How doctors learn: education and learning across the medical-school-to-practice trajectory.

People have needs they address daily over the course of their lives. They address these needs through identifying and resolving problems in ways that reflect their identities. This means that education, including medical education, is an identity development process because it provides people with more and better ways to satisfy their needs. Also, education does this by providing them with the knowledge and skills they use to occupy identifiable niches in society. These niches are describable in terms of what people do and the ways in which they relate to others. Medical education, in other words, allows medical students and residents to take on physicians' identities, and their identities go a long way toward defining when, where, and how they will address their psychosocial needs. Doctors begin developing the skills and knowledge they need in medical school and continue developing them through residency and into practice. However, there are important differences among medical students, residents, and practicing physicians, and these differences have an impact on how the individuals satisfy their psychosocial needs. These differences also bear on how well they will satisfy their needs later in their careers; i.e., the things physicians-in-training do to satisfy their psychosocial needs in the course of learning to become doctors are expected to prepare them to address their psychosocial needs later in life in their roles as both healers and professionals. It is against this background of describing how education helps physicians solve problems and so address their recurring psychosocial needs that the author presents 12 conclusions concerning physicians' learning.