A healer’s rites of passage: An ethnographic study of residency challenges

Document Type : Research Paper

Author

Assistant Professor, Faculty of Social Sciences, Yazd University, Yazd, Iran

10.22059/ijar.2026.406673.459946

Abstract

 
Purpose- The residency period is a transitional phase involving full-time education with definite working hours for residents. A critical point to note is that although a minimum number of shifts is specified for each resident, no maximum limit is defined for these shifts or for the resident's active presence in the hospital. Consequently, this period is regarded as a demanding stage characterized not only by psychological pressure and a heavy burden of responsibility, but also by numerous challenges that can negatively impact professional identity as well as the physical and mental health of the medical students. The present study aims to investigate the challenges and experiences of residents during their occupational transition in teaching hospitals.
Methodology- This research was conducted using an ethnographic approach. Data were collected through direct observation, participant observation, and deep, informal conversations in two teaching hospitals located in different districts in the city of Yazd during the years 2024-2025. Available sampling was employed in this study, and data collection continued until data saturation was reached. Subsequently, general narratives regarding the challenges residents encounter in their daily lives were presented using James Spradley’s method. These were analyzed based on the three-stage approach of domain, taxonomic, and component analysis to reveal the hidden semantic layers of the phenomenon. To ensure the trustworthiness of the research findings, strategies such as long-term and repetitive engagement in the field, data collection through interviews and observations, as well as the designation of interview questions and extraction of codes during the progress of the work were utilized. Finally, Van Gennep and Turner’s theory of rites of passage was employed to analyze the findings.
Findings- Based on narratives emerging from the residency experience, five domains were identified with themes such as experiencing recurrent sleeplessness, limitations in food access, coping with patient mortality, the lengthy path to becoming a physician, the high volume of academic tasks coupled with continuous assessment, and carrying heavy responsibilities in the hospital. In the taxonomic analysis, the identified domains and created themes were systematically arranged based on their semantic relationships, resulting in codes such as coping with academic burnout, role strain, suffering without lamentation, lack of nutritional and sleep hygiene, and the endless cycle of assessment and learning. Finally, in the component analysis stage, all identified domains and taxonomies were placed under the cultural sub-theme of the rites of passage of a healer.
Conclusion- Residents experience numerous difficulties throughout the residency period. These issues affect both the professional and personal performance of residents. While some of these difficulties, such as coping with patient death, the high volume of academic tasks, and the long years of study, are inseparable parts of the medical profession and responsibility, others are not considered intrinsic to the state of being a resident. These challenges require structural reforms in the medical education system to ensure that educational quality is maintained while establishing a work-life balance for residents

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References

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Iranian Journal of Anthropological Research
Volume 15, Issue 2 - Serial Number 28
Indexing Databases
December 2025
Pages 154-171

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