Summary Galkin K. (1136925)
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National Research UniversityHigher School of EconomicsAs a manuscriptKonstantin GalkinProfessional identity of young doctors in the city and in the village: life strategiesand everyday practices (the case of St. Petersburg and Leningrad region)Thesis Summary for the purpose of obtaining PhD in Sociology HSEAcademic supervisor:Doctor of science in SociologyElena OmelchenkoMoscow, 20182RelevanceThe majority of modern studies concerned with the professional identity ofphysicians pay attention to citizens living in large megalopolis or million-plus cities. Thisexperience becomes universal for generalization and analysis of career and life strategiesof physicians.It is noted that physicians who live and work not in large cities, but in small townsand villages, are on the periphery of the attention of researchers and often are excludedfrom consideration at all.
In some degree, it is due to the fact that today rural areas, the"Russian village", are sidelined, which results in mass migration of young ruralpopulation to the cities. Specialists and especially representatives of medical professionsleave the villages in search of more prestigious or highly paid job.A clear research interest is a comparative study of the specifics of the work,everyday practices and professional values of young doctors working in the city of federalimportance and in the villages, small towns.Investigations of the specifics of medical practice of young specialists in villagesand small towns give grounds to assume that their everyday practices can significantlydiffer from those of physicians working in large cities, which makes comparisons ofyoung physicians working in a large metropolitan area and young physicians working insmall towns/villages quite relevant.
At the same time, the development of moderntechnologies and the inclusion of rural specialists in Internet communications and socialnetworks is reflected in the similarity of part of the everyday practices of urban and ruralyoung physicians.Work, personal life and emerging life strategies of urban and rural young physiciansdiffer, first of all, by the nature of everyday practices.Actually, the very work of young physicians with patients in rural areas has anumber of features.
For city physicians, this communication problem can be explained inthe framework of the biomedical model.3However, with this examination of the medical profession, it will not becharacterized by any additional (humanistic) traits, only professionalism and expertknowledge of the physician become the defining characteristics of this kind of activity.This paradigm does not fit the characteristics of medical practice in small townsand villages, which can be explained to a greater extent by the humanistic model of thephysician-patient interaction. The local community intervenes in medical activities, thusdictating the model of communication and, in a certain sense, imposing standards ofconduct on young professionals, which certainly influences the motivation to work as aphysician in rural areas.In the study, we pay attention to the analysis of all components of the formation ofthe professional identity of young physicians: childhood, interest in the profession, schooland out-of-school socialization, studies in a medical university – integration into theprofession, communication and interaction with patients and colleagues.
At the sametime, professional identity is considered by us in the context of the everyday practice ofa physician.The scope of prior researchThere is a wide variety of theories defining the concept of professional identity.However, structural functionalists T. Parsons, A., E.
Freidson 1 made a significantcontribution to research of identity and its formation, where professional identity isprimarily represented as the institutional affiliation of the individual to the profession[Parsons, 1951; Freidson, 1982].In recent years, the phenomenological and social-anthropological approaches to thestudy of professions of Schutz A., Hughes E., Romanov P., Yarskaya-Smirnova E., GamstF., Starks H., Finlay L., Abramov R is actively developing, where professional identity isdefined as the product of the individual's life world.
The life world is understood as anatural attitude, conditioned by everyday practices, both at work and outside theworkplace [Schutz, 1972; Finlay, 1999; Starks, 2007; Romanov P., Yarskaya-Smirnova,42009]. Thus, the phenomenological and social-anthropological approaches defineprofessional identity as being constructed from the point of view of everyday practicesthat differ in different everyday contexts.From the point of view of the social-anthropological approach, professional activitycan be conceptualized as a special culture; in this case the sociologists of the professionturn to the interpretation of various everyday practices and symbols of profession ineveryday life.Everyday practices of professionals are always filled with the symbols of theprofession and are determined by a special professional symbolism.The medical profession is an expert community with its own professional practicesand standards.
