Hierarchical challenges: A study on the obstacles that foreign specialist doctors encounter in their Danish workplaces
Author
Lyngbak, Anne-Sofie Houen
Term
4. term
Publication year
2023
Submitted on
2023-05-31
Pages
68
Abstract
This thesis addresses the ongoing shortage of specialist doctors in the Danish healthcare system by examining how foreign specialist doctors experience cultural and hierarchical challenges during their job start in Denmark—and what might ease their integration. Using a constructivist, interpretivist, and inductive qualitative design, the study draws on five semi-structured interviews with foreign specialists currently living and working in Denmark. Data were analyzed using Braun and Clarke’s six-step thematic analysis and interpreted through Goffman’s concepts of face and frame alongside a non-essentialist view of culture. The analysis identified the themes of forms of address, workplace hierarchies, discrimination, upholding status, insecurity, and culture, from which five key challenges were derived that can affect doctors’ well-being during onboarding. Some challenges appeared to be unconsciously co-constructed by both foreign doctors and Danish colleagues, making specific solutions difficult. However, raising awareness and sharing knowledge emerged as steps toward mitigation. The findings also point to managerial initiatives to build cultural competence among staff as a way to foster environments that support the successful integration and retention of foreign specialist doctors, and they highlight the need for continued inquiry into this underexplored area.
Denne specialeundersøgelse tager udgangspunkt i den vedvarende mangel på speciallæger i det danske sundhedsvæsen og fokuserer på, hvordan udenlandske speciallæger oplever kulturelle og hierarkiske udfordringer ved jobstart i Danmark – samt hvad der kan lette deres integration. Med et konstruktivistisk og fortolkende afsæt gennemførtes et kvalitativt, induktivt studie baseret på fem semistrukturerede interviews med udenlandske speciallæger, der nu bor og arbejder i Danmark. Data blev analyseret med Braun og Clarkes seks-trins tematiske analyse og belyst gennem Goffmans begreber om “face” og “frame” samt en ikke-essentiel forståelse af kultur. Analysen identificerede temaerne tiltaleformer, hierarkier på arbejdspladsen, diskrimination, opretholdelse af status, usikkerhed og kultur, hvorfra fem centrale udfordringer blev udledt, som kan påvirke lægernes trivsel i opstartsfasen. Nogle udfordringer syntes at være ubevidst medskabte af både de udenlandske læger og deres danske kolleger, hvilket gør konkrete løsninger vanskelige. Øget bevidsthed og vidensdeling blev dog fremhævet som et skridt mod at afbøde udfordringerne. Desuden peger resultaterne på behov for ledelsesmæssige initiativer, der styrker medarbejdernes kulturelle kompetence og skaber rammer for en vellykket integration og fastholdelse af udenlandske speciallæger, samt for yderligere undersøgelse af dette underbelyste område.
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