Royal College of Surgeons in Ireland
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‘You do not cross them’: Hierarchy and emotion in doctors' narratives of power relations in specialist training

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journal contribution
posted on 2022-01-19, 11:25 authored by Sophie Crowe, Nicholas Clarke, Ruairi BrughaRuairi Brugha

Studies of medical education often focus on experiences and socialisation processes among undergraduate students, with fewer examining emotionality among postgraduate trainees. This article explores the relationship between power and emotion, questioning how affective relations between senior and junior doctors are patterned on the hierarchical structure of medicine. The study employs qualitative methods of in-depth, face-to-face and telephone interviews with fifty doctors at initial and advanced stages of specialist postgraduate training in teaching hospitals across Ireland, conducted between May and July, 2015. The study found that respect for hierarchy, anger and fear, intimidation, and disillusion were key themes in participants' narratives of relationships with senior staff who oversaw their postgraduate training. The implications of these emotional subjectivities for quality of training, patient care and willingness of junior doctors to pursue careers in Ireland, are discussed and recommendations and areas for further research proposed.


We particularly wish to acknowledge and thank the doctors who shared their experiences with us. We also acknowledge the Medical Council of Ireland which facilitated access to doctors through its national trainee experience survey. This research was funded by the Health Research BoardHRA_HSR/2013/318.



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Published Citation

Crowe S, Clarke N, Brugha R. ‘You do not cross them’: Hierarchy and emotion in doctors' narratives of power relations in specialist training. Social Science & Medicine. 2017;186:70-77.

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  • Public Health and Epidemiology

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