The diagnosis, the ability to put shots, or the expertise of professionaladvice - all this is inscribed in the contexts of everyday discourse around medicalprofessions and is the basis for defining the medical profession as a closed and specializedactivity included in special professional practices, which is indicated in the studies ofFoucault M., Romanov P., Yarskaya-Smirnova E., Becker H., Monrouxe L., JarvisSelinger S., Mann K., Gill D., Skorikov V., Vondracek F., Ryynänen K [Foucault, 2010;Romanov, Yarskaya-Smirnova E, 2009; Becker, 1961; Monrouxe, 2010 Jarvis-Selinger,2012; Mann, 2009; Gill, 2013; Skorikov et.
аll, 2011; Ryynänen, 2001].Another important problem is the demand for "new type" workers by medicaluniversities: a specialist combining both professional and personal qualities, aprofessional who has communicative, emotional skills and is ready to work in theconditions of a crisis of professional employment in healthcare that is presented in studiesof Chirikova A., Petrova L., Gill D [Chirkova, 2013; Petrova, 2012; Gill, 2013].
Specialattention in the study of modern professional employment in medicine is given to careersand career strategies for the employment of young physicians. Traditional careers and theopportunity to build a career strategy working in one organization are a thing of the past.They are replaced by boundless, multidirectional, kaleidoscopic careers, portfolio careers(Labor and consumption in the life of Russian youth: a comparative analysis of rural andurban experience, Center for Youth Studies at the National Research University High5School of Economics, 2015). All this shows that employment in traditional professions issubject to transformations occurring in a society of fluid modernity.Recently, the anthropology of professions has been actively developing, which firstof all represents activity as a professional culture, integration into which can bedetermined through everyday practices of Prisyazhnyuk D., Romanov P., YarskayaSmirnova E [Prisyazhnyuk, 2012; Romanov, Yarskaya-Smirnova, 2005].
The individual,a young physician, is a key actor in all everyday practices and interactions – it is theindividual level and individual ideas about the profession that are the structural elementsof professional identity and its formation.In this case, the key research interest is indicated by the studying individual lifeand everyday practices, how professional identity (resource and value) of belonging tothe profession affects the definition of oneself as a professional.At the same time, research interest is centered around the study of life strategiesand how a physician, as a professional, defines himself in everyday life and plans hisstrategy.Modern discussions about the life strategies of young people are developing inseveral, rarely overlapping areas.
In the classical sense, the life strategies of young peopleare presented as a rational choice of the individual based on the goals and tasks that theperson sets himself [Reznik, 1995]. At the same time, very often there is a lowpresentation and inconsistency of the conclusions. This method is defended by fact thatthe study of life strategies is achieved due to the reflexivity of the informants themselves,the completeness and narrative richness of the life stories they told, which is representedin the studies of Plummer J [Plummer, 1974].The second body of study devoted to the study of life strategies is characterized bystudies of their institutional dimension.
From this point of view, life strategies areclassified as supra-situational and integrative, i.e. characterizing a person's ability to riseabove the level of a concrete life situation and to retain a holistic view. They are longterm and promising, are designed for a sufficiently long period and expected in the longterm orientation of the individual. The key characteristics of life strategies in this caseare: socio-demographic situation, a system of regulations and standards, professional6ethos. Another direction, identified in the studies of Volokitina A., Naumova N.,represents life strategies as adaptation strategies in specific situations. Adaptation can beexpressed through the individual's acceptance of values and standards, as well as theconditions of a particular situation in order to improve their lives in the future [Volokitina,2010; Naumova, 1995].However, the absence from the person's point of view of individual ideas about hislife, as well as the role and place of his career and profession, contributed to theemergence of a third, style examination of the life strategies of young people and youngprofessionals.As a group of professionals, young physicians certainly have all the characteristicfeatures from the point of view of division according to the life style strategies of youth,which is represented in the studies of Miles S., Omelchenko E [Miles, 2000; Omelchenko,2002].
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