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Stuck in the middle: the liminal experiences of entering practice
  1. Bjorn K Watsjold,
  2. Max Griffith,
  3. Jonathan S Ilgen
  1. Emergency Medicine, University of Washington School of Medicine, Seattle, Washington, USA
  1. Correspondence to Dr Jonathan S Ilgen, Emergency Medicine, University of Washington, Seattle, WA 98104, USA; ilgen{at}

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Most physicians can recall the palpable stresses of entering practice, from the pressures of figuring out new systems, to worries of how others will view their expertise, to experiencing the weight of responsibility for important clinical decisions. Recent work by Collini et al 1 nicely illustrates these experiences among new emergency medicine consultants, framing the transition from training to practice as a liminal period. Liminal experiences such as these give individuals opportunities to construct and reconstruct how they view themselves as professionals through an interplay between the identities they seek to present, the identities others see in them and the ways they embody their new roles.2 3 The experiences of newly minted consultants in this study echo these processes of (re)construction, and are resonant with similar findings across a wide range of medical specialties.4 5 Yet, their stories are also particularly powerful in the ways they spotlight the stresses and potential toll that these transitions take on new members of our communities, providing opportunities to reflect on how we might better support these transitions into practice. How can we better prepare trainees for the uncertainties of clinical practice without supervision? And how can …

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  • Handling editor Ellen J Weber

  • Twitter @docbjorn, @Jon_Ilgen

  • Contributors All authors made substantive contributions to the initial outline and final prose of this commentary.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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