Study 1: Not ready in the ways that count – a qualitative exploration of junior doctor’s perceived preparedness for practice using Legitimation Code Theory

A qualitative, descriptive study using focus groups was undertaken with first year internship doctors. Thirty-two junior doctors in their first year of internship took part in five focus groups. The data were analysed using a reflective thematic analysis approach with a subsequent analysis using the Legitima¬tion Code Theory (LCT) specialisation dimension coding framework to aid interpretation.

Personal attributes including adaptability, organisation and proactivity form the basis of achievement in internship. While graduates felt ready in some ways, it was not in the ways that counted. Participants felt well prepared in terms of their clinical knowledge and skills, but legitimacy came from being able to take responsibility, communicate effectively and apply knowledge confidently and efficiently to all aspects of patient care, something that they did not feel ready to do.

Using LCT has revealed a shift in the basis of achievement between medical school, where individual academic performance is rewarded, and intern¬ship, where personal and social competencies are legitimised. There is a clash between what graduates feel well prepared for and the expectations and demands of the internship role, resulting in a difficult and stressful transition from student to doctor. Data Files All documents described below are Microsoft Word files .

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