Doctors' experiences of uncertainty during the transition to internship: The sources, responses and moderators

Uncertainty is innate to medical practice. Uncertainty Tolerance (UT) describes how individuals experience and respond to uncertainty, with lower UT associated with negative outcomes (1). Uncertainty is particularly prevalent during the transition from student to clinician (2), and it is pertinent that new doctors are prepared to manage this. This research explored doctors' experiences of uncertainty during their transition to internship (TTI) and considered how clinicians, educators and workplaces can impact this.

Engaging social constructionism, we conducted a cross-sectional qualitative study with 13 intern doctors who graduated from an Australian medical school. Participants completed a semi-structured interview within 5 months of commencing practice in 2021. Data were analysed using framework analysis with the integrative UT model as the preliminary framework (1).

The dominant sources of uncertainty participants described were the tasks, responsibilities and encounters they experienced for the first time in their new role. In response to uncertainty, participants predominantly described feeling stressed and asking senior colleagues for help. Key factors that moderated participants' responses to uncertainty included the presence of support, time availability and perceived risk.

The TTI is an uncertain time. Even with the requisite knowledge and skills, assuming the role of a doctor stimulated substantive uncertainty for participants. The findings highlight the importance of workforce planning to ensure interns have the time and support to address their uncertainty. Research should focus on techniques to manage uncertainty, given the reports of stress and reliance on asking for help. Educators should help students to get prior experience of internship.