We are committed to a culture that encourages the development and internalization of the attributes, applied knowledge, judgment and behaviors of the master clinician into one's concept of self.

• The personal development of a new "professional" self identity
• Creation of a new understanding of self and the world
• Occurs in stages
• Results from meaningful professional experiences, dialog and reflection

Stage 1: Early Entry

• Reflex responses derived from previous non-professional life
• Rules of the profession not clearly understood
• Immature learner "I am smart and can beat anyone at the game"
• Surprise and angst at adverse reactions to "usual behaviors"

Stage 2: Reward/Punishment

• It's all about ME
• Figuring out the "rules of the game"
• What's on the test?
• Cram and forget, get high grades
• Motivation is the "system's reward/punishment"
• Satisfaction comes from the external rewards

Stage 3: Team Membership

• Can hold multiple points of view
• Relationships are critical
• Begin to integrate and apply knowledge
• The "Profession" is a relationship
• Motivation is the "Medicine team does it this way"
• Satisfaction is from successful team and individual relationships

Stage 4: Physician Self

• Integrated the Profession (values, thinking, etc) into a knew self identity
• Professional behaviors become habitual
• Can break away from the rules and the team when appropriate
• Leads the team
• Knowledge is put into effective action
• Can be flexible and self-critical
• Motivation "I know the right thing to do"
• Satisfaction is internally derived (self-actualization)

Stage 5: Mentor

• It's all about the others
• Holds a "big picture" perspective
• Teaches the "rules" of doctoring
• Guides the team
• Art and Science of Medicine are one
• Nurtures the transformation to physician
• Motivation is to see others succeed
• Satisfaction derives from the accomplishments of others