during late-career transitions or on the factors that influence their retirement decisions. The authors examine these issues through the lens of sociopsychological identity theory, specifically examining how identity threat influences academic physicians' decisions about retirement.
  
  
  METHODS
  Participants were academic physicians at a Canadian medical school and were recruited via e-mail requests for clinical faculty interested in discussing late-career and retirement planning issues. Participants included 15 males and 6 females (N = 21; mean age = 63, standard deviation = 7.54), representing eight specialties (clinical and surgical). Data were collected in October and November 2012 via facilitated focus groups, which were digitally recorded, transcribed verbatim, and anonymized, then analyzed using thematic analysis.
  
  
  RESULTS
  Four primary themes were identified: centrality of occupational identity, experiences of identity threat, experiences of aging in an indifferent system, and coping with late-career transitions. Identity threats were manifested in apprehensions about self-esteem after retirement, practice continuity, and clinical competence, as well as in a loss of meaning and belonging. These identity challenges influenced decisions on whether to retire. Organizational and system support was perceived as wanting. Coping strategies included reimagining and revaluing various aspects of the self through assimilating new activities and reprioritizing others.
  
  
  CONCLUSIONS
  Identity-related struggles are a significant feature of academic physicians' considerations about late-career transitions. Understanding these challenges, their antecedents, and their consequences can prepare faculty, and their institutions, to better manage late-career transitions. Individual- and institution-level implications are discussed.
authors.affiliation: B. Onyura is research and evaluation consultant, Centre for Faculty Development, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. J. Bohnen is professor of surgery and vice dean of clinical affairs, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. D. Wasylenki is professor, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. A. Jarvis is professor, Department of Pediatrics, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. B. Giblon is a retired family physician, Department of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. R. Hyland is a practicing respirologist and professor, Department of Medicine, University of Toronto Faculty of Medicine, and former physician-in-chief, St. Michael's Hospital, Toronto, Ontario, Canada. I. Silver is professor, University of Toronto Faculty of Medicine, and vice president of education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. K. Leslie is director, Centre for Faculty Development, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and professor, Department of Pediatrics, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada..
authors.forename: Betty
authors.initials: B
authors.lastname: Onyura
authors.forename: John
authors.initials: J
authors.lastname: Bohnen
authors.forename: Don
authors.initials: D
authors.lastname: Wasylenki
authors.forename: Anna
authors.initials: A
authors.lastname: Jarvis
authors.forename: Barney
authors.initials: B
authors.lastname: Giblon
authors.forename: Robert
authors.initials: R
authors.lastname: Hyland
authors.forename: Ivan
authors.initials: I
authors.lastname: Silver
authors.forename: Karen
authors.initials: K
authors.lastname: Leslie
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000375:Aging / Q000523:psychology*; D002170:Canada; D002321:Career Choice; D002983:Clinical Competence; D003266:Continuity of Patient Care; D003657:Decision Making; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011582:Psychological Theory; D012179:Retirement / Q000523:psychology*; D012649:Self Concept; D012933:Social Identification