ORIGINAL RESEARCH article
Front. Med.
Sec. Healthcare Professions Education
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1536572
This article is part of the Research TopicPalliative and End of Life Care in the Post-Pandemic Era: Old Problems and New PerspectivesView all 7 articles
The Impact of Death and Dying: A Qualitative Interview Study on Professional Identity Formation Among Palliative Care Physicians in Malaysia
Provisionally accepted
Jun Hao Tan1
Yun Ting Ong2
Annushkha Sinnathamby3,4
Shu Xian Lim5Aaron Wi Han Hiew5Sing Yee Ng6
Mark Kiak Min Tan7Nur Amira Binte Abdul Hamid2Simon Yew Kuang Ong2,8
Lalit Kumar Radha Krishna10,2,8,9*- 1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- 2National Cancer Centre Singapore, Singapore, Singapore
- 3Department of Paediatrics, Khoo Teck Puat National University Children’s Medical Institute, Singapore, Singapore
- 4National University Cancer Institute, Singapore, Singapore
- 5Kuala Lumpur Hospital, Kuala Lumpur, Kuala Lumpur, Malaysia
- 6Sultan Ismail Specialist Hospital, Johor Bahru, Johor Darul Takzim, Malaysia
- 7Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
- 8Duke-NUS Medical School, Singapore, Singapore
- 9University of Liverpool, Liverpool, United Kingdom
- 10Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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IntroductionPhysicians face ethical, moral, existential and clinical conflicts caring for palliative care patients and their families. Along with near-constant exposure to patient suffering, grief, family distress and healthcare team disquiet, such conflicts influence how these physicians think, feel and act as palliative care physicians, or their professional identity formation (PIF). Better understanding of shifts in PIF is required to guide socioculturally congruent and ethically, legally and clinically appropriate care and support of these physicians. MethodsThis study thus seeks to investigate the impact of death and dying amongst Malaysian palliative care physicians and attend to current gaps in understanding of PIF in palliative care and similar specialties in Malaysia and beyond. 11 palliative care physicians, ranging from 2.5 to 11 years of palliative care experience, across 10 local hospitals in Malaysia were recruited via electronic invitations for a one-on-one interview conducted on institutionally secured Zoom video-conferencing platform. Interview transcripts underwent thematic and content analyses. ResultsData analysis revealed four key domains: 1) initial belief systems; 2) shifts in belief systems; 3) meaning-making and refinement of identity; and 4) impact of PIF. Shaped by maturing competencies and greater insights, palliative care physicians’ skills, sensitivity to possible changes to belief systems and their willingness to address them build their ‘internal compass’ that guides an individualized context-specific notion of PIF. DiscussionThese insights allow the forwarding of a clinically relevant theory of PIF that should better support physicians in palliative care in evolving circumstances by guiding the development of the ‘internal compass’.
Keywords: Palliative Care, Physicians, professional identity, Hospital, Death and dying, Personhood, Moral distress
Received: 29 Nov 2024; Accepted: 12 May 2025.
Copyright: © 2025 Tan, Ong, Sinnathamby, Lim, Hiew, Ng, Tan, Abdul Hamid, Ong and Krishna. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lalit Kumar Radha Krishna, University of Liverpool, Liverpool, United Kingdom
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