Authors:

Abstract

A physician’s duty to care for patients and to care for self are in significant tension during epidemics. Especially when the infectivity and fatality of the epidemic remains unclear, the internal professional identity of a physician in training is challenged. There are various elements of moral significance that medical students may reflect on in the context of professional identity formation (PIF). These elements include: 1) the duty to treat concept, 2) societal role expectations, 3) beneficence, 4) distributive justice, 5) balancing risks and benefits and 6) faculty role modeling. Licensed physicians and those in training will balance multiple perspectives to make their personal decisions as to how to approach the pandemic and define their own role in it. During times of pandemics, when the entire physician workforce is called upon to help with the emerging crisis, positive role models emerge and that invisible pedagogy profoundly influences PIF of medical students. Physicians in training balance the values of altruism and self-care in their decision making. COVID-19 since its first recognition in December 2019 has caused major disruption of medical educational activities in the United States. The role of medical students during such crises can vary greatly depending on their level of training, competence and their evolving professional identities. Given the enormity of the COVID-19 crisis, many will act in solidarity with patients and colleagues. PIF may remain abstract to students throughout much of their medical training, but it becomes concrete during epidemics in which students personally confront deepened awareness of what it means to be a physician. The concept of PIF rapidly crystallizes into tangible thoughts, emotions, beliefs, and actions. This article elaborates on a framework consisting of six moral elements that guides one’s decision in contributing to pandemic relief efforts and posit that a crisis accelerates the rapid crystallization of PIF in medical students (Figure 1). These decisions must still allow room for individual conscience and students may take the six elements of moral significance into consideration when determining their role. The epidemic becomes a “giant leap” in PIF. Regardless of which decision students make, the way trainees reflect on their participation and choose to approach this novel COVID-19 pandemic marks a pivotal moment in each medical student’s academic career and PIF journey.