IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v383y2025ics0277953625008214.html

First entrants in a new medical specialty: Resolving relational ambivalence during Dutch hospitalists’ identity formation

Author

Listed:
  • van Offenbeek, Marjolein A.G.
  • Regts, Gerdien
  • Vos, Janita F.J.

Abstract

Our case study analyses individuals' professional identity formation and resulting identity outcomes in the first cohorts of ‘Dutch hospital medicine’, a specialty introduced top-down within the Netherlands in 2012 that remained controversial for a long time. First entrants in any newly introduced health occupation will have a hard time in experiencing both their professional selves and their occupation as somewhere in-between existence and non-existence. Therefore, they will need to engage in dual professional identity formation: the process by which individuals form their professional selves, parallel to, yet intertwined with, contributing to their specialty's identity development. Using 93 interviews plus supplementary sources, we zoom in on nine individual hospitalists' trajectories, complemented with 11 retrospectively validating accounts. We show how the dual nature of first entrants' professional identity formation brings along role-based tensions, evoking ambivalence in first entrants' relationships with seniors of incumbent health occupations and among themselves as peers. We find that first entrants differ in how they resolve such relational ambivalence during their professional identity formation. Three pathways emerge that result in different outcomes in terms of professional self and contribution to their specialty's development: (1) specialty-oriented incremental pioneering, (2) self-oriented adaptive role development, and (3) career-oriented struggling. We contribute, firstly, by highlighting and clarifying the relational ambivalence that dual professional identity formation in a new health occupation evokes. Secondly, as first entrants cannot be expected to form a homogeneous group, the pathways provide a model for future inquiry and inform seniors how to offer first entrants guidance.

