The dual nature of medical enculturation in postgraduate medical training and practice

OBJECTIVES: Enculturation is a normal and continuing part of human development. This study examined how medical graduates perceive the process of enculturation after graduation.

METHODS: We conducted a qualitative study of the values of medical graduates associated with Sydney Medical School to identify processes that contribute to the ongoing process of enculturation.

RESULTS: Two processes contributing to the process of enculturation were identified. Participants were aware of having passively absorbed the explicit and implicit culture of medicine, and of having actively sought to assimilate (or to avoid assimilating) the medical culture. The processes of enculturation were particularly evident in relation to three major concerns: competence; patient-centredness, and self-care.

CONCLUSIONS: The participants in this study demonstrated the capacity to reflect on and differentiate between two types of enculturation: absorption and assimilation. They were aware of the impacts of enculturation with respect to three main sets of values that are, respectively, epistemic, interpersonal and personal. Faculty development programmes might benefit from paying explicit attention to the process of enculturation and its influence on learning and practice.