Suggested Citation

  • van Offenbeek, Marjolein A.G. & Regts, Gerdien & Vos, Janita F.J., 2025. "First entrants in a new medical specialty: Resolving relational ambivalence during Dutch hospitalists’ identity formation," Social Science & Medicine, Elsevier, vol. 383(C).
    • Handle: RePEc:eee:socmed:v:383:y:2025:i:c:s0277953625008214
    DOI: 10.1016/j.socscimed.2025.118490
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953625008214
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2025.118490?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Schrøder, Katja & Janssens, Astrid & Hvidt, Elisabeth Assing, 2021. "Adverse events as transitional markers - Using liminality to understand experiences of second victims," Social Science & Medicine, Elsevier, vol. 268(C).
    2. Traynor, Michael & Buus, Niels, 2016. "Professional identity in nursing: UK students' explanations for poor standards of care," Social Science & Medicine, Elsevier, vol. 166(C), pages 186-194.
    3. Lockett, Andy & Currie, Graeme & Waring, Justin & Finn, Rachael & Martin, Graham, 2012. "The role of institutional entrepreneurs in reforming healthcare," Social Science & Medicine, Elsevier, vol. 74(3), pages 356-363.
    4. Elizabeth Goodrick & Trish Reay, 2010. "Florence Nightingale Endures: Legitimizing a New Professional Role Identity," Journal of Management Studies, Wiley Blackwell, vol. 47(1), pages 55-84, January.
    5. Lukas Goretzki & Martin Messner & Maria Wurm, 2023. "Magicians, unicorns or data cleaners? Exploring the identity narratives and work experiences of data scientists," Accounting, Auditing & Accountability Journal, Emerald Group Publishing Limited, vol. 36(9), pages 253-280, July.
    6. Schubert, Samantha & Buus, Niels & Monrouxe, Lynn & Hunt, Caroline, 2023. "Interrogation in clinical supervision sessions: Exploring the construction of clinical psychology trainees’ professional identities," Social Science & Medicine, Elsevier, vol. 325(C).
    7. Simon Moralee & Berne Ferry, 2023. "New professions and leadership: the case of healthcare scientists in the United Kingdom," Chapters, in: Research Handbook on Leadership in Healthcare, chapter 28, pages 524-549, Edward Elgar Publishing.
    8. Mats Alvesson & Hugh Willmott, 2002. "Identity Regulation as Organizational Control: Producing the Appropriate Individual," Journal of Management Studies, Wiley Blackwell, vol. 39(5), pages 619-644, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Patriotta, Gerardo & Spedale, Simona, 2011. "Micro-interaction dynamics in group decision making: Face games, interaction order and boundary work," Scandinavian Journal of Management, Elsevier, vol. 27(4), pages 362-374.
    2. Croft, Charlotte & Reay, Trish, 2025. "Breaching the professional social contract to drive system innovation: Nurse managers and the emergence of a new professional group," Social Science & Medicine, Elsevier, vol. 373(C).
    3. Eveline Bruijn & Gail Whiteman, 2010. "That Which Doesn’t Break Us: Identity Work by Local Indigenous ‘Stakeholders’," Journal of Business Ethics, Springer, vol. 96(3), pages 479-495, October.
    4. Carlos Martin-Rios, 2016. "Innovative management control systems in knowledge work: a middle manager perspective," Journal of Management Control: Zeitschrift für Planung und Unternehmenssteuerung, Springer, vol. 27(2), pages 181-204, May.
    5. repec:bcp:journl:v:9:y:2025:i:10:p:4092-4109 is not listed on IDEAS
    6. Minbaeva, Dana & Rabbiosi, Larissa & Stahl, Günter K., 2018. "Not walking the talk? How host country cultural orientations may buffer the damage of corporate values’ misalignment in multinational corporations," Journal of World Business, Elsevier, vol. 53(6), pages 880-895.
    7. Suzan Lewis & Deirdre Anderson & Clare Lyonette & Nicola Payne & Stephen Wood, 2017. "Public sector austerity cuts in Britain and the changing discourse of work–life balance," Work, Employment & Society, British Sociological Association, vol. 31(4), pages 586-604, August.
    8. Virginie Xhauflair & Benjamin Huybrechts & François Pichault, 2018. "How Can New Players Establish Themselves in Highly Institutionalized Labour Markets? A Belgian Case Study in the Area of Project†Based Work," British Journal of Industrial Relations, London School of Economics, vol. 56(2), pages 370-394, June.
    9. Nathan Wilmers & Letian Zhang, 2022. "Values and Inequality: Prosocial Jobs and the College Wage Premium," American Sociological Review, , vol. 87(3), pages 415-442, June.
    10. Sharon Koppman & Elisa Mattarelli & Amar Gupta, 2016. "Third-World “Sloggers” or Elite Global Professionals? Using Organizational Toolkits to Redefine Work Identity in Information Technology Offshore Outsourcing," Organization Science, INFORMS, vol. 27(4), pages 825-845, August.
    11. Zec, Dejan & Rüling, Charles-Clemens & Wang, Tao, 2020. "Parliament in action: Drug withdrawals and policy changes in the U.K," Health Policy, Elsevier, vol. 124(9), pages 984-990.
    12. Paul, Michael & Hennig-Thurau, Thorsten & Groth, Markus, 2015. "Tightening or loosening the “iron cage”? The impact of formal and informal display controls on service customers," Journal of Business Research, Elsevier, vol. 68(5), pages 1062-1073.
    13. Macfarlane, Fraser & Barton-Sweeney, Cathy & Woodard, Fran & Greenhalgh, Trisha, 2013. "Achieving and sustaining profound institutional change in healthcare: Case study using neo-institutional theory," Social Science & Medicine, Elsevier, vol. 80(C), pages 10-18.
    14. Karoline Strauss & Julija N. Mell & Frederik Anseel & Annemijn Loermans & David Sluss, 2026. "Complementarity in Future Selves: How Networks of Future-Oriented Cognitive Representations Influence Individuals’ Ability to Proactively and Adaptively Manage Their Career," Organization Science, INFORMS, vol. 37(1), pages 90-112, January.
    15. Yves Gendron & Laura F. Spira, 2009. "What Went Wrong? The Downfall of Arthur Andersen and the Construction of Controllability Boundaries Surrounding Financial Auditing," Contemporary Accounting Research, John Wiley & Sons, vol. 26(4), pages 987-1027, December.
    16. repec:bcp:journl:v:6:y:2022:i:8:p:447-453 is not listed on IDEAS
    17. Danielle Treiber & Lize A. E. Booysen, 2021. "Identity (Re)Construction of Female Adolescents with Substance Use Disorders," IJERPH, MDPI, vol. 18(13), pages 1-19, June.
    18. Dentoni, Domenico & Pascucci, Stefano & Poldner, Kim & Gartner, William B., 2018. "Learning “who we are” by doing: Processes of co-constructing prosocial identities in community-based enterprises," Journal of Business Venturing, Elsevier, vol. 33(5), pages 603-622.
    19. Crozier, Sarah E & Atkinson, Carol & Bresnen, Mike & Goodwin, Peter, 2025. "Inter-identity threats and opportunities shaping professional influence for the Allied Health Profession (AHP) healthcare workforce: a study of identity paradox," Social Science & Medicine, Elsevier, vol. 386(C).
    20. Sörgärde, Nadja, 2020. "Story-dismantling, story-meandering, and story-confirming: Organizational identity work in times of public disgrace," Scandinavian Journal of Management, Elsevier, vol. 36(3).
    21. Claudia Gross, 2010. "Spiritual Cleansing: A Case Study on how Spirituality Can Be Mis/used by a Company," management revue - Socio-Economic Studies, Nomos Verlagsgesellschaft mbH & Co. KG, vol. 21(1), pages 60-81.
    22. O’Kane, Conor & Mangematin, Vincent & Geoghegan, Will & Fitzgerald, Ciara, 2015. "University technology transfer offices: The search for identity to build legitimacy," Research Policy, Elsevier, vol. 44(2), pages 421-437.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:383:y:2025:i:c:s0277953625008214. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.